ABO/RhD-mismatch transfusions are frequently encountered in clinical practice, so a systematic and thorough understanding of these events is necessary. In the case of ABO minor-incompatible transfusions, it is important to consider the possibility of hemolytic transfusion reactions because of the reaction between the ABO antibodies in the blood product and the patient’s red blood cells. For platelet products, the risk is approximately 1 in 9,000.In ABO major-incompatible transfusions, red blood cell products are contraindicated, but plasma or platelet products may be allowed in situations such as blood product shortages. In RhD major-incompatible transfusions, the use of Rh immunoglobulin to prevent alloimmunization may be considered depending on the patient’s clinical status and the availability of blood products. In the case of RhD major-incompatible red blood cell transfusions, however, such prevention is difficult to apply in Korea. ABO/RhD-mismatch transfusion may also affect the long-term outcomes of patients, in addition to immediate hemolytic transfusion reactions. Therefore, decisions must be made based on the patient’s clinical situation considering the benefits and potential risks.

A 64-year-old male patient diagnosed with B-cell lymphoma required regular platelet transfusions due to persistent thrombocytopenia. Over time, he developed severe transfusion-related allergic reactions, including anaphylaxis, necessitating the use of washed apheresis platelets (W-APLT). However, as the designated blood center was unable to produce W-APLT, the issue was resolved by collaborating with a neighboring blood center to source the product.Key strategies included verifying the patient’s history of transfusion-related anaphylaxis, coordinating the production schedule of blood products, and implementing administrative procedures such as pre-scheduled ambulance transport on the day of transfusion. These measures ensured the timely supply of W-APLT while minimizing the risk of product wastage. As a result, the patient successfully received multiple W-APLT transfusions without further allergic reactions. This case serves as a model for overcoming infrastructure limitations in W-APLT supply through hospital-blood center collaboration, to provide timely and safe blood products to patients at risk of severe transfusion-related allergic reactions and anaphylaxis.

This study reviewed allergic transfusion reactions (ATRs) and the efficacy of pre-transfusion antihistamine (PreTAH) administration. Studies have shown that PreTAH does not prevent all ATRs and provides no significant benefit over non-administration groups. Instead, they may cause sedation, increase the burden on medical staff, and lack cost-effectiveness. Most transfused patients do not experience ATRs; except for anaphylaxis, they pose minimal risk. Thus, the decision to administer PreTAH should carefully weigh the benefits and risks. Routine PreTAH use in all transfusion patients is not recommended. Instead, PreTAH should be reserved for patients with a high risk of allergic reactions based on their medical history and risk factors.

In 2023, blood donations from registered donors at the Korean Red Cross Blood Centers accounted for 72.6% of blood donations from the Korean Red Cross, helping secure blood equivalent to 65.9% of entire blood donations, 87.6% of plasmapheresis, and 95.1% of platelets component donations. The number of newly registered blood donors increased from 94,998 in 2017 to 218,767 in 2023, and 1,928,053 donors were registered as of December 2023. The age distribution of registered blood donors showed that teenagers and people in their 20s accounted for approximately 70% of the total. Nevertheless, additional research on the blood donation status according to the age of new and cumulative registered blood donors is needed to manage blood donation resources.

ABO/RhD-mismatch transfusions are frequently encountered in clinical practice, so a systematic and thorough understanding of these events is necessary. In the case of ABO minor-incompatible transfusions, it is important to consider the possibility of hemolytic transfusion reactions because of the reaction between the ABO antibodies in the blood product and the patient’s red blood cells. For platelet products, the risk is approximately 1 in 9,000.In ABO major-incompatible transfusions, red blood cell products are contraindicated, but plasma or platelet products may be allowed in situations such as blood product shortages. In RhD major-incompatible transfusions, the use of Rh immunoglobulin to prevent alloimmunization may be considered depending on the patient’s clinical status and the availability of blood products. In the case of RhD major-incompatible red blood cell transfusions, however, such prevention is difficult to apply in Korea. ABO/RhD-mismatch transfusion may also affect the long-term outcomes of patients, in addition to immediate hemolytic transfusion reactions. Therefore, decisions must be made based on the patient’s clinical situation considering the benefits and potential risks.

