Transfüzyon Tıbbı: Günümüzde yeteri kadar güvenli mi?

Öz

Transfüzyon tıbbı, bilimsel ve teknolojik gelişmelerin etkisiyle son yıllarda güvenlik açısından kayda değer ilerlemeler kaydetmiştir. Bu gelişmelere rağmen kan transfüzyonu, halen ciddi riskleri olan bir tedavi modalitesi olmaya devam etmektedir. Bu derleme, donör seçimi, laboratuvar taraması, hemovijilans sistemleri ve yeni ortaya çıkan teknolojiler de dahil olmak üzere transfüzyon güvenliğindeki mevcut standartları ve gelecek perspektiflerini değerlendirmektedir. Derleme, transfüzyon tıbbının her zamankinden daha güvenli olmasına rağmen henüz tam bir güvenliğe ulaşılamadığı sonucuna varmaktadır. Gelecekte optimum transfüzyon güvenliğine ulaşmak için sürekli gözetim, küresel standardizasyon, ileri teknolojilerin entegrasyonu ve disiplinler arası iş birliği şarttır.

Anahtar Kelimeler

• Eritrosit
• Hemovijilans
• Transfüzyon
• Trombosit.

Transfusion Medicine: Is It Safe Enough Today?

Öz

Transfusion medicine has made significant advances in safety in recent years, driven by scientific and technological advances. Despite these advances, blood transfusion remains a treatment modality with significant risks. This review evaluates current standards and future perspectives in transfusion safety, including donor selection, laboratory screening, hemovigilance systems, and emerging technologies. The review concludes that while transfusion medicine is safer than ever, complete safety has not yet been achieved. To achieve optimal transfusion safety in the future, continuous surveillance, global standardization, integration of advanced technologies, and interdisciplinary collaboration are essential.

Anahtar Kelimeler

• Erythrocyte
• Hemovigilance
• Platelet
• Transfusion.

Kaynakça

1. Landsteiner K. Zur Kenntnis der antifermentativen, lytischen und agglutinierenden Wirkungen des Blutserums und der Lymphe. Zentralblatt Bakteriologie 1900;27:357–362.
2. Chiavetta JA, Escobar M, Newman A, et al. Incidence and estimated rates of residual risk for HIV, hepatitis C, hepatitis B and human T-cell lymphotropic viruses in blood donors in Canada, 1990-2000. CMAJ 2003;169(8):767-773.
3. WHO Guidelines Approved by the Guidelines Review Committee. Screening Donated Blood for Transfusion-Transmissible Infections: Recommendations. World Health Organization (Accessed Date: 05.11.2025).
4. Wood EM, Ang AL, Bisht A, et al. International haemovigilance: what have we learned and what do we need to do next? Transfus Med (Oxford) 2019;29(4):221-230.
5. National Hemovigilance Guide Version 2 (2020). [https://shgmkanhizmetleridb.saglik.gov.tr/TR71524/ulusal-hemovijilans-rehberi-versiyon-2-2020.html#](https://shgmkanhizmetleridb.saglik.gov.tr/TR71524/ulusal-hemovijilans-rehberi-versiyon-2-2020.html#) (accessed: 23/11/2025).
6. Vuk T, Politis C, Laspina S, et al. Thirty years of hemovigilance - achievements and future perspectives. Transfus Clin Biol 2023;30(1):166-172.
7. Brown C, Brown M. Blood and blood products transfusion errors: what can we do to improve patient safety? Br J Nurs 2023;32(7):326-332.
8. Riaz M, Abbas M, Rasool G, et al. Prevalence of transfusion-transmitted infections in multiple blood transfusion-dependent thalassemic patients in Asia: a systemic review. Int J Immunopathol Pharmacol 2022;36:3946320221096909.

