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Transfusion-related mortality: the ongoing risks of allogeneic blood transfusion and the available strategies for their prevention [Article de Revue]

 
[Mortalité liée aux transfusions : risques des transfusions sanguines allogènes et stratégies disponibles leur prévention]
VAMVAKAS EC ; BLAJCHMAN MA
Blood. 2009/04/09; 113(15) : 3406-3417
Summary: As the risks of allogeneic blood transfusion (ABT)-transmitted viruses were reduced to exceedingly low levels in the US, transfusion-related acute lung injury (TRALI), hemolytic transfusion reactions (HTRs), and transfusion-associated sepsis (TAS) emerged as the leading causes of ABTrelated deaths. Since 2004, preventive measures for TRALI and TAS have been implemented, but their implementation remains incomplete. Infectious causes ABT-related deaths currently account for less than 15% of all transfusion-related mortality, but the possibility remains that a new transfusion-transmitted agent causing a fatal infectious disease may emerge in the future.Aside from these established complications of ABT, randomized controlled trials comparing recipients of non-white blood cell (WBC)-reduced versus WBC-reduced blood components in cardiac surgery have documented increased mortality in association with the use of non-WBC-reducedABT. ABT-related mortality can thus be further reduced by universally applying the policies of avoiding prospective donors alloimmunized to WBC antigens from donating plasma products, adopting strategies to prevent HTRs, WBC-reducing components transfused to patients undergoing cardiac surgery, reducing exposure to allogeneic donors through conservative transfusion guidelines and avoidance of product pooling, and implementing pathogen- reduction technologies to address the residual risk of TAS as well as the potential risk of the next transfusion-transmitted agent to emerge in the foreseeable future. (RESUME D'AUTEUR)
Publication
2009/04/09

Pages
3406-3417

Language
Anglais

Number of ref
89

Published in
Blood

ID notice
319265

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CClin Sud-Ouest
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33076 Bordeaux
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http://www.cclin-sudouest.com/

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