Transfusion最新文献

{"title":"Plasma transfusion in the intensive care unit.","authors":"Maite M T van Haeren, Senta Jorinde Raasveld, Sanne de Bruin, Merijn C Reuland, Claudia van den Oord, Jimmy Schenk, Cécile Aubron, Jan Bakker, Maurizio Cecconi, Aarne Feldheiser, Harm-Jan de Grooth, Jens Meier, Thomas W L Scheeren, Zoe McQuilten, Andrew Flint, Tarikul Hamid, Michaël Piagnerelli, Tina Tomić Mahečić, Jan Benes, Lene Russell, Hernan Aguirre-Bermeo, Konstantina Triantafyllopoulou, Vasiliki Chantziara, Mohan Gurjar, Sheila Nainan Myatra, Vincenzo Pota, Muhammed Elhadi, Ryszard Gawda, Mafalda Mourisco, Marcus Lance, Vojislava Neskovic, Matej Podbregar, Juan V Llau, Manual Quintana-Diaz, Maria Cronhjort, Carmen A Pfortmueller, Nihan Yapici, Nathan D Nielsen, Akshay Shah, Alexander P J Vlaar, Marcella C A Müller","doi":"10.1111/trf.18071","DOIUrl":"10.1111/trf.18071","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines discourage prophylactic plasma use in non-bleeding patients. This study assesses global plasma transfusion practices in the intensive care unit (ICU) and their alignment with current guidelines.</p><p><strong>Study design and methods: </strong>This was a sub-study of an international, prospective, observational cohort. Primary outcomes were in-ICU occurrence rate of plasma transfusion, proportion of plasma events of total blood products events, and number of plasma units per event. Secondary outcomes included transfusion indications, INR/PT, and proportion of events for non-bleeding indications.</p><p><strong>Results: </strong>Of 3643 patients included, 356 patients (10%) experienced 547 plasma transfusion events, accounting for 18% of total transfusion events. A median of 2 (IQR 1, 2) units was given per event excluding massive transfusion protocol (MTP) and 3 (IQR 2, 6) when MTP was activated. MTP accounted for 39 (7%) of events. Indications of non-MTP events included active bleeding (54%), prophylactic (25%), and pre-procedure (12%). Target INR/PT was stated for 43% of transfusion events; pre-transfusion INR/PT or visco-elastic hemostatic assays (VHA) were reported for 73%. Thirty-seven percent of events were administered for non-bleeding indications, 54% with a pre-transfusion INR < 3.0 and 30% with an INR < 1.5.</p><p><strong>Discussion: </strong>Plasma transfusions occurred in 10% of ICU patients. Over a third were given for non-bleeding indications and might have been avoidable. Target INR/PT was not stated in more than half of transfusions, and pre-transfusion INR/PT or VHA was not reported for 27%. Further research and education is needed to optimize guideline implementation and to identify appropriate indications for plasma transfusion.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"73-87"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11747124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric blood transfusions in Colombia: Dissecting adverse reaction trends and age dynamics.","authors":"María-Isabel Bermúdez-Forero, Diego-Alexander Anzola-Samudio, Michel-Andrés García-Otálora","doi":"10.1111/trf.18074","DOIUrl":"10.1111/trf.18074","url":null,"abstract":"<p><strong>Background: </strong>Adverse transfusion reactions (ATRs) represent undesired responses in patients. Different reports indicate that rates of ATRs are 1.3-2.6 times higher in pediatric populations compared with adults. The aim of this study was to investigate whether similar trends are observed within the pediatric population in Colombia.</p><p><strong>Study design and methods: </strong>This retrospective study, conducted from January 1, 2018, to December 31, 2022, investigated transfusion occurrences and ATRs. Data were collected from the National Hemovigilance Information System. ATRs were reported by medical personnel using standardized forms following guidelines set by the International Society of Blood Transfusion.</p><p><strong>Results: </strong>The study included 2,097,179 patients receiving 6,637,363 transfusions, with 6830 ATRs. In comparison with adult transfusions, pediatric transfusions exhibit a male bias, a higher rate of ATRs per 10,000 transfused patients (79.4 vs. 27.7), a greater prevalence of allergic reactions and a lower incidence of febrile nonhemolytic transfusion reactions (FNHTRs). The rate of ATRs varied across age groups: 17.1 for those aged 0-1 year, 120.5 for individuals aged 2-14 years, 42.5 for people aged 15-65 years, and 24.4 for those over 65 years. Among pediatric patients, 688 of 1126 allergic reactions were linked to platelet transfusions. Platelets obtained via apheresis had a higher ATR rate compared with those from the buffy coat method (OR: 1.44), while in adults, 960 of 3002 allergic reactions were attributed to platelet transfusions, with higher ATR rates for apheresis platelets compared with buffy coat platelets (OR: 1.41).