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Jadidi S, Habibian Sezavar F, Amrollahi F, Miri S M, Mehrpouri M. Prevalence and Effective factors for Acute Transfusion Reactions in Hospitals of Alborz Province (2018-2021): A Cross-Sectional Study. bloodj 2025; 22 (4) :277-284
URL: http://bloodjournal.ir/article-1-1591-en.html
Prevalence and Effective factors for Acute Transfusion Reactions in Hospitals of Alborz Province (2018-2021): A Cross-Sectional Study
Shima Jadidi , Fariba Habibian Sezavar , Fatemeh Amrollahi , Seyed Mohammad Miri , Mahdieh Mehrpouri *
Keywords: Transfusion Reaction, Hypersensitivity, Febrile Non-Hemolytic Transfusion Reaction, Age Factors, Hospitals, Blood Transfusion
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    References:
  1. Clevenger B, Kelleher A. Hazards of blood transfusion in adults and children. Continuing Education in Anaesthesia Critical Care & Pain 2014; 14(3): 112-8. [DOI:10.1093/bjaceaccp/mkt042]
  2. Amiri F, Jambbozorg H, Biglarii M, Mohammadi A, Afshari M, Seyedi S. Survey on the blood transfusion-related reactions in blood recipients referred to Hamadan hospitals in 2018-2019. J Iran Blood Transfus 2021; 18(2): 87-96. [Article in Farsi]
  3. Moncharmont P. Adverse transfusion reactions in transfused children. Transfus Clin Biol 2019; 26(4): 329-35. [DOI:10.1016/j.tracli.2019.08.002] [PMID]
  4. Panch SR, Montemayor-Garcia C, Klein HG. Hemolytic Transfusion Reactions. N Engl J Med 2019; 381(2): 150-62. [DOI:10.1056/NEJMra1802338] [PMID]
  5. Hendrickson JE, Roubinian NH, Chowdhury D, Brambilla D, Murphy EL, Wu Y, et al. Incidence of transfusion reactions: a multicenter study utilizing systematic active surveillance and expert adjudication. Transfusion 2016; 56(10): 2587-96. [DOI:10.1111/trf.13730] [PMID] []
  6. Ackfeld T, Schmutz T, Guechi Y, Le Terrier C. Blood Transfusion Reactions-A Comprehensive Review of the Literature including a Swiss Perspective. J Clin Med 2022; 11(10): 2859. [DOI:10.3390/jcm11102859] [PMID] []
  7. Rogers MA, Rohde JM, Blumberg N. Haemovigilance of reactions associated with red blood cell transfusion: comparison across 17 Countries. Vox Sang 2016; 110(3): 266-77. [DOI:10.1111/vox.12367] [PMID] []
  8. U.S.Food and Drug Administration. Fatalities Reported to FDA Following Blood Collection and Transfusion: Annual Summary for Fiscal Year 2020. FDA; 2020. Available from: https://www.fda.gov/media/186751/download.
  9. Oyekan F, McAleese H, Ahmed M, Booth C, Bowles L, Murphy MF, et al. Quantifying Harms Associated With Red Cell ABO Incompatible Blood Transfusion: A Systematic Review of the UK SHOT Literature. Transfus Med Rev 2025; 39(3): 150906. [DOI:10.1016/j.tmrv.2025.150906] [PMID]
  10. Wang H, Ren D, Sun H, Liu J. Research progress on febrile non-hemolytic transfusion reaction: a narrative review. Ann Transl Med 2022; 10(24): 1401. [DOI:10.21037/atm-22-4932] [PMID] []
  11. Savage WJ, Tobian AA, Savage JH, Wood RA, Schroeder JT, Ness PM. Scratching the surface of allergic transfusion reactions. Transfusion 2013; 53(6): 1361-71. [DOI:10.1111/j.1537-2995.2012.03892.x] [PMID] []
  12. Kracalik I, Mowla S, Basavaraju SV, Sapiano MR. Transfusion‐related adverse reactions: Data from the National Healthcare Safety Network Hemovigilance Module-United States, 2013-2018. Transfusion 2021; 61(5): 1424-34. [DOI:10.1111/trf.16362] [PMID]
  13. Khalid S, Usman M, Khurshid M. Acute transfusion reactions encountered in patients at a tertiary care center. J Pak Med Assoc 2010; 60(10): 832-6.
  14. Lemssahli I, Benajiba M, Belmekki A. Review of haemovigilance at the Rabat Regional Blood Transfusion Centre in Morocco (2017-2021). Pan Afr Med J 2024; 47: 60. [DOI:10.11604/pamj.2024.47.60.42250] [PMID] []
  15. Bodaghkhan F, Ramzi M, Vazirian S, Ahmadi M, Hajebi Rajabi M, Kohan N, et al . The prevalence of acute blood transfusion reactions in Nemazee Hospital. J Iran Blood Transfus 2014; 11(3): 247-51. [Article in Farsi]
  16. Azizi S, Tabary SZ, Soleimani A. Prevalence of acute blood transfusion reactions in Mazandaran Heart Center, Sari, Iran, 2010-2012. Med Arch 2014; 68(2): 137-9. [DOI:10.5455/medarh.2014.68.137-139] [PMID] []
  17. Asgharnia M, Pakseresht S, Hosseinzadeh F, Kazemi S, Rojaie F. Acute Complications of Blood Transfusion and Related Factors at Al-Zahra Educational, Therapeutic, and Research Center in Rasht (2009-2014). Iranian Journal of Surgery 2016; 4: 52. [Article in Farsi]
  18. Sharma DK, Datta S, Gupta A. Study of acute transfusion reactions in a teaching hospital of Sikkim: A hemovigilance initiative. Indian J Pharmacol 2015; 47(4): 370-4. [DOI:10.4103/0253-7613.161257] [PMID] []
  19. Yıldız A, Evren G, Zihar B, Yaman S. Non-hemolytic acute transfusion reactions: the impact of patient and blood product characteristics. Postgrad Med 2024; 136(7): 726-30. [DOI:10.1080/00325481.2024.2396797] [PMID]
  20. Aminiahidashti H, Bozorgi F, Montazer H, Zeinali F, Seyed Jaber S J. Acute Outcomes of Blood Transfusions in Patients Admitted to Emergency Department. J Mazandaran Univ Med Sci 2016; 25(134): 324-8. [Article in Farsi]
  21. Muche Y, Gelaw Y, Atnaf A, Getaneh Z. Blood transfusion complications and associated factors among blood-transfused adult patients at Debre Markos Comprehensive Specialized Hospital, Ethiopia: A cross sectional study. J Blood Med 2023; 14: 389-98. [DOI:10.2147/JBM.S412002] [PMID] []
  22. Mardani A, Balali MR. Transfusion reactions: A retrospective analysis of the Iranian national haemovigilance system (INHS) data. Transfus Apher Sci 2020; 59(4): 102767. [DOI:10.1016/j.transci.2020.102767] [PMID]





