Transfusion-associated adverse reactions (TAARs) and cytokine accumulations in the stored blood components: the impact of prestorage versus poststorage leukoreduction

Chang, Chih‐Chun; Lee, Tai-Chen; Su, Ming-Jang; Lin, Hsiu‐Chen; Cheng, Fang-Yi; Chen, Yi-Ting; Yen, Tzung‐Hai; Chu, Fang-Yeh

doi:10.18632/oncotarget.23136

Cited by 23 publications

(39 citation statements)

References 41 publications

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“…32 In non-leukocyte-reduced blood, cytokines are highly elevated in stored blood component and they induce leucocyte recruitment and cause an allergic reaction, when such a blood component is transfused. 33 In the current study, allergic (65%) and FNHTR (30%) were the most frequently observed ATRs. This was similar 30 and Malaysia (50.2% vs 38%) 35 which revealed that these ATRs were the most frequently observed transfusion reactions.…”

Section: Discussionmentioning

confidence: 47%

<p>Proportion of Acute Transfusion Reaction and Associated Factors Among Adult Transfused Patients at Felege Hiwot Compressive Referral Hospital, Bahir Dar, Northwest Ethiopia: A Cross-Sectional Study</p>

Gelaw¹,

Woldu²,

Melku³

2020

JBM

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Introduction: Acute transfusion reactions are adverse events occurring within 24 hrs of transfusion and cause simple-to-severe complications. They may vary with the blood component transfused and recipient factors. In Ethiopia, there is a limited evidence about the incidence and associated factors of transfusion reactions. Objective: To determine the proportion of acute transfusion reactions and associated factors among adult transfused patients. Methods: A total of 384 study participants were included in the study. Structured questionnaires were used for socio-demographic and past medical history data collection. Vital signs were measured as a baseline for every study participants and monitored and followed for 24 hrs. Laboratory tests like complete blood count, direct anti-human globulin test and urine hemoglobin were done as a baseline for suspected patients. Cross-match, blood grouping, and blood culture for patients and donors sample were also done for suspected patients. Descriptive statistics, bivariable and multivariable binary logistic regression were analyzed using SPSS version 20. P-value of <0.05 in the multivariable model was considered as statistically significant. Results: Acute transfusion reactions were observed in 5.2% of patients. Of total cases of acute transfusion reaction, the majority developed allergic reactions (65%) and febrile non-hemolytic transfusion reaction (30%). It was significantly associated with transfusion history (AOR=3.4; 95% CI: 1.2-9.7), abortion history (AOR=5.0; 95% CI: 1.5-16.4), longer blood storage time (AOR=5.1; 95% CI: 1.7-15.2) and receiving three or more unit of blood (AOR= 4.1; 95% CI: 1.5-11.2). Conclusion: Acute transfusion reactions were observed in 5.2% of patients (allergic reactions (65%), febrile non-hemolytic transfusion reaction (30%) and alloimmunization (5%)). Patients with a history of transfusion, abortion, transfused with blood stored ≥14 days and multi-transfused patients should be closely monitored.

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Section: Discussionmentioning

confidence: 47%

<p>Proportion of Acute Transfusion Reaction and Associated Factors Among Adult Transfused Patients at Felege Hiwot Compressive Referral Hospital, Bahir Dar, Northwest Ethiopia: A Cross-Sectional Study</p>

Gelaw¹,

Woldu²,

Melku³

2020

JBM

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“…Some cytokines that has been identified as the primary cause of febrile related transfusion are interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor α, which are released from leukocytes by acute hemolytic process (febrile hemolytic transfusion reaction/FHTR) or during storage (FNHTR). 11,[14][15][16] In our study, we found two cases of major incompatibility of rhesus antigen. One subject had anti-E, while the other had anti-E and anti-c, both in pre-transfusion and post-transfusion blood samples.…”

Section: Discussionsupporting

confidence: 50%

“…24 Previous study proved that the prevalence of FNHTRs was reduced in the pre-storage leukocyte-reduced RBC transfusion and the prevalence of allergic reactions was reduced in the pre-storage leukocyte-reduced platelets transfusion. 15 It is hardly to determine whether allergic reactions following platelet transfusion are caused by plasma proteins or BRMs, but there is general agreement that the decreased amounts of plasma protein will reduce the risk of allergic reactions. 12 Limitation of this study is not all subjects with moderate or severe transfusion reactions can be proceeded into further examinations.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Acute Transfusion Reactions and its related factors in Cipto Mangunkusumo Hospital Jakarta, Indonesia

