title: Incidence of acute transfusion reactions to platelets in hospitalized pediatric patients based on the US hemovigilance reporting system.
abstract: BACKGROUND
  Transfusion reactions in pediatric populations have not been well studied. We investigated the incidence and type of transfusion reactions to platelets (PLTs) in a pediatric inpatient population.
  
  
  METHODS
  Over 1 year, a retrospective review of all PLT transfusions given to pediatric inpatients (≤ 18 years old) was performed at a single institution with application of the US hemovigilance reporting definitions. Intraoperative transfusions were excluded. Any signs or symptoms that could represent an acute transfusion reaction (ATR) within 24 hours after PLT transfusion were reviewed and classified based on the US hemovigilance reporting definitions.
  
  
  RESULTS
  Between June 1, 2010, and May 31, 2011, a total of 805 PLT transfusions to 126 patients were identified as appropriate for inclusion. Of these 805 transfusions, 116 (14.4%) met the reporting criteria for ATRs. Some PLT transfusions were associated with multiple types of ATRs leading to 120 ATRs overall, as defined by the US hemovigilance reporting system. Of these 120 reportable ATRs, 54 (45.0%) transfusion-associated dyspnea (TAD) reactions, 38 (31.7%) febrile nonhemolytic transfusion reactions, 15 (12.5%) allergic transfusion reactions, eight (6.7%) hypotensive transfusion reactions, and five (4.2%) transfusion-associated cardiac overload reactions were identified. No resultant deaths associated with ATRs were observed. Of these reportable ATRs, only four (3.34%) were reported to the hospital transfusion service.
  
  
  CONCLUSIONS
  Our findings indicate that reportable ATRs in the pediatric populations may be more prevalent than previously reported and were underreported to our transfusion service. TAD encompassed the majority of reportable ATRs and is the main contributor to the increased rate of reportable ATRs.
authors.affiliation: Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Lawrence
authors.initials: L
authors.lastname: Williams
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Zhou
authors.forename: YanYun
authors.initials: Y
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D001787:Blood Group Incompatibility / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017713:Platelet Transfusion / Q000009:adverse effects* / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology