TRANSFUSION REACTIONS - THE CHANGING PRIORITIES

Over the last dozen years the relative frequencies of specific transfu sion reactions have markedly altered, in general for the better. Altho ugh AIDS remains the Public's primary concern, the risk of AIDS from a transfusion is extremely low at this point. Hepatitis remains the mos t common infectious complication of blood transfusion, but only 1 in 6 ,000 units now carry a risk, whereas in the early 1980's the risk is b elieved to have been close to 10% per patient. Transmission of HTLV-I/ II has also been markedly reduced by tests of donor sera. In contrast, cytomegalovirus has become of increased importance in view of the lar ge number of patients immunosuppressed for transplantation and cancer therapy; bacterial growth in blood components appears to be increasing ly common; and Chagas disease is likely to become a serious transfusio n problem in this country. More widespread use of filters which remove three logs or more of white blood cells from components should play a major role in reducing transfusion reactions further.