RT Book, Section
A1 Boyd, Terry
A1 Welsby, Ian J.
A2 Longnecker, David E.
A2 Mackey, Sean C.
A2 Newman, Mark F.
A2 Sandberg, Warren S.
A2 Zapol, Warren M.
SR Print(0)
ID 1144136054
T1 Blood and Blood Component Therapy
T2 Anesthesiology, 3e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071848817
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1144136054
RD 2024/04/19
AB KEY  POINTSHemolytic  transfusion  reactions  remain  as  a  major  safety  consideration  for  blood  transfusion.  Clerical  errors  of  patient  identification  and  sample  labeling  remain  the  primary  cause  of  mistransfusion  of  ABO-incompatible  units.  Non-ABO  hemolytic  reactions  have  surpassed  ABO  incompatibility  as  a  leading  cause  of  transfusion-related  fatality.1Prestorage  leukoreduction  of  cellular  blood  products  has  greatly  reduced,  but  not  eliminated,  the  incidence  of  febrile  reactions,  transfusion-related  immunosuppression,  and  cytomegalovirus  transmission,  and  has  led  to  improved  outcomes  in  surgical  patients  compared  to  the  use  of  nonleukoreduced  products.The  leading  cause  of  transfusion  related  fatality  in  the  United  States  is  TRALI.  Redirecting  blood  from  female  donors  away  from  transfusable  plasma  products  has  reduced,  but  not  eliminated  the  incidence  of  TRALI  mediated  by  leucocyte  reactive  antibodies,  (HLA)  primarily  because  female  donors  have  remained  eligible  to  donate  apheresis  platelets.  New  mitigation  strategies  will  eliminate  this  eligibility  unless  the  female  is  tested  and  found  to  be  negative  for  HLA  antibodies.Transfusion-associated  sepsis  (TAS),  from  bacterial  contamination  of  apheresis  platelets,  continues  to  be  a  major  safety  issue  in  transfusion,  despite  culturing  of  all  apheresis  blood  products.  International  travel  and  emerging  pathogens  not  addressed  by  existing  screening  mechanisms  will  increasingly  limit  suitable  blood  donors.  These  and  other  pressures  on  the  blood  supply  make  patient  blood  management,  bloodless  surgical  techniques,  and  pathogen  inactivation  imperative  strategies  in  the  future  of  transfusion  medicine.