|
What are the Risks of a Blood Transfusion?
Blood from voluntary donors in Canada is screened and tested for a number of known risks, including HIV and Hepatitis C virus. But there is a small possibility that a virus or bacteria may still be transmitted. Some may cause serious reactions. Others may not. Reactions will vary depending on your personal health. This table lists the possibility of a known risk in a single unit of donated red blood cells. If you get more than one unit of blood, the risk will be higher.
what is the possibility of getting a pathogen in blood transfusion?
|
|
RISK: Pathogen (Virus or Bacteria), Incompatibility
|
Recipient Reactions; common and rare
|
Estimated Risk per unit of transfused red blood cells1
|
Possible number of cases per year based on transfusion of 1,000,000 units RBCs
|
|
Bacterial Contamination
|
Minor fever or chills to serious reactions, including death
|
Less than 1 : 100,000
|
Fewer than 10
|
|
CMV (Cytomegalovirus). Herpes virus.
|
If healthy, no symptoms or long-term effects. If compromised immune systems (HIV/AIDS, cancer, organ transplant), may have very serious effects, including death Request CMV-negative blood for at-risk patients.
|
Less than 1 : 5,0002
|
Fewer than200
|
|
Hepatitis B.
|
Often mild (nausea and vomiting, fatigue and jaundice). For few, chronic liver disease. Preventable with Hep B vaccine.
|
Less than 1 : 25,000
|
Fewer than40
|
|
Hepatitis C.
|
From mild to serious. For some, may result in chronic liver disease or liver cirrhosis.
|
About 1 : 3,000,000
|
About 1 every 3 years
|
|
Hepatitis A.
|
From no symptoms to infection of the liver.
|
Less than 1 : 5,000,000
|
Almost none
|
|
Human Immunodeficiency Virus (HIV) –leading to AIDS
|
Usually serious. Attacks immune system, resulting in chronic progressive illness and leaving infected people vulnerable to infections and cancers.
|
About 1 : 5,000,000
|
Almost none
|
|
Human T-Cell Lymphotropic Viruses (HTLV-I and II)
|
Usually, no symptoms. Rarely, linked to cancer of the blood.
|
Less than 1 : 5,000,000
|
Almost none
|
|
Malaria. Parasite
|
Usually, flu-like symptoms. Fever, rigors (severe shakes or muscle spasms) and chills. Rarely, seizures, coma, kidney failure and respiratory failure, which can lead to death.
|
About 1 : 4,000,000
|
About 1 every 4 years
|
|
Babesiosis, Chagas Disease, Parovirus B19.
|
None to serious depending on recipient health
|
Less than 1 : 5,000,000
|
Almost none
|
|
West Nile Virus
|
Most have no symptoms; few have flu-like symptoms, very few have serious illness and death
|
Less than1 : 50,000 (estimate)
|
Fewer than 20
|
|
Incompatibility: Receiving wrong blood type.
|
If ABO or rh(D) incompatibility, could be serious. If other blood factors mismatched, none to mild symptoms (fever, rash) to very serious (destruction of red blood cells)
|
Less than 1 : 25,000
|
Fewer than 40
|
This table lists the reactions you may experience from a transfusion of donated blood and the possibility of their occurrence. Some people may be more likely to get a reaction to a blood transfusion than others. People with lower immune resistance are at greater risk for transfusion reactions.
|
Patient reactions to transfusion
|
Possible Symptoms
|
Estimated Risk per unit of transfused red blood cells)1
|
Possible number of cases per year based on transfusion of 1,000,000 units
|
|
Fever (febrile reactions).
|
Often starts during transfusion, within first half hour. Symptoms include chills, followed by rapid rise in temperature. Rarely, rise in blood pressure. Usually, no long-term effects.
|
1 : 500
|
About 2,000
|
|
Allergic (minor).
|
Includes: Hives, rash, flushing, nausea. No long-term effects.
|
1 : 250
|
About 4,000
|
|
Allergic (major).
|
Includes: decrease in blood pressure, chest pain, wheezing, or loss of consciousness. At the extreme, cardiac arrest, possibly death.
|
Less than 1 : 20,000
|
Fewer than 50
|
|
Volume Overload (more blood volume than heart can pump)
|
Could result in congestive heart failure and acute pulmonary edema.
|
Less than 1 : 5,000
|
Fewer than 200
|
|
Acute Hemolytic Reaction (hemolysis). Acute (immediate) reaction in which antibodies attack and destroy red blood cells
|
Could include: fever, chills, headache, chest pain, shortness of breath, drop in blood pressure . Usually occurs towards the end of the transfusion
|
Less than 1 : 10,000
|
Fewer than100
|
|
Delayed Hemolytic Reaction. A delayed reaction where antibodies attack red blood cells.
|
Could include: fever, chills, headache, chest pain, shortness of breath, drop in blood pressure
|
1 : 9,000
|
About 110
|
|
TRALI (Transfusion-Related Acute Lung Injury). Due to donor antibodies primarily in transfused plasma but also in red blood cells and platelets
|
Symptoms are shortness of breath, low blood pressure, and fever; very serious reaction that can result in death if not treated.
|
1 : 70,000
|
About 15
|
|
Post-Transfusion purpura (PTP). A rare reaction to packed red blood cells, plasma, and platelet concentrates.
|
Clinical signs and symptoms associated with PTP include wet purpura with mucous membrane hemorrhage, epistaxis, gastrointestinal bleeding, and bleeding from the urinary tract.
|
1 : 140,000
|
Fewer than 10
|
|
Graft-Versus-Host Disease (TA-GVHD). Lymphocytes initiate an immune attack against the recipient’s cells.
|
Fever, liver dysfunction, skin rash, diarrhea, and severe pancytopenia. Rare, often fatal complication
|
Less than 1 : 1,000,000
|
Approximately 1
|
|
Combined Risk of pathogens, bacteria, and transfusion-related injury
|
Estimated Risk per unit of transfused blooded blood cells) 1
|
Posssible Number of Cases in Canada per year
|
|
All reactions (all pathogens and reactions combined – includes both mild and severe reactions)
|
1 : 80
|
12,500
|
|
All severe reactions
|
1 : 4,000
|
250
|
|
All infectious reactions
|
1 : 17,000
|
60
|
1 Canadian data from Kleinman, Chan and Robillard, 2003, except where noted. 2 USA data from AuBuchon 2003.
|
