title: Factors related to allergic transfusion reactions and febrile non-haemolytic transfusion reactions in children.
abstract: OBJECTIVE
  Allergic transfusion reactions (ATRs) and febrile non-haemolytic transfusion reactions (FNHTRs) are the two major types of transfusion-related adverse reactions (TRARs). Although prestorage leucocyte reduction and diversion of the first aliquot of blood (LR/D) could reduce FNHTRs and bacterial contamination in adult transfusion, ATRs are still problematic. In addition, there is little information about TRARs in paediatric population.
  
  
  METHODS
  We conducted a single-centre retrospective analysis of all transfusions, except washing products, and TRARs for 153 months to evaluate related factors such as delivery of treatment and the characteristics of recipients.
  
  
  RESULTS
  Most TRARs were FNHTRs and/or ATRs in children. In delivering blood products with LR/D, the frequencies of not only FNHTRs but also ATRs were significantly reduced with both platelet concentrates (PCs) and red cell concentrates (RCCs). TRARs of fresh-frozen plasma were infrequent in children. In addition, even after the introduction of LR/D, ATRs were significantly more frequent in patients with primary haematological and malignant diseases who received PCs and RCCs, older patients who received PCs and patients who received frequent RCCs.
  
  
  CONCLUSIONS
  These results suggest that leucocytes or mediators from leucocytes are underlying cause of ATRs in addition to FNHTRs in children. Furthermore, particular characteristics of patients would be other risk factors for ATRs.
authors.affiliation: Department of Hematology/Oncology, Nagano Children's Hospital, Azumino, Japan.|Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Yanagisawa
authors.affiliation: Division of Blood Transfusion, Shinshu University Hospital, Matsumoto, Japan.|Center for Advanced Cell Therapy, Shinshu University Hospital, Matsumoto, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Shimodaira
authors.affiliation: Department of Hematology/Oncology, Nagano Children's Hospital, Azumino, Japan.|Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Sakashita
authors.affiliation: Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Hidaka
authors.affiliation: Division of Blood Transfusion, Shinshu University Hospital, Matsumoto, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kojima
authors.affiliation: Department of Laboratory Medicine, Nagano Children's Hospital, Azumino, Japan.
authors.forename: F
authors.initials: F
authors.lastname: Nishijima
authors.affiliation: Department of Laboratory Medicine, Nagano Children's Hospital, Azumino, Japan.|Life Science Research Center, Nagano Children's Hospital, Azumino, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Hidaka
authors.affiliation: Department of Pediatrics, School of Dentistry, Matsumoto Dental University, Shiojiri, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Shiohara
authors.affiliation: Department of Hematology/Oncology, Nagano Children's Hospital, Azumino, Japan.|Life Science Research Center, Nagano Children's Hospital, Azumino, Japan.|Division of Neonatology, Nagano Children's Hospital, Azumino, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Nakamura
mesh_terms: D002648:Child; D002675:Child, Preschool; D017707:Erythrocyte Transfusion / Q000009:adverse effects; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology*; D007223:Infant; D007962:Leukocytes / Q000166:cytology; D008297:Male; D015999:Multivariate Analysis; D010949:Plasma / Q000737:chemistry; D017713:Platelet Transfusion / Q000009:adverse effects; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D065227:Transfusion Reaction / Q000209:etiology*
keywords: allergic transfusion reaction; diversion method; febrile non-haemolytic transfusion reaction; platelet concentrate; red cell concentrate; transfusion-related adverse reaction