Wahidiyat¹,

Marpaung²,

Iskandar³

2019

hsji

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Latar belakang: Reaksi transfusi akut (RTA) merupakan sekelompok kejadian yang tidak diinginkan akibat pemberian transfusi darah. Manifestasi dari RTA bervariasi dari yang ringan hingga mengancam nyawa. Saat ini, data mengenai reaksi transfusi di Indonesia masih sangat terbatas. Dalam studi ini, kami bertujuan untuk memberikan gambaran mengenai karakteristik RTA dan faktor-faktor yang mempengaruhinya. Metode: Studi ini merupakan studi retrospektif yang melibatkan 288 subyek dengan RTA. Studi dilakukan di Rumah Sakit Dr. Cipto Mangunkusumo, dimulai sejak Januari hingga Desember 2017. RTA dikelompokkan berdasarkan sistem tubuh yang mengalami manifestasi, serta derajat manifestasinya. Hasil: Sel darah merah merupakan produk darah utama yang ditransfusikan ke subyek, diikuti dengan konsentrat trombosit, plasma segar beku, dan kriopresipitat. Lima gejala utama dari RTA adalah gatal, demam/kenaikan suhu tubuh, menggigil, urtikaria, dan angioedema. Berdasarkan sistem tubuh yang terkena, umumnya RTA bermanifestasi sebagai gejala pada kulit (56.6%). Berdasarkan derajat manifestasinya, RTA umumnya dikategorikan dalam derajat ringan (55.9%). Anak-anak cenderung mengalami manifestasi yang ringan (64.8%) dan utamanya bermanifestasi pada kulit (65.4%). Riwayat transfusi mempengaruhi derajat RTA secara signifikan. RTA derajat sedang dan gejala konstitusional lebih banyak ditemukan pada subyek yang mendapat PRC dibanding produk darah lainnya. Kesimpulan: Umumnya RTA bermanifestasi sebagai gejala dermatologi. Hanya sedikit kasus RTA yang disebabkan oleh reaksi inkompatibilitas. Manifestasi dan derajat RTA juga dipengaruhi oleh umur, riwayat transfusi, dan jenis komponen darah. Kata kunci: Transfusi darah, reaksi transfusi akut, riwayat transfuse, usia Abstract Background: Acute transfusion reactions (ATRs) are a group of adverse events caused by blood transfusions. Manifestations of ATRs vary from mild to life threatening. At present, data about transfusion reactions in Indonesia are still limited. In this study, we aim to determine the characteristics of ATRs and its related factors. Methods: This was a retrospective study of 288 subjects with ATRs. The study was conducted in Cipto Mangunkusumo Hospital, started from January to December 2017. ATRs were categorized based on the body systems affected and degree of manifestations. Results: Packed red cells (PRC) was the predominant blood product (51.4%) which was transfused to subjects, followed by thrombocyte concentrate (TC), fresh frozen plasma (FFP), and cryoprecipitate. Five most common predominant symptoms of ATRs were pruritus/itch, febrile/increased temperature, chills, transient urticaria, and angioedema. Based on the affected body systems, the majority of ATRs manifested as dermatologic symptoms (56.6%). Based on the degree of manifestations, the majority of ATRs were categorized as mild degree (55.9%). Children tended to have milder symptoms (64.8%), which mostly manifested as dermatologic symptoms (65.4%). History of transfusion affected the degree of ATR significantly. Moderate degree of ATRs and constitutional symptoms were found more common in subjects who received PRC than other blood products. Conclusion: Most of ATRs manifest as dermatologic symptoms, which represent allergic reactions. Only a small portion of ATRs are caused by incompatibility reactions. The manifestation and degree of ATRs are also affected by age, history of transfusion, and type of blood components. Keywords: Blood transfusion, acute transfusion reaction, transfusion history, age

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“…Poststorage leukoreduction of blood products, including apheresis platelets, significantly increased the production of pro-inflammatory cytokines like IL-1β and IL-8. This fact was associated with the increased incidence of ATRs to the transfusion of poststorage leukocyte-reduced blood components [15]. Lin et al also reported the significant increase in the levels of plasma IL-8 and IL-6 in patients had FNHTR [16].…”

Section: Discussionmentioning

confidence: 99%

Platelet concentrate and type II IL-1 receptor are risk factors for allergic transfusion reactions in children

et al. 2020

Ital J Pediatr

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Purpose: Allergic transfusion reactions (ATRs) are immunological reactions after transfusion. Interleukin-1 (IL-1) is a critical regulator for human diseases. We performed this study to investigate the association of type II IL-1 decoy receptor (IL1R2) expression with ATRs in children. Methods: Children received blood transfusions between January and December 2019 were included. The age, sex, number and type of blood transfusion, allergic history, and medical history were collected and statistically analyzed. The blood samples were collected from children with and without ATRs for detecting the relative expression IL1R2 mRNA. Logistics regression analysis was performed to identify the risk factors for ATRs in children. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the predictive performance of risk factors. Results: Totally, 28,840 transfusions in 20,230 children, with 236 ATRs (0.82%) in 117 patients (0.58%) were included. ATRs were common in children at the hematology-oncology department, in children received higher number of blood transfusions, and older children. Platelet concentrate induced a higher incidence of ATRs (3.31%) than red cell concentrate (0.22%, p < 0.0001). After the transfusion, IL1R2 mRNA level was higher in the blood samples in children with ATRs than those without ATRs (p < 0.0001). Logistics regression analysis indicated that platelet concentrate (95% CI 3.555, 293.782) and IL1R2 expression (95% CI 1.171 × 10 2 , 1.494 × 10 4) were independent risk factors for ATRs in children. IL1R2 expression had high performance in predicting ATRs (AUC = 0.998, 100% sensitivity and 98.85% specificity). Conclusion: High IL1R2 expression level in children who received blood transfusions may predict the morbidity of ATR.

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Transfusion-associated adverse reactions (TAARs) and cytokine accumulations in the stored blood components: the impact of prestorage versus poststorage leukoreduction

Cited by 23 publications

References 41 publications

<p>Proportion of Acute Transfusion Reaction and Associated Factors Among Adult Transfused Patients at Felege Hiwot Compressive Referral Hospital, Bahir Dar, Northwest Ethiopia: A Cross-Sectional Study</p>

<p>Proportion of Acute Transfusion Reaction and Associated Factors Among Adult Transfused Patients at Felege Hiwot Compressive Referral Hospital, Bahir Dar, Northwest Ethiopia: A Cross-Sectional Study</p>

Characteristics of Acute Transfusion Reactions and its related factors in Cipto Mangunkusumo Hospital Jakarta, Indonesia

Platelet concentrate and type II IL-1 receptor are risk factors for allergic transfusion reactions in children

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