JPAC Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee

Febrile non-haemolytic reaction

Definition 
Febrile reactions are characterised by a rise in temperature and/or other inflammatory symptoms such as rigors, myalgia or nausea. In some cases they may require medical intervention.
The cause is not fully understood, but is thought to be due to residual white cells in the unit or cytokines built up during storage.
Usually a reaction to a specific unit of blood component, it is difficult to mitigate against and often unpredictable.

Frequency 
Mild: Common (≥1/100 to <1/10).
Moderate & Severe: Rare (≥1/10,000 to <1/1,000).

Reducing the risk 
Since the introduction of leucodepleted blood components febrile reactions have become less common. Transfusing over a longer period or temporarily stopping the transfusion and/or giving paracetamol may help.
Only a small proportion of patients will experience recurrent febrile reactions. In such cases, giving prophylactic paracetamol may reduce the incidence.

Further information/ resources
NHSBT (2015/16) Histocompatibility and Immunogenetics diagnostic services user guide
Handbook of Transfusion Medicine: 5.2 Non-infectious hazards of transfusion