Patients with a history of this reaction that require additional transfusions should receive leukocyte poor transfusions. Use of a filter traps most contaminants. Urticarial reactions are characterized by erythema, hives and itching without fever. It is thought to be due to sensitization against plasma proteins. The use of packed red blood cells rather than whole blood has decreased the likelihood of this problem.
Treatment is with antihistamines for symptomatic relief.
Anaphylactic reactions are rare and occur in about 1 of 150,000 transfusions. These antibodies react to transfusions containing IgA. Treatment is with epinephrine, fluids, corticosteroids and supportive measures. IgA deficiency occurs in 1 of 600-800 patients in the general population. Patients with known IgA deficiency should receive thoroughly washed packed red blood cells, deglycerolized frozen red cells or IgA free blood units. This is a rare but serious complication that is thought to be due to the transfusion of antileukocyte antibodies that interact with the patient's white blood cells causing them to aggregate in the pulmonary circulation.