Transfusion-Associated Necrotising Enterocolitis (TANEC): Necrotising enterocolitis (a serious neonatal gastrointestinal condition associated with significant morbidity and mortality) occurring within 48 hours of a blood transfusion.
Frequency: Not known; some clinicians do not believe the cause of the NEC is transfusion, but instead that it is related to the hypoxia of tissues in the gut due to anaemia; SHOT state that this appears to be under-reported.
Reducing the risk: Some clinicians advocate withholding enteral feeds to neonates receiving a transfusion for a period of time prior to, during and after transfusion.
Transfusion-Associated Graft versus Host Disease (TA-GvHD): Engraftment and clonal expansion of viable donor lymphocytes in a susceptible host, characterised by fever, rash, liver dysfunction, diarrhoea, pancytopenia and bone marrow hypoplasia occurring less than 30 days after transfusion.
Frequency: Very Rare (<1/10,000).
Reducing the risk: In most cases TA-GvHD is fatal. Irradiation of cellular blood components (red cells, platelets, granulocytes) greatly reduces occurrence - if your patient might be at risk of TA-GvHD you must ensure the need for irradiated blood components is clearly communicated.
Since 1999 all allogeneic blood components produced in the UK have been subjected to a leucocyte depletion process, with very few stated exceptions (e.g. granulocytes).
No cases of TA-GvHD have been reported in patients receiving leucodepleted components. However, as it cannot be assured that leucodepletion is fully protective, irradiation is still required.
Further information/ resources: **NHSBT clinical information sheet is currently under review**
Unknown risks
There is an established network in the UK which continually collates and analyses reports of adverse reactions and events related to transfusion (the SHOT haemovigilance system). This enables any new emerging safety concerns or trends to be identified and addressed promptly.