</p><p><strong>Conclusion: </strong>ATRs in the Colombian pediatric population were three times higher than adults.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"100-109"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of molecular sterility assay for rapid quality release of cord blood erythrocytes units for transfusion.","authors":"Laia Closa, Dinara Samarkanova, Carina Lera, Noemí Gonzalez, Mireia Lloret, Margarita Codinach, Gemma Aran, Jesús Fernandez-Sojo, Francisco Vidal, Maria Gloria Soria, Sergi Querol","doi":"10.1111/trf.18084","DOIUrl":"10.1111/trf.18084","url":null,"abstract":"<p><strong>Background: </strong>Umbilical cord blood (CB) units stored in banks are an important source of hematopoietic stem cells for transplantation and other cell therapies. New applications, such as their use in transfusions, require rapid quality release as cord blood red blood cells (CB-RBC) have a shorter shelf life.</p><p><strong>Study design and methods: </strong>This project aims to investigate the most prevalent microbial contaminants in CB preparations and validate a rapid sterility testing strategy for CB-RBC based on an automated system (BACT/ALERT®) in tandem with a molecular assay (real-time PCR) capable of detecting at least 100 CFU/mL of Cutibacterium acnes in CB-RBC to accelerate the detection of the most common slow-growing bacteria.</p><p><strong>Results: </strong>Microbial contamination incidence was assessed by reviewing 4696 CB sterility tests, revealing a positivity rate of 3.4%, with C. acnes being the most common slow-growing pathogen. The BACT/ALERT® system, which was validated according to European Pharmacopeia guidelines, was an appropriate method for sterility testing of CB-RBC, although it required up to 14 days of culture to detect C. acnes when iFAPlus and iFNPlus bottles were used to neutralize antimicrobials. Interestingly, the BACT/ALERT® method detected C. acnes at 30 CFU/mL within 14 days, while real-time PCR identified concentrations ≥65 CFU/mL by Day 4.</p><p><strong>Discussion: </strong>In conclusion, we developed a rapid sterility testing strategy that combines automated culture systems and real-time PCR for early microbial contamination, enhancing CB-RBC shelf life for transfusion and emphasizing the importance of combining detection methods.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"140-151"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From pandemic to participation: A two-year follow-up of blood donors in the Netherlands who registered during the first wave of the COVID-19 pandemic.","authors":"Femmeke J Prinsze, Eva-Maria Merz, Marloes L C Spekman","doi":"10.1111/trf.18079","DOIUrl":"10.1111/trf.18079","url":null,"abstract":"<p><strong>Background: </strong>During the height of the COVID-19 pandemic (2020-2021), people were urged to minimize movements. Nevertheless, the Netherlands observed a huge increase in new donor registrations in early 2020. It is unclear whether such \"pandemic\" donors are willing to become repeat donors. The aim of this study was to analyze the donation behavior of these \"pandemic\" donors during 2 years after registration.</p><p><strong>Methods: </strong>All donors registered in weeks 11-20 of 2020 were followed for 2 years and their turnout for the new donor screening (NDS), their first-time donation (FTD), their donation(s) in the follow-up period, and their availability at the end of the follow-up period was compared with donors registered in weeks 11-20 of the previous years, 2017-2019.</p><p><strong>Results: </strong>Totally 26,463 donors registered during week 11-20 in 2020; more than double as in the same period in previous years. Their turnout for the NDS (80%) and FTD (60%) was like donors registered in 2017-2019. On the longer term, we saw lower donor availability with a shift in number of whole blood and plasma donations.</p><p><strong>Discussion: </strong>During the first phase of the pandemic, more people registered than usual. Their show rates for the NDS and the FTD were comparable with previous years, suggesting that \"pandemic\" donors show identical behavior as regular donors. On the long term, however, donation behavior differed (lower return rates and shift in donation types). Further research is needed to disentangle impacts of the pandemic especially on the long-term changes as they happened simultaneously with policy and recruitment changes.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"122-130"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of acid citrate dextrose-acidification for platelet volume reduction protocols in the transfusion service.","authors":"Yujung Jung, Jenna Khan, Theresa Nester, Chomkan Usaneerungrueng, Moritz Stolla, Dwight Barry, Ann-Marie Taroc, Kristin Ricci, Nabiha H Saifee","doi":"10.1111/trf.18067","DOIUrl":"10.1111/trf.18067","url":null,"abstract":"<p><strong>Background: </strong>Volume-reduced platelets can minimize circulatory overload, allergic transfusion reactions, or out-of-group plasma infusion. Our center adopted a volume reduction protocol that includes acidification with acid citrate dextrose solution A (ACD-A) before centrifugation and without any rest period prior to resuspension allowing a better turnaround time for platelet issue.</p><p><strong>Study design and methods: </strong>This report compares corrected count increments (CCIs) from full-volume and ACD-A acidified volume-reduced human platelets in a retrospective study at a single hospital and in a mouse model.</p><p><strong>Results: </strong>At a pediatric tertiary care hospital, 530 patients received conventional apheresis platelets during the 20-month study period. Among all patients, the expected 4-h mean CCI was 9.8 (95% CI: 8.7, 10.9) for full-volume platelets, and 8.8 (95% CI: 7.3, 10.6) for ACD-acidified volume-reduced platelets (p = .29). A statistically significant difference (p = .01) was identified in the expected 24-h mean CCI: 6.3 (95% CI: 5.5-7.0) with full-volume platelet, 4.7 (95% CI: 3.6-6.0) with ACD-acidified volume-reduced platelet. Limiting CCI calculations to patients with Hematology/Oncology/Hematopoietic Progenitor Cell Transplant diagnosis (n = 296, 56%) indicated a statistically significant difference in both 4- and 24-h predicted CCIs, showing lower CCIs in ACD-acidified volume-reduced platelet, although these were still similar to the CCIs observed in all patients and considered to be clinically acceptable responses similar to other volume reduction protocols. The recovery of count-adjusted, volume-reduced platelets was significantly lower in mice, suggesting a procedure-related defect.</p><p><strong>Discussion: </strong>ACD-A acidification of platelets before volume reduction decreases turnaround time for platelet issue and provides clinically allowable 4-h and 24-h platelet increments.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"4-9"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma exchange using peripheral arterial and venous access in the pediatric intensive care unit.","authors":"Eytan Kaplan, Avichai Weissbach, Gili Kadmon, Elhanan Nahum, Jerry Stein","doi":"10.1111/trf.18075","DOIUrl":"10.1111/trf.18075","url":null,"abstract":"<p><strong>Objective: </strong>Therapeutic plasma exchange (TPE) is a vital therapeutic modality in pediatric intensive care units (PICU) for various indications. Traditionally, pediatric TPE is performed via a large bore, double lumen catheter, whose insertion necessitates deep sedation, and poses risk of hemorrhagic and thrombotic complications. Building on our previous success utilizing percutaneous radial artery catheters (ALs) for apheresis procedures, we present our experience with ALs for TPE procedures in the PICU.</p><p><strong>Methods: </strong>A retrospective cohort study, conducted in the PICU of a tertiary, university affiliated pediatric hospital, including all children aged 19 years and younger, who underwent TPE using an AL for vascular access, between 2018 and 2023. TPE procedures were evaluated for utility (the procedure was performed as planned) and safety.</p><p><strong>Results: </strong>A total of 72 procedures were performed on 20 children, using ALs for inlet access and peripheral intra-venous catheters for blood return. Procedure success rate was 94%, with AL malfunction causing transient delays in 6%. All were successfully completed following AL replacement. ALs were mostly 20 and 22 gauge, predominantly located in the radial artery. AL gauge did not significantly affect flow rate or procedure duration.</p><p><strong>Conclusions: </strong>Our findings support AL use for vascular access, as a viable alternative to the traditional large bore, double lumen catheters most often used for TPE in children. Benefits of AL use may include a decrease in sedation requirements and a lower risk of vascular complications. Further investigation is warranted, for consideration as routine practice in PICUs.