A 64-year-old male patient diagnosed with B-cell lymphoma required regular platelet transfusions due to persistent thrombocytopenia. Over time, he developed severe transfusion-related allergic reactions, including anaphylaxis, necessitating the use of washed apheresis platelets (W-APLT). However, as the designated blood center was unable to produce W-APLT, the issue was resolved by collaborating with a neighboring blood center to source the product.Key strategies included verifying the patient’s history of transfusion-related anaphylaxis, coordinating the production schedule of blood products, and implementing administrative procedures such as pre-scheduled ambulance transport on the day of transfusion. These measures ensured the timely supply of W-APLT while minimizing the risk of product wastage. As a result, the patient successfully received multiple W-APLT transfusions without further allergic reactions. This case serves as a model for overcoming infrastructure limitations in W-APLT supply through hospital-blood center collaboration, to provide timely and safe blood products to patients at risk of severe transfusion-related allergic reactions and anaphylaxis.

This study reviewed allergic transfusion reactions (ATRs) and the efficacy of pre-transfusion antihistamine (PreTAH) administration. Studies have shown that PreTAH does not prevent all ATRs and provides no significant benefit over non-administration groups. Instead, they may cause sedation, increase the burden on medical staff, and lack cost-effectiveness. Most transfused patients do not experience ATRs; except for anaphylaxis, they pose minimal risk. Thus, the decision to administer PreTAH should carefully weigh the benefits and risks. Routine PreTAH use in all transfusion patients is not recommended. Instead, PreTAH should be reserved for patients with a high risk of allergic reactions based on their medical history and risk factors.

In 2023, blood donations from registered donors at the Korean Red Cross Blood Centers accounted for 72.6% of blood donations from the Korean Red Cross, helping secure blood equivalent to 65.9% of entire blood donations, 87.6% of plasmapheresis, and 95.1% of platelets component donations. The number of newly registered blood donors increased from 94,998 in 2017 to 218,767 in 2023, and 1,928,053 donors were registered as of December 2023. The age distribution of registered blood donors showed that teenagers and people in their 20s accounted for approximately 70% of the total. Nevertheless, additional research on the blood donation status according to the age of new and cumulative registered blood donors is needed to manage blood donation resources.

ABO/RhD-mismatch transfusions are frequently encountered in clinical practice, so a systematic and thorough understanding of these events is necessary. In the case of ABO minor-incompatible transfusions, it is important to consider the possibility of hemolytic transfusion reactions because of the reaction between the ABO antibodies in the blood product and the patient’s red blood cells. For platelet products, the risk is approximately 1 in 9,000.In ABO major-incompatible transfusions, red blood cell products are contraindicated, but plasma or platelet products may be allowed in situations such as blood product shortages. In RhD major-incompatible transfusions, the use of Rh immunoglobulin to prevent alloimmunization may be considered depending on the patient’s clinical status and the availability of blood products. In the case of RhD major-incompatible red blood cell transfusions, however, such prevention is difficult to apply in Korea. ABO/RhD-mismatch transfusion may also affect the long-term outcomes of patients, in addition to immediate hemolytic transfusion reactions. Therefore, decisions must be made based on the patient’s clinical situation considering the benefits and potential risks.

A 64-year-old male patient diagnosed with B-cell lymphoma required regular platelet transfusions due to persistent thrombocytopenia. Over time, he developed severe transfusion-related allergic reactions, including anaphylaxis, necessitating the use of washed apheresis platelets (W-APLT). However, as the designated blood center was unable to produce W-APLT, the issue was resolved by collaborating with a neighboring blood center to source the product.Key strategies included verifying the patient’s history of transfusion-related anaphylaxis, coordinating the production schedule of blood products, and implementing administrative procedures such as pre-scheduled ambulance transport on the day of transfusion. These measures ensured the timely supply of W-APLT while minimizing the risk of product wastage. As a result, the patient successfully received multiple W-APLT transfusions without further allergic reactions. This case serves as a model for overcoming infrastructure limitations in W-APLT supply through hospital-blood center collaboration, to provide timely and safe blood products to patients at risk of severe transfusion-related allergic reactions and anaphylaxis.