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Complications of red cell transfusion

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Modern blood transfusion is extremely safe practice when compared with other medical and surgical procedures. However deaths and major morbidity still do occur with blood transfusion.

  • majority are caused by identification errors (of patients, blood samples and blood components) resulting in ‘wrong blood into patient’ incidents, including ABO-incompatible transfusions
    • around 1 in 13 000 blood component units is transfused to the wrong patient (not always with adverse consequences)
    • up to 1 in 1 300 pre-transfusion blood samples are taken from the wrong patient.

In 2012, UK Serious Hazards of Transfusion haemovigilance scheme (SHOT) reported:

  • 252 incidents of ‘incorrect blood component transfused’
  • 10 ABO-incompatible transfusions (all due to clinical errors)
  • 145 incidents of ‘avoidable, delayed or under-transfusion’
  • 9 transfusion-related deaths (six associated with transfusion-associated circulatory overload)
  • 134 cases of major morbidity (most often following acute transfusion reactions) (1).

Adverse effects of transfusion may be classified into:

  • acute - occur within minutes to 24 hours of the transfusion
  • chronic - may develop days, months, or even years later

This can be divided further into the categories of noninfectious and infectious.

  • infectious complications are less common due to advances in the blood screening process
    • risk of contracting an infection from transfusion has decreased 10,000-fold since the 1980s
    • current risk of an infectious donation entering the UK blood supply is now
      • <1 in 1.2 million donations for hepatitis B,
      • <1 in 7 million for HIV
      • <1 in 28 million for hepatitis C
  • noninfectious serious hazards of transfusion are up to 1,000 times more likely than an infectious complication (1,2)

Reference:


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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