IMMUNOHEMOLYTIC TRANSFUSION REACTIONS .4. ANALYSIS, RISKS, AND PREVENTION

The immunological risk of red blood cell transfusions now seems higher than the viral risk. According to studies, severe accidents due to bl ood incompatibility occur with a frequency estimated at 1/6000 to 1/29 000; despite technical progress, the risk does not significantly dimin ish. The majority of accidents do not originate from laboratory or pro duction stages but from defects in the application of clinical procedu res. Preventive measures are based on (i) the elaboration of clinical guidelines, (ii) the compliance to strict rules in carrying out bedsid e ABO check, and (iii) the recitation and interpretation of antibody s creening tests. The implementation of quality assurance systems and of the epidemiological. surveillance system, which define the basis of a prevention policy, leads to the expectation of an improvement of tran sfusion safety.