Transfusion and component characteristics are not associated with allergic transfusion reactions to apheresis platelets.

Abstract:

BACKGROUND:Transfusion-related characteristics have been hypothesized to cause allergic transfusion reactions (ATRs) but they have not been thoroughly studied. The primary objective of this study is to evaluate the associations of infusion rate, infusion volume, ABO mismatching, component age, and pretransfusion medication with the incidence and severity of ATRs. A secondary objective is to compare the risk of these attributes relative to the previously reported risk factor for aeroallergen sensitization in transfusion recipients, as measured by an aeroallergen-specific immunoglobulin (Ig)E antibody screen. STUDY DESIGN AND METHODS:Clinical and transfusion-related data were collected on subjects with reported ATRs and uneventful (control) apheresis platelet (PLT) transfusions over a combined 21-month period at two academic medical centers. Control transfusions were selected as the next uneventful transfusion after an ATR was reported. Logistic regression, Mann-Whitney, and t tests were used to assess associations with ATRs. Previously reported aeroallergen-specific IgE screening data were incorporated into a multivariable logistic regression. RESULTS:A total of 143 ATRs and 61 control transfusions were evaluated among 168 subjects, ages 2 to 86 years. Infusion rate, infusion volume, ABO mismatching, component age, and pretransfusion medication showed no significant association with ATRs (p > 0.05). Neither infusion rate nor infusion volume increased the risk of anaphylaxis versus mucocutaneous-only ATRs. Aeroallergen sensitization has previously been associated with ATRs. After transfusion-related covariates were controlled for, aeroallergen sensitization remained significantly associated with ATRs (odds ratio, 2.68; 95% confidence interval, 1.26-5.69). CONCLUSIONS:Transfusion- and component-specific attributes are not associated with ATRs. An allergic predisposition in transfusion recipients is associated most strongly with ATR risk.

journal_name

Transfusion

journal_title

Transfusion

authors

Savage WJ,Tobian AA,Savage JH,Hamilton RG,Borge PD,Kaufman RM,Ness PM

doi

10.1111/trf.12852

subject

Has Abstract

pub_date

2015-02-01 00:00:00

pages

296-300

issue

2

eissn

0041-1132

issn

1537-2995

journal_volume

55

pub_type

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