Prevalence and Effective factors for Acute Transfusion
Reactions in Hospitals of Alborz Province (2018-2021):
A Cross-Sectional Study

Shima Jadidi1, Fariba Habibian Sezavar2,3, Fatemeh Amrollahi2,3, Seyed Mohammad Miri2,3,
Mahdieh Mehrpouri1


1School of Allied Medical Sciences, Alborz University of Medical Sciences, Karaj, Iran
2Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
3Alborz Blood Transfusion Center, Karaj, Iran

Received: 2025/07/15
Accepted: 2025/09/30
 





    http://dx.doi.org/10.61186/bloodj.22.1.11
    



Citation:
Jadidi Sh, Habibian Sezavar F, Amrollahi F, Miri S.M, Mehrpouri M. Prevalence and Effective factors for Acute Transfusion Reactions in Hospitals of Alborz Province (2018-2021): A Cross-Sectional Study . J Iran Blood Transfus. 2025: 22 (4): 277-284
    



Correspondence: Mehrpouri M, Assistant professor of School of Allied Medical Sciences, Alborz University of Medical Sciences.
P.O.Box: 3149969415, Karaj, Iran.
Tel: (+9826) 34287341
E-mail:
1- Acridine Orange
1- Biological safety cabinet
1- Platelet Concentrate
2- Food and Drug Administration
3- Normal Skin Flora
4- Platelet Rich Plasma-Platelet Concentrate
5- Eosin-Methylene blue
6- Thioglycolate
1- Acridine Orange
1- Biological safety cabinet
1- Platelet Concentrate
2- Food and Drug Administration
3- Normal Skin Flora
4- Platelet Rich Plasma-Platelet Concentrate
5- Eosin-Methylene blue
6- Thioglycolate
mahdiyemehrpoori@gmail.com		 A B S T R A C T
Background and Objectives
Blood transfusion is one of the major achievements of medicine that can save patients’ lives; However, it may also be associated with acute reactions. This study aimed to investigate the prevalence of acute transfusion reactions (ATRs) and their associations with age, sex, underlying diseases, blood group, history of blood product transfusion, and hospital type.
Materials and Methods
This cross-sectional study examined 539 patients with acute transfusion reactions among 235,124 transfused blood products administered in hospitals of Alborz Province between 2018 and 2021. Collected data included age, sex, underlying diseases, blood group, history of blood product transfusion, and type of acute reaction. The data were analyzed using Jamovi software (version 2.6) and R software (version 4.4).
Results
The results showed that, the most common acute transfusion reactions were allergic reactions, accounting for 48.9% of all acute reactions and 0.11% of all transfused blood products, and febrile non-hemolytic transfusion reactions (FNHTR), accounting for 35.8% of all acute reactions and 0.08% of all transfused blood products. No significant associations were observed between ATRs and sex, blood group, underlying diseases, and history of blood product transfusion. However, age showed a significant negative association with the occurrence of allergic reactions (p < 0.001).
Conclusions 
Allergic reactions and FNHTR were the most frequent acute transfusion reactions. Although most demographic and clinical variables were not significantly related to ATRs, age was found to play an important role in allergic reactions. These findings underscore the need for larger and more rigorous studies to better predict transfusion-related complications and enhance transfusion safety.
Key words: Transfusion Reaction, Hypersensitivity, Febrile Non-Hemolytic Transfusion Reaction, Age Factors, Hospitals, Blood Transfusion

 
Copyright © 2025 Journal of Iranian Blood Transfusion, Published by Blood Transfusion Research Center.
This work is licensed under a Creative Common Attribution-Non Commercial 4.0 International license.