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"152-158"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11747134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Planning antepartum directed donations in preparation for neonatal cardiac surgery in the absence of compatible donors.","authors":"Marc Bienz, Jessica Constanzo-Yanez, Nadia Baillargeon, Gabriel André Leiva-Torres, Mélissa Boileau, Marc Cloutier, Audrey Laforce-Lavoie, Nancy Robitaille","doi":"10.1111/trf.18087","DOIUrl":"10.1111/trf.18087","url":null,"abstract":"<p><strong>Background: </strong>Homozygous inheritance of the R^N haplotype, characterized by the absence of the high frequency antigen Sec, as well as partial C and e antigens, is rare and is associated with potential for alloimmunization. Anti-Sec has been reported to be associated with a risk of delayed hemolytic transfusion reaction and hemolytic disease of the fetus and newborn (HDFN).</p><p><strong>Results: </strong>We report the case of a 36-year-old pregnant woman with known sickle cell trait (SCT) and homozygous for the R^N haplotype with anti-Sec, anti-c, and anti-e. Morphological ultrasound identified dextro-transposition of the great arteries in the fetus. Neonatal cardiac surgery was planned with cardiopulmonary bypass support. Due to the rarity of this genotype, there were no compatible donors in our registry. For this reason, in addition to two previously glycerolized maternal donations, the mother donated three units during pregnancy and one unit postpartum.</p><p><strong>Discussion: </strong>This case highlights the many complexities for the blood supplier pertaining to organizing blood donations during pregnancy, the risk of leukoreduction failure and jellification during the deglycerolization process of units from donors with rare blood carrying the SCT, as well as planning the rare-blood inventory and managing expiry dates to provide transfusion support during delivery, neonatal surgery, and the postoperative period. This case also exemplifies the importance of a strong partnership between blood suppliers and medical teams.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"234-239"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11747082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet storage in small bags as a model of platelet function in full-sized containers.","authors":"Kathleen Kelly, Tamir Kanias, Caroline Leite, Crystal Stanley, Larry J Dumont","doi":"10.1111/trf.18097","DOIUrl":"10.1111/trf.18097","url":null,"abstract":"<p><strong>Background: </strong>Evaluation of additive solutions, storage containers, new collection and storage methods, and other potential modifications is resource intensive, resulting in diversion of platelets away from blood bank inventories and significant time to complete study recruitments. Our goal was to evaluate the feasibility of a small bag for the study of platelet storage, and, by using a standardized respirometry test, separate daily metabolic capacity from observations made in the dynamic storage environment of changing pH, fuels, and end products.</p><p><strong>Methods: </strong>Single-donor apheresis platelets collected in 100% plasma had small volumes removed to meet secondary processing requirements. Small volumes (23 ± 1.4 mL) were placed in 50-mL bags constructed of platelet storage material, stored 7 days, and assessed with a panel of in vitro assays. Platelet bioenergetics (oxygen consumption and acid production rates) were measured with a respirometer.</p><p><strong>Results: </strong>The patterns of platelet pH decline, activation, and potency by thrombin generation were consistent with historical reports. Lactate production rates (54.1 ± 11.3 μmol/10¹²plt/h) were significantly correlated with pH decrease, increased activation, and thrombin generation potency by Day 7. Respirometry revealed a reduction of the glycolytic capacity and accumulating damage to the oxidative system for ATP production over storage.</p><p><strong>Discussion: </strong>Small bags present a storage profile of metabolic changes and activation consistent with historical data for full bag storage. Therefore, this system has promise to provide a platform for scaling experiments of platelet storage in a manner that maximizes platelets collected in research settings and does not compromise availability for patient treatment as exercised in this study.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"185-193"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Are my blood products coming?