Table 1 Possible consequences of variation in transfusion conditions and the type of packed red blood cells administered
Variable | Primary or immediate consequences (efficacy) | Secondary or delayed consequences (hazards) |
|---|---|---|
Total volume | Possibly needs to be adjusted according to the patient's needs | Possibly needs to be adjusted to correct for anemia |
Hematocrit | Possibly needs to be adjusted according to the patient's needs | Possibly needs to be adjusted to correct for anemia |
Residual plasma volume | Possibly includes anti-HLA antibodies (from female donors) | Increases the risk of TRALI |
Increases the risk of inflammation and aggravates the risk of TRALI | ||
Possibly affects the amount of soluble, free biological response modifiers | ||
Leukocytes | No pre-test (possibly affects donor eligibility) | |
Pre-activation of leukocytes | Increases the risk of inflammation | |
Release of biological response modifiers | ||
Release of microparticles and neutrophil extracellular | Aggravates sepsis | |
traps | Increases the risk of TRALI | |
HLA antibody targets | Increases the risk of viral infections | |
Infectious risk (intracellular viruses) | ||
Age of blood | Decreases the benefit of oxygen transport | |
Release of microparticles | Increases the risk of inflammation | |
Expression of stress signals on red blood cells | ||
Free iron release | Potentiates the risk of TRALI by stressing target | |
NO and iNOS release | neutrophils | |
Oxygenated lipid and lipid degradation | ||
Possibly increases the risk of allo-immunization |