Febrile, Nonhemolytic Transfusion Reactions and the Limited Role of Leukoagglutinins in Their Etiology

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Abstract
In more than ten thousand transfusions given over a four‐year period to 1,649 patients, the incidence of urticarial reactions was 1.1 per cent. There were no hemolytic transfusion reactions and none due to bacterial contamination or to bacterial pyrogens. There were 276 “Febrile Nonhemolytic” reactions for an incidence of 2.5 per cent.The clinical picture described for reactions due to leukocyte incompatibility was extremely rare. Eighteen per cent of patients responding with fever to transfusion did so following their very first transfusion. Many patients had only one transfusion reaction despite many further transfusions and others had many successive reactions followed by numerous reaction‐free transfusions of blood from which leukocytes had not been removed.A prospective study was made to investigate the relationship between the presence of leukoagglutinins and incidence of “Febrile Nonhemolytic” transfusion reactions. In 185 individuals who were tested and then transfused without regard to leukocyte compatibility, we did not demonstrate any correlation between the presence of leukoagglutinins and the occurrence of transfusion reactions.