Recetved:7 December 2022 Accepted:21 March 2023D0L:10.1111/bh.18789BJHaemGUIDELINEGuideline on the investigation and management of acutetransfusion reactionsRichard Soutar Wendy McSporran2 Tracey Tomlinson3 Catherine Booth34Sharran GreysGarnavel General Hospital NHS Greater Glasgow and Clyde,Glasgow.UKRoyal Marsden NHS Foundation Trust,London,UKNHS Blood and Transplant,London,UKBarts Health NHS Trust.London.UKSBlackpool Teaching Hospitals NHS Foundation Trust,Blackpool,UKCorrespondenceRichard Soutar,British Society for Haematology,100 White Lion Street,London,N1 9PF,UK.Email:bshguidelines@b-s-h.org.ukFunding informationBritish Society for HaematologyKeywords:acute,reactions,transfusionMETHODOLOGYoedema'OR 'respiratory'OR 'ARDS'OR 'reaction'OR'anaphylaxis'OR'febrile reaction'OR 'allergic reaction'ORThis guideline was compiled according to the British Society'non haemolytic reaction'OR'haemolytic reaction),wrongfor Haematology (BSH)process at https://b-s-h.orguk/blood to wrong person,incompatible transfusion reaction,media/19922/bsh-guidance-development-process-july-2021.ABO-relatedincompatible transfusions.pdf.The Grading of Recommendations Assessment,Development and Evaluation (GRADE)nomenclature wasused to evaluate levels of evidence and to assess the strengthPURPOSE AND OBJECTIVESof recommendations.'The GRADE criteria can be found inAppendix S3 of the above BSH document.The purpose of this document is to provide clear guidanceon the recognition,investigation and management of acuteadverse reactions to blood components.It is clinicallyLITERATURE REVIEWfocused and recognised that the precise nature of reactionsmay not be apparent at presentation.The emphasis is onThe literature search was performed in January 2021 andthe immediate management of potentially life-threateningupdated in January 2022.With the assistance of the Oxfordreactions,but it also makes recommendations aroundSystematic Reviews Initiative (SRI),the following databasesappropriate investigation and prophylactic strategies.Thewere searched for relevant publications in English:MEDLINEkey objectives are to:(from 1950),EMBASE (from 1980),CINAHL (from 1982),The Cochrane Library,DARE (CRD website)and SRI hand1.Provide a flow diagram to aid recognition of acute trans-search databases.The initial search and filtering producedfusion reactions (ATRs)and their immediate clinical1693 systematic reviews,randomised controlled trials andmanagement;observational studies from which relevant publications were2.Advise on further management of the patient during theextractedbythe members ofthe Writing Group.Search termsreaction;include Transfusion AND (TACO'ORTRALI'OR'TAD'3.Provide advice on investigations;OR 'pulmonary complication'OR 'lung'OR pulmonary4.Discuss management of subsequent transfusions;=”””””””2023 British Society for Haematology and John Wiley Sons Ltd.832 wileyonlinelibrary.com/journal/bjhBr J HaematoL.2023:201:832-844.
