Acute Transfusion Reactions

The filter used in transfusion removes clots, cellular debris, and coagulated protein to ensure the safety and quality of the blood product. Leukoreduction, which is the routine removal of white blood cells from cellular products during manufacturing, is performed to reduce the risk of adverse reactions. Because cellular components supplied for transfusion are already leukoreduced, bedside leukocyte-reduction filters are not routinely needed in Canada. Additionally, cellular components are often irradiated to prevent donor T lymphocytes from proliferating, which helps reduce the risk of transfusion-associated graft-versus-host disease. Irradiating cellular components prevents donor T lymphocytes from proliferating, thereby minimizing the risk of these cells attacking the recipient's tissues. However, pathogen-reduced platelets treated with amotosalen and UVA light do not require irradiation and are considered cytomegalovirus (CMV)-negative, eliminating the need for additional CMV-seronegative donor selection. It is important to note that pathogen reduction techniques do not inactivate certain infectious agents, including hepatitis A, hepatitis E, poliovirus, or prions.