\": Implementation of a novel blood product tracker in the electronic health record system.","authors":"Tina Chai, Connor Hartzell, Randy Winstead, Kirk Krokosky, Kaycie Atchison, Angela Mueller, Erika Hall, Jonathan P Wanderer, Jennifer Andrews","doi":"10.1111/trf.18089","DOIUrl":"10.1111/trf.18089","url":null,"abstract":"<p><strong>Background: </strong>Blood transfusions are the most common procedure performed in American hospitals. The steps required for blood product delivery are often misunderstood by providers, leading to numerous phone calls to the blood bank requesting order status. Distracting calls can lengthen turnaround time, especially during blood product or staff shortages. We sought a tool to address these questions and reduce distraction. This study highlights a novel blood tracker tool implemented in the electronic health record (EHR) that allows providers to see their blood order's status.</p><p><strong>Study design and methods: </strong>With a multidisciplinary team of healthcare professionals, we constructed a user-friendly blood tracker highly visible in our EHR. It shows the status of a blood product in real time from \"order printed\" to \"preparing\" to \"on its way.\" We surveyed blood bank technologists to determine if call volume and distraction changed.</p><p><strong>Results: </strong>We counted the number of views per month as a surrogate of usage. The blood tracker was viewed 109,626 times per month on average from January through December 2023. The fraction of technologists who received 21 or more calls per shift decreased by 47%.</p><p><strong>Discussion: </strong>We successfully constructed and implemented a novel blood tracker into our EHR that relays the status of a blood product. It is a highly viewed piece of information in our EHR and decreases blood bank call volume as reported by blood bank technologists. Its success demonstrates that closed-loop communication between the lab and providers regarding blood products is beneficial within our organization and potentially others.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"17-21"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11747110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of adverse events related to intravenous immunoglobulin therapy in children.","authors":"Jade Côté, Mathilde Chaloult-Lavoie, Élisabeth Poulin, Laurence A Hayes, Mahukpe Narcisse U Singbo, Pierre Ouellet, Marie-Claude Pelland-Marcotte","doi":"10.1111/trf.18083","DOIUrl":"10.1111/trf.18083","url":null,"abstract":"<p><strong>Background: </strong>Intravenous immunoglobulin (IVIG) therapy is used in the treatment of pediatric diseases, although data about IVIG-related adverse events (IVIG-AEs) are limited. Objectives of this study were to document the incidence of IVIG-AEs in pediatric hospitalized patients and to identify risk factors for IVIG-AEs.</p><p><strong>Methods: </strong>This retrospective cohort study included patients <18 years old who received IVIG therapy while admitted at a Canadian pediatric tertiary care center between 2016 and 2020. Patients and IVIG-perfusions characteristics were collected, as well as IVIG-AEs. Bivariate and multivariable logistic regressions were used to explore predictors of IVIG-AEs.</p><p><strong>Results: </strong>We included 228 children, totaling 478 IVIG perfusions. Indications included treatment for inflammatory (52.6%), autoimmune disorders (35.5%), and immunoglobulin replacement (11.8%). A total of 213 IVIG-AEs were reported. Fever (13.6%) and headache (6.7%) were the most frequent IVIG-AEs. Most IVIG-AEs were mild (57%) or moderate (31%) in severity, but 12% were severe reactions. The following factors were predictive of IVIG-AEs in univariate analyses: older age (OR 1.14 [95% CI: 1.07-1.21]), dehydration (OR 2.55 [95% CI: 1.43-4.55]), concurrent allergies (OR 2.87 [95% CI: 1.26-6.56]), first perfusion (OR 1.53 [95% CI: 1.02-2.30]), and higher dosage (OR 2.14 [95% CI: 1.39-3.33]). Concurrent steroids decreased the risk of IVIG-AEs (OR 0.43 [95% CI: 0.19-0.96]). Older age and higher IVIG dose remained independent predictors of IVIG-AEs in multivariable analyses.</p><p><strong>Conclusions: </strong>Mild IVIG-AEs are frequent in children, and serious reactions may occur. Prospective studies are needed to confirm risk factors for IVIG-AEs and to evaluate how to best prevent them.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"88-99"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11747083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}