PMID- 36660666
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230121
IS  - 2305-5839 (Print)
IS  - 2305-5847 (Electronic)
IS  - 2305-5839 (Linking)
VI  - 10
IP  - 24
DP  - 2022 Dec
TI  - Research progress on febrile non-hemolytic transfusion reaction: a narrative 
      review.
PG  - 1401
LID - 10.21037/atm-22-4932 [doi]
LID - 1401
AB  - BACKGROUND AND OBJECTIVE: About 1% of patients who receive blood transfusions 
      will develop transfusion reactions. Febrile non-hemolytic transfusion reaction 
      (FNHTR) is the most common type of transfusion reaction. It not only leads to 
      misdiagnosis and delayed treatment, but also incurs a huge economic burden. This 
      article reviews FNHTR systematically, aiming to make clinicians have a more 
      comprehensive understanding of FNHTR and reduce the occurrence of this side 
      effect. METHODS: A comprehensive search of the PubMed, Embase, and Cochrane 
      Library databases was performed. Medical Subject Headings (MeSH) included Blood 
      Transfusion, Transfusion Reaction, and Febrile Non-Hemolytic Transfusion 
      Reaction. The searches and literature screening were performed by 2 researchers; 
      any differences of opinion or results were resolved through negotiation. KEY 
      CONTENT AND FINDINGS: The pathophysiological mechanisms of FNHTR mainly included 
      immune and non-immune pathways. The former was associated with antibodies against 
      human leukocyte antigen (HLA) produced in transfused patients, while the latter 
      was associated with cytokines released from blood products during storage. Women 
      with a reproductive history and those patients with multiple blood transfusions 
      were more likely to experience FNHTR. Primary hematologic disease, malignant 
      disease, and transfusion with over 6 units of leukocyte-depleted packed red blood 
      cells were independent risk factors for the development of FNHTR. FNHTR could be 
      diagnosed by accompaniment of the fever symptom (body temperature >/=38 ℃, maybe an 
      increase of body temperature of more than 1 ℃ compared with that before blood 
      transfusion) during or within 4 hours after transfusion, or the presence of 
      chills, shakes, headache, and nausea, among other symptoms. FNHTR should be 
      mainly differentiated from other types of transfusion reactions with similar 
      symptoms. Prophylactic strategies for the routine use of antipyretic drugs before 
      transfusion remain controversial. Removal of leukocyte components from blood 
      could reduce the incidence of FNHTR significantly. CONCLUSIONS: The pathogenesis 
      of FNHTR is mainly associated with anti-HLA antibodies and cytokines released 
      from blood products during storage. Specific markers and effective detection 
      methods for FNHTR are still lacking. Treatment for FNHTR is currently limited to 
      antipyretic drugs, sedation, and other symptomatic treatment measures. More 
      studies are warranted to focus on the pathological mechanism of FNHTR.
CI  - 2022 Annals of Translational Medicine. All rights reserved.
FAU - Wang, Hekong
AU  - Wang H
AD  - Department of Procurement Service, the Characteristic Medical Center of the 
      Chinese People's Armed Police Force, Tianjin, China.
FAU - Ren, Dangli
AU  - Ren D
AD  - Institute of Nerve Trauma and Repair, the Characteristic Medical Center of the 
      Chinese People's Armed Police Force, Tianjin, China.
FAU - Sun, Hongtao
AU  - Sun H
AD  - Institute of Nerve Trauma and Repair, the Characteristic Medical Center of the 
      Chinese People's Armed Police Force, Tianjin, China.
FAU - Liu, Jiqin
AU  - Liu J
AD  - Department of Clinical Laboratory, the Characteristic Medical Center of the 
      Chinese People's Armed Police Force, Tianjin, China.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - China
TA  - Ann Transl Med
JT  - Annals of translational medicine
JID - 101617978
PMC - PMC9843350
OTO - NOTNLM
OT  - Blood transfusion
OT  - febrile non-hemolytic transfusion reaction
OT  - review
OT  - transfusion reaction
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://atm.amegroups.com/article/view/10.21037/atm-22-4932/coif). The authors 
      have no conflicts of interest to declare.
EDAT- 2023/01/21 06:00
MHDA- 2023/01/21 06:01
PMCR- 2022/12/01
CRDT- 2023/01/20 02:16
PHST- 2022/09/13 00:00 [received]
PHST- 2022/11/17 00:00 [accepted]
PHST- 2023/01/20 02:16 [entrez]
PHST- 2023/01/21 06:00 [pubmed]
PHST- 2023/01/21 06:01 [medline]
PHST- 2022/12/01 00:00 [pmc-release]
AID - atm-10-24-1401 [pii]
AID - 10.21037/atm-22-4932 [doi]
PST - ppublish
SO  - Ann Transl Med. 2022 Dec;10(24):1401. doi: 10.21037/atm-22-4932.