Five currently available interventions for further reducing allogeneic blood transfusion-related mortality
| Strategy . | Causes of ABT-related deaths mitigated by the strategy . |
|---|---|
| Reduction in the number of exposures to allogeneic blood donors through: conservative transfusion guidelines avoidance of pooled blood products | Transmission of any emerging, potentially fatal TTI |
| Residual risk from known TTIs (especially TAS and babesiosis; Table 3) | |
| Other potentially fatal transfusion complications (Table 2) | |
| Use of FFP and single-donor platelets collected exclusively from male donors or female donors without a history of pregnancy or shown not to have WBC antibodies | TRALI |
| Information systems for checking the identity of units and intended recipients*/other measures to prevent HTRs† | Acute HTRs due to ABO-incompatible transfusions |
| Acute and delayed HTRs due to non-ABO alloantibodies to RBC antigens | |
| WBC reduction of RBCs and platelets administered in cardiac surgery | Adverse effects of ABT attributable to WBCs and their biologically active products elaborated during storage |
| Pathogen reduction (PR) of platelets and FFP‡ | Transmission of most emerging, potentially fatal TTIs |
| Residual risk of known TTIs (especially TAS and babesiosis; Table 3) | |
| Transfusion-associated GVHD |
| Strategy . | Causes of ABT-related deaths mitigated by the strategy . |
|---|---|
| Reduction in the number of exposures to allogeneic blood donors through: conservative transfusion guidelines avoidance of pooled blood products | Transmission of any emerging, potentially fatal TTI |
| Residual risk from known TTIs (especially TAS and babesiosis; Table 3) | |
| Other potentially fatal transfusion complications (Table 2) | |
| Use of FFP and single-donor platelets collected exclusively from male donors or female donors without a history of pregnancy or shown not to have WBC antibodies | TRALI |
| Information systems for checking the identity of units and intended recipients*/other measures to prevent HTRs† | Acute HTRs due to ABO-incompatible transfusions |
| Acute and delayed HTRs due to non-ABO alloantibodies to RBC antigens | |
| WBC reduction of RBCs and platelets administered in cardiac surgery | Adverse effects of ABT attributable to WBCs and their biologically active products elaborated during storage |
| Pathogen reduction (PR) of platelets and FFP‡ | Transmission of most emerging, potentially fatal TTIs |
| Residual risk of known TTIs (especially TAS and babesiosis; Table 3) | |
| Transfusion-associated GVHD |
Technologies such as barrier systems, bar codes, and/or national patient identification systems.
Including donor genotyping for RBC antigens, phenotypic matching of donor and recipient for clinically significant RBC antigens, and/or RBC antibody detection methods with improved sensitivity.
No FDA-licensed technology is available in the United States. Moreover, the benefit from this intervention will be suboptimal until PR is also available for RBCs.