What is the increased risk of multisystem organ failure (MSOF) following transfusion?

Updated: Apr 16, 2019
  • Author: Linda L Maerz, MD, FACS, FCCM; Chief Editor: Emmanuel C Besa, MD  more...
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Blood transfusion in trauma is an independent predictor of multisystem organ failure (MSOF). This relationship was initially described in a 3-year single-institution prospective cohort study. One of the independent predictors of MSOF proved to be greater than 6 units PRBC transfused in the first 12 hours following admission. [59]

In a second prospective study by the same group, a dose-response relationship between early blood transfusion and postinjury MSOF was identified, further cementing the relationship between transfusion, organ failure, and mortality. [60]

Despite the association of transfusion and MSOF, massive transfusion is often required after injury and saves many lives. [61] The discrepancy in these observations may reflect proteomic and genotypic differences.

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