Analysis of clinical presentations of allergic transfusion reactions and febrile non-haemolytic transfusion reactions in paediatric patients

Vox Sang. 2019 Nov;114(8):826-834. doi: 10.1111/vox.12833. Epub 2019 Aug 28.

Abstract

Background and objectives: Like adults, children can have allergic transfusion reactions (ATRs) and febrile non-haemolytic transfusion reactions (FNHTRs). But published information about the incidence of paediatric ATR and FNHTR is scarce.

Materials and methods: This retrospective study was conducted from April 2002 to June 2018 on children who had ATRs and/or FNHTRs to platelet (PLT), red blood cell (RBC) or washed PLT/RBC concentrate transfusions. We analysed ATR/FNHTR clinical presentations, such as severity, time of occurrence and other features when they occurred.

Results: During the study, 2742 children received 23 444 bags of PLT and RBC concentrate (including washed products). ATRs occurred in 100 cases (3·6% of total patients), caused by 201 products (0·9% of total products). In contrast, 28 patients (1·0% of total patients) had 42 FNHTRs caused by 42 products (0·2% of total products). Upon analysis of cases with detailed clinical information, the median onset time for ATRs and FNHTRs was 2·0 h after the start of transfusion. Of the 40% of ATRs that necessitated the discontinuation of blood transfusions, 10% escalated to anaphylaxis. Compared with minor ATRs, anaphylaxis tended to develop quickly. Moreover, 96% of patients with FNHTRs had a fever less than 39°C. There were no associations between blood product types and numbers or occurrence patterns of these reactions.

Conclusion: The occurrence of ATRs and FNHTRs in children was variable, although there are common features such as severity and time of occurrence.

Keywords: ATR; FNHTR; anaphylaxis; children; occurrence pattern.

MeSH terms

  • Adolescent
  • Anaphylaxis / diagnosis
  • Anaphylaxis / epidemiology*
  • Blood Transfusion / statistics & numerical data
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Transfusion Reaction / diagnosis
  • Transfusion Reaction / epidemiology*
  • Young Adult