Immunological complications of blood transfusion: current insights and advances

IF 5.8 2区医学 Q1 IMMUNOLOGY

Current Opinion in Immunology Pub Date : 2025-07-29 DOI:10.1016/j.coi.2025.102617

Naveen Bansal , Manish Raturi , Charu Singh , Yashik Bansal

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Abstract

Blood transfusion is integral to modern medicine but carries significant immunological risks. This review outlines key immune-mediated complications, including acute hemolytic transfusion reactions from ABO incompatibility, and febrile nonhemolytic reactions caused by cytokines or antileukocyte antibodies. Other reactions include allergic responses, anaphylaxis (notably in IgA-deficient patients), and transfusion-related acute lung injury — the leading cause of transfusion-related mortality. Delayed hemolytic reactions, alloimmunization-induced platelet refractoriness, transfusion-associated graft-versus-host disease, and post-transfusion purpura also contribute to morbidity. Transfusion-related immunomodulation may increase infection and cancer recurrence risks. Preventive measures such as leukoreduction, irradiation, extended antigen matching, and restrictive transfusion strategies are crucial. This review article emphasis the importance on the need for strict adherence to protocols, enhanced hemovigilance, and education, especially in resource-limited settings. This review article summarizes the various immunological complications of blood transfusion and the recent advances in their etiopathogenesis, prevention, mitigation, and future research direction.

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输血的免疫学并发症：当前的见解和进展

输血是现代医学不可或缺的一部分，但也会带来重大的免疫风险。这篇综述概述了主要的免疫介导的并发症，包括ABO不相容引起的急性溶血性输血反应，以及由细胞因子或抗白细胞抗体引起的发热性非溶血性反应。其他反应包括过敏反应、过敏反应（特别是iga缺乏患者）和输血相关的急性肺损伤（输血相关死亡的主要原因）。延迟溶血反应、同种异体免疫诱导的血小板难治性、输血相关的移植物抗宿主病和输血后紫癜也有助于发病率。输血相关的免疫调节可能增加感染和癌症复发的风险。预防措施，如白细胞诱导、照射、扩大抗原匹配和限制性输血策略是至关重要的。这篇综述文章强调了严格遵守协议、加强血液警戒和教育的重要性，特别是在资源有限的情况下。本文综述了输血引起的各种免疫并发症及其发病机制、预防、缓解和未来研究方向等方面的最新进展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Immunology 医学-免疫学

CiteScore

13.30

自引率

1.40%

发文量

审稿时长

67 days

期刊介绍： Current Opinion in Immunology aims to stimulate scientifically grounded, interdisciplinary, multi-scale debate and exchange of ideas. It contains polished, concise and timely reviews and opinions, with particular emphasis on those articles published in the past two years. In addition to describing recent trends, the authors are encouraged to give their subjective opinion of the topics discussed. In Current Opinion in Immunology we help the reader by providing in a systematic manner: 1. The views of experts on current advances in their field in a clear and readable form. 2. Evaluations of the most interesting papers, annotated by experts, from the great wealth of original publications. Current Opinion in Immunology will serve as an invaluable source of information for researchers, lecturers, teachers, professionals, policy makers and students. Current Opinion in Immunology builds on Elsevier''s reputation for excellence in scientific publishing and long-standing commitment to communicating reproducible biomedical research targeted at improving human health. It is a companion to the new Gold Open Access journal Current Research in Immunology and is part of the Current Opinion and Research(CO+RE) suite of journals. All CO+RE journals leverage the Current Opinion legacy-of editorial excellence, high-impact, and global reach-to ensure they are a widely read resource that is integral to scientists'' workflow.