 
Type of Study: Research | Subject: Blood Transfusion
References
1. Clevenger B, Kelleher A. Hazards of blood transfusion in adults and children. Continuing Education in Anaesthesia Critical Care & Pain 2014; 14(3): 112-8. [DOI:10.1093/bjaceaccp/mkt042] [DOI:10.1093/bjaceaccp/mkt042]
2. Amiri F, Jambbozorg H, Biglarii M, Mohammadi A, Afshari M, Seyedi S. Survey on the blood transfusion-related reactions in blood recipients referred to Hamadan hospitals in 2018-2019. J Iran Blood Transfus 2021; 18(2): 87-96. [Article in Farsi]
3. Moncharmont P. Adverse transfusion reactions in transfused children. Transfus Clin Biol 2019; 26(4): 329-35. [DOI:10.1016/j.tracli.2019.08.002] [PMID] [DOI:10.1016/j.tracli.2019.08.002] [PMID]
4. Panch SR, Montemayor-Garcia C, Klein HG. Hemolytic Transfusion Reactions. N Engl J Med 2019; 381(2): 150-62. [DOI:10.1056/NEJMra1802338] [PMID] [DOI:10.1056/NEJMra1802338] [PMID]
5. Hendrickson JE, Roubinian NH, Chowdhury D, Brambilla D, Murphy EL, Wu Y, et al. Incidence of transfusion reactions: a multicenter study utilizing systematic active surveillance and expert adjudication. Transfusion 2016; 56(10): 2587-96. [DOI:10.1111/trf.13730] [PMID] [] [DOI:10.1111/trf.13730] [PMID] []
6. Ackfeld T, Schmutz T, Guechi Y, Le Terrier C. Blood Transfusion Reactions-A Comprehensive Review of the Literature including a Swiss Perspective. J Clin Med 2022; 11(10): 2859. [DOI:10.3390/jcm11102859] [PMID] [] [DOI:10.3390/jcm11102859] [PMID] []
7. Rogers MA, Rohde JM, Blumberg N. Haemovigilance of reactions associated with red blood cell transfusion: comparison across 17 Countries. Vox Sang 2016; 110(3): 266-77. [DOI:10.1111/vox.12367] [PMID] [] [DOI:10.1111/vox.12367] [PMID] []
8. U.S.Food and Drug Administration. Fatalities Reported to FDA Following Blood Collection and Transfusion: Annual Summary for Fiscal Year 2020. FDA; 2020. Available from: https://www.fda.gov/media/186751/download.
9. Oyekan F, McAleese H, Ahmed M, Booth C, Bowles L, Murphy MF, et al. Quantifying Harms Associated With Red Cell ABO Incompatible Blood Transfusion: A Systematic Review of the UK SHOT Literature. Transfus Med Rev 2025; 39(3): 150906. [DOI:10.1016/j.tmrv.2025.150906] [PMID] [DOI:10.1016/j.tmrv.2025.150906] [PMID]
10. Wang H, Ren D, Sun H, Liu J. Research progress on febrile non-hemolytic transfusion reaction: a narrative review. Ann Transl Med 2022; 10(24): 1401. [DOI:10.21037/atm-22-4932] [PMID] [] [DOI:10.21037/atm-22-4932] [PMID] []
11. Savage WJ, Tobian AA, Savage JH, Wood RA, Schroeder JT, Ness PM. Scratching the surface of allergic transfusion reactions. Transfusion 2013; 53(6): 1361-71. [DOI:10.1111/j.1537-2995.2012.03892.x] [PMID] [] [DOI:10.1111/j.1537-2995.2012.03892.x] [PMID] []
