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<p>Transfusion-related adverse events (TRAEs) remain clinically relevant, yet component-specific risk estimates are often derived from single-center registries and may not represent routine practice across a region. We performed a retrospective cohort analysis using a citywide transfusion traceability and hemovigilance platform in a prefectural-level city in China (January 1, 2021–December 31, 2023). Allogeneic transfusion episodes involving red blood cells (RBCs), platelets (PLTs), fresh frozen plasma (FFP), or cryoprecipitate (Cryo) were eligible. TRAEs were defined and adjudicated according to CDC/NHSN hemovigilance criteria within the network. Multivariable logistic regression was used to evaluate predictors of overall TRAEs and of the two most common subtypes: febrile non-hemolytic transfusion reactions (FNHTRs) and allergic reactions. Among 220,000 transfusion episodes, 726 (0.33%) were associated with TRAEs. FNHTRs (55.4%) and allergic reactions (36.8%) accounted for most events. Older age, higher pre-transfusion temperature, lower hemoglobin, reduced left ventricular ejection fraction (LVEF), and diabetes mellitus were independently associated with overall TRAEs. Compared with RBC exposure, PLTs (OR 1.571, 95% CI 1.305–1.891) and FFP (OR 1.322, 95% CI 1.067–1.638) were associated with higher TRAE risk. FNHTR risk tracked with older age, febrile status, anemia, reduced cardiac function, and non-RBC components, whereas allergic reactions were more frequent in younger and female recipients and were particularly linked to PLT and FFP exposure. Cryo was not independently associated with either subtype. TRAEs were uncommon in this regional network, but risks varied by both recipient profile and component type. These real-world patterns support component-aware monitoring and targeted prevention in routine transfusion workflows.</p>

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Differential Risk Profiles of Blood Components in Transfusion-Related Adverse Events: A Cohort Analysis from a Citywide Surveillance Network

  • 期刊论文

  • 发表日期：

    2026年5月26日

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  • Wei Bai,
  • Juan Li

摘要

Transfusion-related adverse events (TRAEs) remain clinically relevant, yet component-specific risk estimates are often derived from single-center registries and may not represent routine practice across a region. We performed a retrospective cohort analysis using a citywide transfusion traceability and hemovigilance platform in a prefectural-level city in China (January 1, 2021–December 31, 2023). Allogeneic transfusion episodes involving red blood cells (RBCs), platelets (PLTs), fresh frozen plasma (FFP), or cryoprecipitate (Cryo) were eligible. TRAEs were defined and adjudicated according to CDC/NHSN hemovigilance criteria within the network. Multivariable logistic regression was used to evaluate predictors of overall TRAEs and of the two most common subtypes: febrile non-hemolytic transfusion reactions (FNHTRs) and allergic reactions. Among 220,000 transfusion episodes, 726 (0.33%) were associated with TRAEs. FNHTRs (55.4%) and allergic reactions (36.8%) accounted for most events. Older age, higher pre-transfusion temperature, lower hemoglobin, reduced left ventricular ejection fraction (LVEF), and diabetes mellitus were independently associated with overall TRAEs. Compared with RBC exposure, PLTs (OR 1.571, 95% CI 1.305–1.891) and FFP (OR 1.322, 95% CI 1.067–1.638) were associated with higher TRAE risk. FNHTR risk tracked with older age, febrile status, anemia, reduced cardiac function, and non-RBC components, whereas allergic reactions were more frequent in younger and female recipients and were particularly linked to PLT and FFP exposure. Cryo was not independently associated with either subtype. TRAEs were uncommon in this regional network, but risks varied by both recipient profile and component type. These real-world patterns support component-aware monitoring and targeted prevention in routine transfusion workflows.