Epidemiology

Acute haemolytic transfusion reaction occurs during or immediately after transfusion and is usually the result of a clerical error, with misidentification of the patient or mislabelling of the blood product.[3][4]​​​​​ In the US, the incidence of red-cell products transfused to the wrong patient is estimated to range from 1/12,000 to 1/19,000 transfusions.[10][11][12]​​​​ Mortality from an acute haemolytic transfusion reaction is estimated to occur in approximately 1:600,000-1.5 million transfusions.[6][13]

Febrile non-haemolytic transfusion reaction is one of the more common transfusion reactions. In the clinical setting of universal leukoreduction of the blood supply, the frequency of febrile non-haemolytic transfusion reaction is 0.15% to 0.19% for red cells and 0.11% to 0.15% for platelets. Where non-leukoreduced products are routinely administered, the frequency is higher, at 0.33% to 0.37% for red cells and 0.45% to 2.18% for platelets.[14][15][16]

Allergic reactions are common, with an overall incidence of 0.4% to 3% of transfusions.[6][17] Most reactions involve urticaria alone. Anaphylactic reactions are rare, occuring in about 1/20,000 to 1/50,000 transfusions.[6][18][19] Although difficult to determine precisely, the incidence of delayed haemolytic transfusion reaction is estimated to be approximately 1/2500 transfusions.[11][20]​​ Transfusion-associated graft-versus-host disease is rarely observed, and is largely confined to patients with immunosuppression.[9][21] Post-transfusion purpura occurs relatively uncommonly, with an incidence of less than 1 in 2,000,000 in the US.[6]​ It is observed more commonly in females than males, most often in multi-parous, middle-aged women.[22]​ Transfusion-related acute lung injury (TRALI) incidence is estimated to be between 0.04% and 0.1% of all transfusions.[23][24]​ TRALI is the leading cause of transfusion-related mortality in the US.[4][25][26]

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