Hazards of Homologous Blood Transfusion

SUMMARY In the current era of evidence‐based medical practice, clinicians should ensure they have a good understanding of the potential benefits of and indications for potentially dangerous homologous blood component therapy. More attention is now being given to assessing the appropriateness of homologous transfusion therapy, with efforts to establish better evidence of improvements in patient outcomes. Such an approach allows for a more logical and realistic analysis of the risk/benefit equation in clinical management. In this summary of our current knowledge of the potential hazards of homologous blood transfusion, transfusion‐transmitted infections are not addressed in detail, as most of the major problems relating to HIV and viral hepatitis have been solved and good reviews are available in the literature. In this review of the potential hazards of homologous blood transfusion, the focus is on many of the other areas of concern regarding the risk/benefit equation for homologous transfusion. Transfusion‐related immunosuppression, the clinical significance of storage lesions, the potential adverse effects of leukocytes, error minimization, transfusion‐related lung injury and less well‐known immunological incompatibilities are addressed.