Special report: transfusion risks.

The benefits of blood transfusion must be considered and evaluated in terms of risk factors relating to the adverse effects of transfusion. Transfusions may result in either serious or troublesome complications. Although the risk of transfusion-associated acquired immune deficiency syndrome (AIDS) is of paramount concern in the patient population, it has been virtually eliminated because of testing of donor units for antibody to human immunodeficiency virus. Serious and troublesome adverse effects of blood transfusion are listed and ranked in order of approximate frequency. About 20% of all transfusions result in some type of adverse effect. The major serious risk of blood transfusion today continues to be transfusion-associated viral hepatitis. This entity is usually subclinical but frequently results in serious chronic liver disease. Transfusions should be avoided unless patient care would be compromised if withheld.