Risks Associated with Transfusion
In light of many recent advances in donor screening, infectious disease testing protocols (NAT, bacterial testing of platelets) and component preparation (leukoreduction), blood transfusion has never been safer. However, risks associated with transfusion remain and the possibility of further unknown or unanticipated risks continues. Therefore the decision to transfuse blood remains a careful clinical evaluation of these risks against the anticipated benefit provided by transfusion.
Infectious Risks of Blood Transfusion
|
Agent |
Risk/Unit Transfused |
|
HIV |
1: 2,000,000 |
|
HCV |
1: 1,600,000 |
|
HBV |
1: 140,000 – 250,000 |
|
HTLV I/II |
1: 1,000,000 |
|
HAV |
1: 1,000,000 |
|
B19 Parvovirus |
1: 3,300-40,000 |
|
Bacteria (Platelets) |
1: 75,000 (with testing) |
|
Bacteria (RBC) |
1: 500,000 |
|
Malaria & Babesia |
<1: 1,000,000 |
|
WNV |
1: 350,000 – 1.4 million |
|
CMV |
Rare with leukoreduction |
Non-Infectious Risks of Blood Transfusion
|
Adverse Event |
Risk/unit Transfused |
|
Acute Hemolytic |
1: 6,000 - 38,000 |
|
(Fatal 1: 500,000 – 1.8 million) |
|
|
Delayed Hemolytic |
1: 2,500 – 12,000 |
|
Allergic – Non-anaphylactic |
1 - 3% |
|
Allergic-Anaphylactic |
1: 20,000 - 150,000 |
|
Circulatory Overload |
0.1 - 1% |
|
Febrile Non-hemolytic |
0.5 - 6% (RBC) |
|
1 - 38% (Platelets) |
|
|
Graft Versus Host Disease |
1: 10,000 (without irradiation) |
|
1: 1,000,000 (with irradiation) |
|
|
Transfusion Related Acute Lung Injury |
1: 5,000 – 20,000 (fatal 5 – 10%) |
|
Post Transfusion Purpura |
1: 140,000 – 300,000 |
