Hypotensive transfusion reactions (HTR)

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Record number: 
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
Incidence of 1.33 per 10,000 transfusions; RBCs implicated in 60% of reported reactions occurring in 35 patients, platelets in 31% and plasma in 9%. Clinical settings: cardiovascular surgery (37%), hematology-oncology diseases (31%), general surgery (20%).
Time to detection: 
Less than 24 hours
Alerting signals, symptoms, evidence of occurrence: 
Hypotension: decreased systolic blood pressure at least 30mmHg, systolic blood pressure not more than 80mmHg, > 25% decrease of systolic blood pressure in pediatric patients.
Demonstration of imputability or root cause: 
A retrospective review of medical records of patients with hypotensive transfusion reactions during the years 2011 and 2012 was performed at two academic medical institutions. Classified as HTRs according to the US hemovigilance program.
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
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Reference attachment: 
Suggest references: 
Pagano, MB, Ness PM, Chajewski OS, King KE. Wu Y, Tobian AAR. Hypotensive transfusion reactions in the era of prestorage leukoreduction. Transfusion doi: 1111/trf.13047
Expert comments for publication: 
In the absence of bedside leukoreduction filters, several medical situations are associated with HTRs. Pathophysiology not defined, but though to be related to medical situations resulting in increased bradykinin levels.