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
| Estimated frequency (event/no. of transfusions)* | Comment | ||
|---|---|---|---|
| Infectious transmission [89, 90] | |||
| HIV | 1/2.3 106 | ||
| HBV | 1/350000 | ||
| HCV | 1/1.8 106 | ||
| HTLV 1/2 | 1/2 106 | ||
| Bacterial contamination | 1/14,000 to 1/28,000 | GNB such as Y. Enterocolitica mostly encountered | |
| Noninfectious complications | |||
| Immune-mediated [53, 89] | |||
| 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 | |
| Nonimmune-mediated [89, 94] | |||
| 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 | ||
