Febrile Transfusion Reaction: What Blood Component Should Be Given Next?

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Abstract
Reports of febrile, nonhemolytic transfusion reactions (FNHTR) occurring at hospitals served by a regional blood center supplying 99,658 units of blood during 1980 were analyzed to determine if leukocyte-poor red blood cells prepared by the inverted centrifugation technique (LP RBC) were adequate to prevent subsequent reactions. FNHTR occurred following 0.5% of units transfused. The records of transfusions given to patients who had a FNHTR were reviewed in a subgroup of hospitals. Of 253 such patients, 161 received subsequent transfusions: 140 received red cells or LP RBC without a reaction. The remaining 21 had a 2nd reaction following transfusion of packed red cells. Twelve of the 21 received further red cell transfusions. Only 1 experienced a 3rd febrile reaction after receiving LP RBC. LP RBC are adequate to prevent recurrence of FNHTR, and the need for costly, saline-washed, leukocyte-poor red blood cells for this purpose is questioned.