CLINICAL COURSE OF NONHEMOLYTIC TRANSFUSION REACTIONS

Recipients who experienced severe nonhemolytic transfusion reactions (NHTRs) were analyzed with regard to their main clinical symptoms during and after transfusion in 44 national university hospitals in Japan. From 1999 through 2001, we received reports of 56 cases of severe NHTRs. Patient signs and symptoms varied, but dyspnea, decreased blood pressure, and wheals were the most common. Thirty-three (59%) of 56 cases were associated with platelet transfusion. Twenty-one (38%) cases had multiple transfusion reactions. In all 56 cases, the patient's serum was screened for anti-plasma protein antibodies and anti-HLA antibodies by the laboratory of the Japanese Red Cross Blood Center, but only 39 (70%) of 56 cases were specimens of the units of blood products transfused. Three of 56 cases resulted in death and 2 of these 3 reported deaths resulted from transfusion-related acute lung injury (TRALI). Most reactions seemed to be allergic in origin. However, other causes of reactions could not be ruled out because of the lack of blood samples from the blood products transfused. It is important to create a management system for transfusion reactions and to continue research into TRALI.