A patient develops fever and rigors 45 minutes into a routine red cell transfusion. Temperature rises to 38.4 degrees C with no haemoglobinuria, hypotension, or respiratory distress. Direct antiglobulin test is negative. Which measure most effectively prevents recurrence?

• A Pre-transfusion antihistamine administration
• B Use of leucocyte-reduced (leucodepleted) packed red cell units ✓
• C Use of irradiated blood components
• D Slowing the transfusion rate and giving paracetamol prophylaxis

Explanation

Febrile non-haemolytic transfusion reactions result from recipient antibodies reacting against donor leucocytes and from cytokines accumulated in stored components. Leucodepletion removes the donor white cells responsible and is the single most effective preventive measure. Antihistamines and paracetamol may blunt symptoms but do not address the mechanism, and irradiation prevents graft-versus-host disease, a different entity entirely.

Reference: Williams Hematology, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.