Table 2 Selected infectious and non-infectious hazards of RBC transfusion in the ICU environment
From: Red blood cell transfusion in the critically ill patient
| Â | Â | Estimated frequency (event/no. of transfusions)* | Comment |
|---|---|---|---|
| Â | HIV | 1/2.3 106 | Â |
| Â | HBV | 1/350000 | Â |
| Â | HCV | 1/1.8 106 | Â |
| Â | HTLV 1/2 | 1/2 106 | Â |
| Â | Bacterial contamination | 1/14,000 to 1/28,000 | GNB such as Y. Enterocolitica mostly encountered |
Noninfectious complications | |||
|  |    Acute hemolytic transfusion reactions | 1/10,000 to 1/50,000 | Most frequently due to IgM, sometimes IgG |
|  |    Febrile nonhemolytic transfusion reactions | 1/500 | Reduced incidence with prestorage leukoreduction |
|  |    Anaphylactic reactions | 1/20,000 to 1/50,000 | May be associated with IgA deficiency |
|  |    Transfusion-related acute lung injury (TRALI) | Highly variable (e.g., 1/29,000 [91], 1/46,700 [92], 1/173,000 [93] units transfused) | Must be differentiated from TACO |
|  |    Posttransfusion purpura | 1/143,000 | Rare; occurs 5-10 days after transfusion |
|  |    Transfusion-associated graft versus host disease | Rare (prevention by irradiation of blood products) | Mostly in immunocompromised hosts, poor prognosis |
|  |    Incorrect blood component transfused (IBCT) | 9.7/100,000 components | Remains frequent despite prevention strategies; must be differentiated from near-miss transfusion |
|  |    Transfusion-associated circulatory overload (TACO) | Up to 1% of transfusions | Major cause of transfusion-related death |
|  |    Hyperkalemia |  | Mainly after transfusion in newborns |
|  |    Hypocalcemia - hypothermia |  | Mainly after massive transfusion |
|  |    Dilutional coagulopathy/thrombocytopenia |  | Mainly after massive transfusion |