Incidence of acute transfusion reactions to platelets in hospitalized pediatric patients based on the US hemovigilance reporting system

Abstract

Transfusion reactions in pediatric populations have not been well studied. We investigated the incidence and type of transfusion reactions to platelets (PLTs) in a pediatric inpatient population. Over 1 year, a retrospective review of all PLT transfusions given to pediatric inpatients (≤ 18 years old) was performed at a single institution with application of the US hemovigilance reporting definitions. Intraoperative transfusions were excluded. Any signs or symptoms that could represent an acute transfusion reaction (ATR) within 24 hours after PLT transfusion were reviewed and classified based on the US hemovigilance reporting definitions. Between June 1, 2010, and May 31, 2011, a total of 805 PLT transfusions to 126 patients were identified as appropriate for inclusion. Of these 805 transfusions, 116 (14.4%) met the reporting criteria for ATRs. Some PLT transfusions were associated with multiple types of ATRs leading to 120 ATRs overall, as defined by the US hemovigilance reporting system. Of these 120 reportable ATRs, 54 (45.0%) transfusion-associated dyspnea (TAD) reactions, 38 (31.7%) febrile nonhemolytic transfusion reactions, 15 (12.5%) allergic transfusion reactions, eight (6.7%) hypotensive transfusion reactions, and five (4.2%) transfusion-associated cardiac overload reactions were identified. No resultant deaths associated with ATRs were observed. Of these reportable ATRs, only four (3.34%) were reported to the hospital transfusion service. Our findings indicate that reportable ATRs in the pediatric populations may be more prevalent than previously reported and were underreported to our transfusion service. TAD encompassed the majority of reportable ATRs and is the main contributor to the increased rate of reportable ATRs.