Transfusion‐Associated Septic Reactions

Abstract

SUMMARYTransfusion reactions associated with bacteria and/or their products, during or following a blood transfusion, were one of the earliest recognized complications of allogeneic blood transfusions. Bacterial contamination of blood products has, therefore, been a problem for many decades and, at the present time, is likely the most common microbiological cause of transfusion‐associated mortality and morbidity. Septic reactions associated with platelet concentrates appear to be much more common than those associated with contaminated red blood cells. The overall prevalence of contaminated cellular blood products has been estimated to be approximately 1 in 3000; however, the transfusion of contaminated platelet or red blood cell units may not necessarily be associated with clinically apparent morbidity in recipients because the majority of contaminated blood product units contain relatively few organisms. Unfortunately, though, in a minority of instances, contaminated blood product units contain clinically significant numbers of bacteria as well as endotoxins that may be associated with significant mortality and/or morbidity. The incidence of clinically evident severe septic episodes has not yet been clearly established, but is probably in the order of 1 per 50,000 platelet units transfused and 1 per 500,000 red blood cell units transfused. In recent years, a variety of interventions have been proposed, and in some instances implemented, in an effort to reduce this significant and potentially preventable transfusion risk.