Adverse Reactions to Blood Transfusion in Pediatric Cardiac Surgery: A Retrospective Cohort Study at a Single Center

OBJECTIVES: Blood transfusion is an integral part of pediatric cardiac surgery. Our study intends to analyze the incidence of transfusion reactions in pediatric cardiac surgery patients. Secondary objectives were to identify the common type of transfusion reaction and the factors that increase the incidence of transfusion reaction. DESIGN: Retrospective cohort study. SETTING: University-level hospital. PARTICIPANTS: Children who underwent cardiac surgery between January 2014 and October 2024 and received blood transfusions. INTERVENTIONS: Nil. MEASUREMENTS AND MAIN RESULTS: Data on blood transfusion were gathered from the institute's database and the Transfusion Reaction Register in the Department of Transfusion Medicine. Patients were evaluated based on age, gender, diagnosis, clinical history, surgical procedures and transfused blood components. Among 13,482 transfusions, 24 cases of transfusion reactions were identified. The reaction rate per 1000 units of transfusion was highest for PRBCs (24.9 per 1000 units of transfusion), followed by FFP ( 3.14 per 1000 units of transfusion). Patients with a history of prior blood transfusion had a 3.02 times higher likelihood of experiencing a transfusion reaction compared to those without prior transfusions (Odds ratio = 3.02, 95% confidence interval: 1.35-6.76). Allergic transfusion reaction was the most prevalent, accounting for 70.8% of cases. CONCLUSION: The incidence of blood transfusion reactions among pediatric cardiac surgery patients is 0.18%. Transfusion of PRBCs was the most frequent cause of reactions in this group, followed by that of FFPs.