Acute transfusion reactions, pediatrics

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Record number: 
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
There was an incidence of 6.2 reactions per 1000 transfusions within the pediatric (age < 21) population and an incidence of 2.4 reactions per 1000 transfusions within the adult population. Within the pediatric population, subset analysis identified multiple differences when compared to the adult population, including an increased incidence of allergic transfusion reactions (2.7/1000 vs. 1.1/1000, p < 0.001), febrile nonhemolytic transfusion reactions (1.9/1000 vs. 0.47/1000, p < 0.001), and hypotensive transfusion reactions (0.29/1000 vs. 0.078/1000, p < 0.05). Interestingly, while the reaction incidence was the same between sexes in adults, in pediatric patients, reactions were more common in male patients (7.9/1000 pediatric males vs. 4.3/1000 pediatric females, p < 0.01).
Alerting signals, symptoms, evidence of occurrence: 
Between the period of January 1, 2011, and February 1, 2013, all reported adult and pediatric transfusion reactions at Vanderbilt University Medical Center (VUMC) were evaluated by transfusion medicine clinical service. A total of 133,671 transfusions were performed at VUMC during the study period including 20,179 platelet (PLT) transfusions, 31,605 plasma transfusions, 79,933 red blood cell (RBC) transfusions, and 2154 cryoprecipitate transfusions. Over the same period, 108 pediatric and 277 adult transfusion reactions were recorded.
Demonstration of imputability or root cause: 
This is the first study to provide detailed comparisons of acute transfusion reactions to all blood products between pediatric and adult populations at a single institution and supported by a single transfusion service and culture. Collectively these data provide insight into pediatric transfusion reactions and demonstrate a general increase in the incidence of transfusion reactions within the pediatric compared to adult population. All reported adult and pediatric transfusion reactions were evaluated by transfusion medicine clinical service.
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
Suggest references: 
Oakley, F.O., Woods, M., Arnold, S. and Young, P.P. (2014). Transfusion reactions in pediatric compared with adult patients: a look at rate, reaction type, and associated products. Transfusion DOI 10.1111/trf.12827.