9. Garraud O, Hamzeh-Cognasse H, Chalayer E, et al. Platelet transfusion in adults: an update. Transfus Clin Biol 2023;30(1):147-165.
10. Stewart AG, Kotton CN. Impact of blood donation biovigilance and transfusion-transmitted infections on organ transplantation. Transpl Infect Dis 2024;26 Suppl 1:e14324.
11. Lanteri MC, Santa-Maria F, Laughhunn A, et al. Inactivation of a broad spectrum of viruses and parasites by photochemical treatment of plasma and platelets using amotosalen and ultraviolet A light. Transfusion 2020;60(6):1319-1331.
12. Qadri SM, Chen D, Schubert P, et al. Pathogen inactivation by riboflavin and ultraviolet light illumination accelerates the red blood cell storage lesion and promotes eryptosis. Transfusion 2017;57(3):661-673.
13. Oikawa S, Minegishi M, Endo K, et al. Impact of the platelet washing process on in vitro platelet properties, and the levels of soluble CD40 ligand and platelet-derived microparticles in the storage media. Transfusion 2019;59(3):1080-1089.
14. Wang Y, Rao Q, Li X. Adverse transfusion reactions and what we can do. Expert Rev Hematol 2022;15(8):711-726.
15. Bansal N, Raturi M, Singh C, et al. Immunological complications of blood transfusion: current insights and advances. Curr Opin Immunol 2025;96:102617.
16. Zulkeflee RH, Hassan MN, Hassan R, et al. Acute hemolytic transfusion reaction following ABO-mismatched platelet transfusion: two case reports. Transfus Apher Sci 2023;62(3):103658.
17. Ackfeld T, Schmutz T, Guechi Y, et al. Blood transfusion reactions - a comprehensive review of the literature including a Swiss perspective. J Clin Med 2022;11(10).
18. van den Akker TA, Grimes ZM, Friedman MT. Transfusion-associated circulatory overload and transfusion-related acute lung injury. Am J Clin Pathol 2021;156(4):529-539.
19. Tanhehco YC. Red blood cell transfusion. Clin Lab Med 2021;41(4):611-619.
20. Yanagisawa R, Shimodaira S, Sakashita K, et al. Factors related to allergic transfusion reactions and febrile non-haemolytic transfusion reactions in children. Vox Sang 2016;110(4):376-384.
21. Martí-Carvajal AJ, Solà I, González LE, et al. Pharmacological interventions for the prevention of allergic and febrile non-haemolytic transfusion reactions. Cochrane Database Syst Rev 2010;2010(6):CD007539.
22. Mowla SJ, Kracalik IT, Sapiano MRP, et al. A comparison of transfusion-related adverse reactions among apheresis platelets, whole blood-derived platelets, and platelets subjected to pathogen reduction technology as reported to the National Healthcare Safety Network Hemovigilance Module. Transfus Med Rev 2021;35(2):78-84.
23. Reverberi R, Ferrari L, Gennari M, et al. Prevention of non-hemolytic transfusion reactions with leucocyte-poor blood: a prospective study. Haematologica 1989;74(3):283-288.
24. Pruss A, Kalus U, Radtke H, et al. Universal leukodepletion of blood components results in a significant reduction of febrile non-hemolytic but not allergic transfusion reactions. Transfus Apher Sci 2004;30(1):41-46.
25. Wang H, Ren D, Sun H, et al. Research progress on febrile non-hemolytic transfusion reaction: a narrative review. Ann Transl Med 2022;10(24):1401.
26. Hirayama F. Current understanding of allergic transfusion reactions: incidence, pathogenesis, laboratory tests, prevention and treatment. Br J Haematol 2013;160(4):434-444.
27. Yanagisawa R. Preventing adverse reactions in pediatric transfusions using washed platelet concentrate. Pediatr Int 2021;63(4):391-403.
28. Hmida MA, Mahjoub S, Ben Hamed L, et al. Transfusion safety: is there a difference between reported reactions in low-to-middle income and high-income countries? Transfus Apher Sci 2024;63(3):103916.
29. Kiyatkin ME, Mladinov D, Jarzebowski ML, et al. Patient blood management, anemia, and transfusion optimization across surgical specialties. Anesthesiol Clin 2023;41(1):161-174.
30. National Blood and Blood Components Preparation, Use and Quality Assurance Guide 2016. [https://shgmkanhizmetleridb.saglik.gov.tr/TR-71523/ulusal-kan-ve-kanbilesenleri-hazirlama--kullanim-ve-kalite-guvencesi-rehberi-2016.html#](https://shgmkanhizmetleridb.saglik.gov.tr/TR-71523/ulusal-kan-ve-kanbilesenleri-hazirlama--kullanim-ve-kalite-guvencesi-rehberi-2016.html#) (accessed: 23/11/2025).
31. Aubron C, Aries P, Le Niger C, et al. How clinicians can minimize transfusion-related adverse events? Transfus Clin Biol 2018;25(4):257-261.
32. Abdallah R, Rai H, Panch SR. Transfusion reactions and adverse events. Clin Lab Med 2021;41(4):669-696.
33. Anstey C, Ullman D, Su L, et al. The practical use of artificial intelligence in transfusion medicine and apheresis. Transfus Apher Sci 2024;63(6):104001.