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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
  1. HIV human immunodeficiency virus; HBV hepatitis B virus; HCV hepatitis C virus; HTLV human T lymphotropic virus; GNB Gram-negative bacteria
  2. *Frequencies may vary among studies and are only indicative