The effect of prestorage WBC reduction on the rates of febrile nonhemolytic transfusion reactions to platelet concentrates and RBC

Yazer, Mark H.; Podlosky, Linda; Clarke, Gwen; Nahirniak, Susan

doi:10.1046/j.0041-1132.2003.00518.x

Cited by 196 publications

(142 citation statements)

References 20 publications

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“…12 Leukoreduction of these stored units have been consistently associated with low rates of non-hemolytic febrile transfusion reactions. [13][14][15] Hebert and colleagues evaluated the impact of leukoreduction across 23 Canadian hospitals subsequent to a universal prestorage leukoreduction program. 16 Outcomes evaluated included mortality, infections, fever and antibiotic use among 14,786 patients (6,982 during a period prior to the implementation, and 7,804 after the program's implementation) who received RBC transfusions secondary to cardiac surgery, repair from hip fracture, or during their intensive care unit stay following a surgical intervention or trauma.…”

Section: Discussionmentioning

confidence: 99%

Red Blood Cell Transfusions Impact Pneumonia Rates After Coronary Artery Bypass Grafting

Likosky

Paone

Zhang

et al. 2015

The Annals of Thoracic Surgery

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Section: Discussionmentioning

confidence: 99%

Red Blood Cell Transfusions Impact Pneumonia Rates After Coronary Artery Bypass Grafting

Likosky

Paone

Zhang

et al. 2015

The Annals of Thoracic Surgery

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“…Further, FNHTR reaction rates at some institutions where leukoreduction is performed are greater than those at other institutions where it is not. For instance, Patterson et al 2 reported a greater than 10% FNHTR rate for platelet transfusions after the initiation of universal leukoreduction, whereas Yazer et al 4 reported a rate of 0.45% without universal leukoreduction. It therefore seems likely that the discrepancy in reported rates results from the combined effect of multiple variables, potentially including differences in premedication use, patient characteristics, product manufacture, storage time, reporting rates, reaction definitions, and monitoring standards.…”

Section: Incidence and Risk Factors Frequency Of Allergic And Febrilementioning

confidence: 99%

Acetaminophen and Diphenhydramine Premedication for Allergic and Febrile Nonhemolytic Transfusion Reactions: Good Prophylaxis or Bad Practice?

Geiger¹,

Howard²

2007

Transfusion Medicine Reviews

117

111

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Febrile non-hemolytic and allergic reactions are the most common transfusion reactions, but usually do not cause significant morbidity. In an attempt to prevent these reactions, US physicians prescribe acetaminophen or diphenhydramine premedication before more than 50% of blood component transfusions. Acetaminophen and diphenhydramine are effective therapies for fever and allergy respectively, so their use in transfusion has some biologic rationale. However, these medications also have potential toxicity, particularly in ill patients, and in the studies performed to date, they have failed to prevent transfusion reactions. Whether the benefits of routine prophylaxis with acetaminophen and diphenhydramine outweigh their risks and cost requires re-examination, particularly in light of the low reaction rates reported at many institutions even when pre-medication is not prescribed.The most common acute adverse reactions to blood-component transfusions, febrile nonhemolytic transfusion reactions (FNHTRs) and allergic reactions, are fortunately among the least harmful. Blood recipients with FNHTRs experience fever (often defined as a temperature rise ≥ 1°C above baseline) and/or rigors within 3 hours of transfusion. Allergic reactions are most often associated with the development of urticaria or other rash, pruritus, wheezing, or angioedema within several hours of transfusion. 1-8 These reactions are temporally limited, self-resolving, and generally pose little risk of causing lasting harm. Mild reactions often consist of a limited increase of temperature without other symptoms or a localized urticarial exanthem. In moderate and severe reactions, rigors and fever may be severe with rapid onset and associated with other symptoms, and urticaria may be extensive and painful or include respiratory or other systemic symptoms.How an incipient urticarial or FNHTR will progress cannot be predicted on the basis of its initial presentation. Further, it is often not possible to distinguish the symptoms of mild reactions from early symptoms of other more consequential problems such as sepsis, hemolytic reactions, or anaphylaxis. Therefore, the earliest indication of a reaction mandates discontinuation of a transfusion and, except for the mildest urticarial reactions, its termination. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errorsmaybe discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Increased clinical and laboratory monitoring is necessary, and infusion of replacement blood may be required. Blood replacement is associated with additional transfusion-associated risks and may deplete low blood inventories. The development of repeated rea...

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“…Proinflammatory cytokines that accumulate with stored red cell blood products are removed by prestorage leukoreduction, while those that are released by platelet activation may not be removed by leukoreduction. TRALI decreased, but did not disappear, with the implementation of universal leukodepletion in Canada (35). Two reasons account for the decrease in TRALI with leukoreduction: First, the 10% of TRALI cases due to patient antibody against donor leukocytes in the unit of blood would not occur.…”

Section: Cytokinesmentioning

confidence: 99%

TRALI – Definition, mechanisms, incidence and clinical relevance

Toy

Lowell

2007

Best Practice & Research Clinical Anaesthesiology

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The effect of prestorage WBC reduction on the rates of febrile nonhemolytic transfusion reactions to platelet concentrates and RBC

Abstract: Prestorage WBC reduction significantly reduced the rate of FNHTRs to PCs and RBCs.

Cited by 196 publications

References 20 publications

Red Blood Cell Transfusions Impact Pneumonia Rates After Coronary Artery Bypass Grafting

Red Blood Cell Transfusions Impact Pneumonia Rates After Coronary Artery Bypass Grafting

Acetaminophen and Diphenhydramine Premedication for Allergic and Febrile Nonhemolytic Transfusion Reactions: Good Prophylaxis or Bad Practice?

TRALI – Definition, mechanisms, incidence and clinical relevance

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