Adverse Reactions to Transfusion of Blood Products and Best Practices for Prevention

Transfusion, a common practice in critical care, is not without complication. Acute adverse reactions to transfusion occur within 24 hours and include acute hemolytic transfusion reaction , febrile nonhemolytic transfusion reaction, allergic and anaphylactic reactions, and transfusion-related acute lung injury, transfusion-related infection or sepsis, and transfusion-associated circulatory overload. Delayed transfusion adverse reactions develop 48 hours or more after transfusion and include erythrocyte and platelet alloimmunization , delayed hemolytic transfusion reactions, posttransfusion purpura , transfusion-related immunomodulation, transfusion-associated graft versus host disease, and, with long-term transfusion, iron overload . Clinical strategies may reduce the likelihood of reactions and improve patient outcomes.