Hume H A, Popovsky M A, Benson K, Glassman A B, Hines D, Oberman H A, Pisciotto P T, Anderson K C
Hôpital Ste-Justine, Montréal, Québec, Canada.
Transfusion. 1996 Oct;36(10):904-9. doi: 10.1046/j.1537-2995.1996.361097017178.x.
In 1993, the American Association of Blood Banks (AABB) received reports of severe hypotensive reactions associated with platelet transfusions. The question arose as to whether these reports were indicative of a previously uncharacterized platelet transfusion reaction.
To further characterize these reactions, the AABB Transfusion Practices Committee developed a series of three questionnaires. The initial questionnaire was sent to all AABB institutional members; the two subsequent questionnaires were sent to those institutions reporting severe and/or unusual platelet transfusion reactions. This report focuses on the 24 responses to the third and most detailed questionnaire, which specifically addressed reactions that were characterized by hypotension and/or unexplained respiratory failure.
Of the 24 detailed responses received, 4 were not considered to represent unusual reactions to platelet transfusion, 3 described reactions consistent with a (presumably unrecognized) diagnosis of transfusion-related acute lung injury, and 17 described reactions that were primarily characterized by hypotension. The majority of the hypotensive reactions occurred within 1 hour of the beginning of the transfusion (88%), were associated with respiratory distress (82%), and resolved rapidly after cessation of the transfusion (82%). Eighty-eight percent of implicated components had been white cell reduced by filtration.
The hypotensive platelet transfusion reactions that were described appear to represent a previously uncharacterized complication of platelet transfusion. However, the nature of the questionnaires used in this investigation does not allow the drawing of firm conclusions as to the frequency or the cause of these reactions.
1993年，美国血库协会（AABB）收到了与血小板输注相关的严重低血压反应报告。问题在于这些报告是否表明存在一种以前未被描述的血小板输注反应。
为了进一步描述这些反应，AABB输血实践委员会编制了一系列三份调查问卷。最初的问卷发送给了所有AABB机构成员；随后的两份问卷发送给了那些报告严重和/或异常血小板输注反应的机构。本报告重点关注对第三份也是最详细问卷的24份回复，该问卷专门针对以低血压和/或不明原因呼吸衰竭为特征的反应。
在收到的24份详细回复中，4份不被认为代表血小板输注的异常反应，3份描述的反应与输血相关急性肺损伤（可能未被认识到）的诊断一致，17份描述的反应主要以低血压为特征。大多数低血压反应发生在输血开始后1小时内（88%），与呼吸窘迫相关（82%），输血停止后迅速缓解（82%）。88%的相关成分已通过过滤去除白细胞。
所描述的低血压血小板输注反应似乎代表了一种以前未被描述的血小板输注并发症。然而，本研究中使用的调查问卷的性质不允许就这些反应的频率或原因得出确凿结论。
