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Transfusion and component characteristics are not associated with allergic transfusion reactions to apheresis platelets
Author(s) -
Savage William J.,
Tobian Aaron A.R.,
Savage Jessica H.,
Hamilton Robert G.,
Borge P. Dayand,
Kaufman Richard M.,
Ness Paul M.
Publication year - 2015
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12852
Subject(s) - medicine , aeroallergen , apheresis , odds ratio , abo blood group system , incidence (geometry) , logistic regression , blood transfusion , immunology , risk factor , platelet , allergen , allergy , physics , optics
Background Transfusion‐related characteristics have been hypothesized to cause allergic transfusion reactions ( ATR s) but they have not been thoroughly studied. The primary objective of this study is to evaluate the associations of infusion rate, infusion volume, ABO mismatching, component age, and pretransfusion medication with the incidence and severity of ATR s. A secondary objective is to compare the risk of these attributes relative to the previously reported risk factor for aeroallergen sensitization in transfusion recipients, as measured by an aeroallergen‐specific immunoglobulin ( Ig ) E antibody screen. Study Design and Methods Clinical and transfusion‐related data were collected on subjects with reported ATR s and uneventful (control) apheresis platelet ( PLT ) transfusions over a combined 21‐month period at two academic medical centers. Control transfusions were selected as the next uneventful transfusion after an ATR was reported. Logistic regression, M ann‐ W hitney, and t tests were used to assess associations with ATR s. Previously reported aeroallergen‐specific IgE screening data were incorporated into a multivariable logistic regression. Results A total of 143 ATR s and 61 control transfusions were evaluated among 168 subjects, ages 2 to 86 years. Infusion rate, infusion volume, ABO mismatching, component age, and pretransfusion medication showed no significant association with ATR s (p > 0.05). Neither infusion rate nor infusion volume increased the risk of anaphylaxis versus mucocutaneous‐only ATR s. Aeroallergen sensitization has previously been associated with ATR s. After transfusion‐related covariates were controlled for, aeroallergen sensitization remained significantly associated with ATR s (odds ratio, 2.68; 95% confidence interval, 1.26‐5.69). Conclusions Transfusion‐ and component‐specific attributes are not associated with ATR s. An allergic predisposition in transfusion recipients is associated most strongly with ATR risk.