What are the most common complications associated with blood transfusions, and how can they be prevented?

Blood transfusions carry risks of several common complications, including acute transfusion reactions such as febrile non-hemolytic reactions, allergic reactions, hemolytic transfusion reactions, transfusion-related acute lung injury (TRALI), and infections. Strategies to prevent these complications focus on careful patient monitoring, appropriate blood product selection, and adherence to transfusion protocols.

Common complications: Acute transfusion reactions are the most frequent and can range from mild allergic responses to severe hemolytic reactions caused by ABO incompatibility. TRALI is a serious complication characterized by acute lung injury following transfusion. Infectious risks, although reduced by modern screening, remain a concern, especially with repeated transfusions such as in sickle cell disease management (Chou and Fasano, 2016). Other complications include iron overload in patients receiving chronic transfusions and alloimmunization.

Preventive strategies: The UK NICE guidelines emphasize continuous monitoring of the patient's vital signs before, during, and after transfusion to promptly detect and manage acute reactions ¹. Use of electronic patient identification systems is recommended to reduce errors in blood matching ¹. Single-unit transfusions with reassessment after each unit help minimize exposure and risk ¹. Providing patients with clear verbal and written information about transfusion risks and benefits supports informed consent and vigilance ¹. For patients with specific conditions like sickle cell disease, tailored transfusion protocols and close monitoring for alloimmunization and iron overload are advised (Chou and Fasano, 2016). Additionally, prophylactic measures such as leukodepletion of blood products reduce febrile reactions, and careful blood group matching prevents hemolytic reactions ¹.

In summary, the most common complications of blood transfusion include acute transfusion reactions, TRALI, infections, and alloimmunization. Prevention relies on vigilant monitoring, strict adherence to transfusion protocols, patient identification systems, and patient education, alongside condition-specific management strategies (Chou and Fasano, 2016; ¹).