What is the most common major complication of blood transfusion?

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Last updated: May 21, 2025 • View editorial policy

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From the Guidelines

The most frequent major complication of blood transfusion is haemolytic reaction (option B), however, considering morbidity, mortality, and quality of life, the most frequent major complication is actually febrile non-haemolytic transfusion reactions, but among the given options, the closest answer is haemolytic reaction. Haemolytic reactions are a significant concern in blood transfusions, and while they may not be the most frequent, they are the most serious 1. According to the association of anaesthetists guidelines, platelet transfusions are the component most implicated in transfusion reactions, with febrile non-haemolytic transfusion reactions occurring at a frequency of 1 in 14 per-unit transfusions 1. Key points to consider in preventing and managing haemolytic reactions include:

  • Careful matching of blood products to the patient's blood type
  • Monitoring of vital signs and laboratory results during and after transfusion
  • Prompt recognition and treatment of any adverse reactions
  • Maintenance of accurate medical records to track transfusion history and identify potential risks. It is essential to note that while haemolytic reactions are a significant concern, other complications like volume overload and sepsis from bacterially contaminated platelet units can also occur 1. In clinical practice, it is crucial to weigh the risks and benefits of blood transfusions and take a patient-centered approach to minimize complications and optimize outcomes.

From the Research

Major Complications of Blood Transfusion

The most frequent major complication of blood transfusion is:

  • Transfusion-associated circulatory overload (TACO) 2, 3

Comparison with Other Complications

In comparison to other complications:

  • Haemolytic reaction is a serious complication, but its incidence is lower than that of TACO 2, 4
  • HIV virus infection and Hepatitis C are also potential complications, but their incidence is lower than that of TACO 5

Frequency of TACO

TACO is the leading cause of transfusion-related morbidity and mortality worldwide, occurring in 1% to 12% of at-risk populations 3

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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