12. Kracalik I, Mowla S, Basavaraju SV, Sapiano MR. Transfusion‐related adverse reactions: Data from the National Healthcare Safety Network Hemovigilance Module-United States, 2013-2018. Transfusion 2021; 61(5): 1424-34. [DOI:10.1111/trf.16362] [PMID] [DOI:10.1111/trf.16362] [PMID]
13. Khalid S, Usman M, Khurshid M. Acute transfusion reactions encountered in patients at a tertiary care center. J Pak Med Assoc 2010; 60(10): 832-6.
14. Lemssahli I, Benajiba M, Belmekki A. Review of haemovigilance at the Rabat Regional Blood Transfusion Centre in Morocco (2017-2021). Pan Afr Med J 2024; 47: 60. [DOI:10.11604/pamj.2024.47.60.42250] [PMID] [] [DOI:10.11604/pamj.2024.47.60.42250] [PMID] []
15. Bodaghkhan F, Ramzi M, Vazirian S, Ahmadi M, Hajebi Rajabi M, Kohan N, et al . The prevalence of acute blood transfusion reactions in Nemazee Hospital. J Iran Blood Transfus 2014; 11(3): 247-51. [Article in Farsi]
16. Azizi S, Tabary SZ, Soleimani A. Prevalence of acute blood transfusion reactions in Mazandaran Heart Center, Sari, Iran, 2010-2012. Med Arch 2014; 68(2): 137-9. [DOI:10.5455/medarh.2014.68.137-139] [PMID] [] [DOI:10.5455/medarh.2014.68.137-139] [PMID] []
17. Asgharnia M, Pakseresht S, Hosseinzadeh F, Kazemi S, Rojaie F. Acute Complications of Blood Transfusion and Related Factors at Al-Zahra Educational, Therapeutic, and Research Center in Rasht (2009-2014). Iranian Journal of Surgery 2016; 4: 52. [Article in Farsi]
18. Sharma DK, Datta S, Gupta A. Study of acute transfusion reactions in a teaching hospital of Sikkim: A hemovigilance initiative. Indian J Pharmacol 2015; 47(4): 370-4. [DOI:10.4103/0253-7613.161257] [PMID] [] [DOI:10.4103/0253-7613.161257] [PMID] []
19. Yıldız A, Evren G, Zihar B, Yaman S. Non-hemolytic acute transfusion reactions: the impact of patient and blood product characteristics. Postgrad Med 2024; 136(7): 726-30. [DOI:10.1080/00325481.2024.2396797] [PMID] [DOI:10.1080/00325481.2024.2396797] [PMID]
20. Aminiahidashti H, Bozorgi F, Montazer H, Zeinali F, Seyed Jaber S J. Acute Outcomes of Blood Transfusions in Patients Admitted to Emergency Department. J Mazandaran Univ Med Sci 2016; 25(134): 324-8. [Article in Farsi]
21. Muche Y, Gelaw Y, Atnaf A, Getaneh Z. Blood transfusion complications and associated factors among blood-transfused adult patients at Debre Markos Comprehensive Specialized Hospital, Ethiopia: A cross sectional study. J Blood Med 2023; 14: 389-98. [DOI:10.2147/JBM.S412002] [PMID] [] [DOI:10.2147/JBM.S412002] [PMID] []
22. Mardani A, Balali MR. Transfusion reactions: A retrospective analysis of the Iranian national haemovigilance system (INHS) data. Transfus Apher Sci 2020; 59(4): 102767. [DOI:10.1016/j.transci.2020.102767] [PMID] [DOI:10.1016/j.transci.2020.102767] [PMID]
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