11/5/03 Allergic transfusion reactionsSummaryAllergic reactions (AR) during transfusion of blood or blood products are not rare. This subject was reviewed by Gilstad. The frequency of such AR is estimated to be about the same as AR to penicillin drugs. However, anaphylactic reactions to blood products are relatively rare. The presence of anti-IgA antibodies in the recipient of whole blood or plasma is responsible for a minority of systemic reactions and there is no consistent policy about the utility of screening prospective transfusion recipients for the presence of anti-IgA. The incidence of reactions to platelet transfusions is higher than due to infusions of fresh frozen plasma or red blood cells. Depleting platelets of leukocytes as much as feasible does not significantly reduce the frequency of AR to platelets. This suggests that some platelet related factor might be responsible for such AR. Reference Curr Opin Hematol 2003; 10:19-23 Editor's Comments The frequency of febrile reactions to transfusions appear to have decreased significantly since the use of washed, packed red blood cells has supplanted whole blood transfusions in most cases. It is now recognized that a leukocytic pyrogen, likely a cytokine, was responsible for most of the febrile transfusion reactions. The exact antigens inducing the occasional urticarial reactions have still not been well defined. An infrequent (though very interesting) cause of AR to whole blood transfusions was the presence of food allergens in the blood due to eating practices of the blood donor. If the recipient was highly allergic to that food, an AR may occur during the transfusion. Even less common were reports of AR due to transfer of IgE antibodies from the donor to a recipient who was then exposed to the relevant allergen by inhalation or ingestion.
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