Yamada-Fujiwara Minami
Division of Blood Transfusion and Cell Therapy, Tohoku University Hospital.
Rinsho Ketsueki. 2023;64(9):925-931. doi: 10.11406/rinketsu.64.925.
Blood transfusion is an essential supportive treatment in modern medicine and is frequently used. Acute hemolytic transfusion reaction is prevented by conducting a cross-matching test; however, nonhemolytic transfusion reactions are difficult to predict. Furthermore, adverse transfusion reactions are not sufficiently recognized by healthcare workers because they rarely occur, except for urticaria and febrile reactions. Thus, further awareness of adverse reactions, particularly regarding transfusion-associated circulatory overload, is needed. Since the introduction of irradiated blood, no transfusion-associated graft-versus-host-disease (TA-GVHD) case has been reported for over 20 years. However, education on the risk of TA-GVHD is important in facilities where nonirradiated blood is supplied or in situations such as unavoidable in-house blood collection on remote islands. The incidence of transfusion-transmitted hepatitis was significantly decreased by the introduction of nucleic acid amplification tests. Recently, the Japanese Red Cross Society is focusing on the reduction of transfusion-associated bacterial infections, which are rare but serious complications. This review provides an updated overview of adverse transfusion reactions and their management measures. Understanding adverse transfusion reactions will enable healthcare workers to recognize symptoms and take prompt action.
输血是现代医学中一项重要的支持性治疗方法，且经常被使用。通过进行交叉配血试验可预防急性溶血性输血反应；然而，非溶血性输血反应难以预测。此外，医护人员对不良输血反应的认识不足，因为除了荨麻疹和发热反应外，这些反应很少发生。因此，需要进一步提高对不良反应的认识，特别是关于输血相关循环超负荷的认识。自从引入辐照血液以来，20多年来未报告过输血相关移植物抗宿主病（TA-GVHD）病例。然而，在供应非辐照血液的机构或在偏远岛屿不可避免地进行内部采血等情况下，对TA-GVHD风险的教育很重要。核酸扩增检测的引入显著降低了输血传播性肝炎的发病率。最近，日本红十字会正专注于减少输血相关细菌感染，这是罕见但严重的并发症。本综述提供了不良输血反应及其管理措施的最新概述。了解不良输血反应将使医护人员能够识别症状并迅速采取行动。
