{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:02:31Z","timestamp":1781071351589,"version":"3.54.1"},"reference-count":43,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T00:00:00Z","timestamp":1774742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T00:00:00Z","timestamp":1774742400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Whole blood (WB) transfusion for major hemorrhage in Western civilian settings has seen a resurgence over the past two decades. This study aims to determine the rate and type of adverse reactions (ARs) following WB transfusion in Norway between 2021 and 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>This retrospective quality surveillance study analyzed, validated, and aggregated all digital reports of ARs after WB transfusion submitted to the Norwegian Hemovigilance system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven ARs were identified, corresponding to an incidence rate of 2.53 per 1000 WB transfusions (7 per 2766 transfusions) or 0.253% (95% CI: 0.123%\u20130.521%). Three cases were classified as acute hemolytic transfusion reactions: one due to ABO minor incompatibility, one to anti\u2010Jk\n                      <jats:sup>a<\/jats:sup>\n                      , and one associated with an unidentified red blood cell alloantibody. One case involved respiratory distress and was diagnosed as transfusion\u2010associated dyspnea. Two reactions were allergic: one mild and one fulfilling the criteria for transfusion\u2010associated anaphylaxis. The most severe case involved cardiac arrest, probably due to hyperkalemia and hypocalcemia following massive transfusion, but the patient made a full recovery after defibrillation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These findings indicate that WB transfusion in Norway is safe. However, there are inherent risks for blood transfusion in general and also risks more specific to WB transfusion. These include the presence of red blood cell alloantibodies anti\u2010A and anti\u2010B combined with approximately 250\u2009mL plasma from a single donor. Accurate and timely hemovigilance work is important to safeguard patient outcomes and provide a foundation for targeted risk mitigation strategies for WB transfusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.70193","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T04:45:18Z","timestamp":1774845918000},"page":"1099-1107","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transfusion reactions after whole blood transfusion in Norway, 2021\u20132024: A report from the Norwegian Hemovigilance program"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8112-3667","authenticated-orcid":false,"given":"Bjarte Skoe","family":"Erikstein","sequence":"first","affiliation":[{"name":"Norwegian Medical Product Agency  Oslo Norway"},{"name":"Department of Immunology and Transfusion Medicine Haukeland University Hospital  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas Larsen","family":"Titze","sequence":"additional","affiliation":[{"name":"Norwegian Medical Product Agency  Oslo Norway"},{"name":"Department of Laboratory Medicine Vestre Viken Health Trust  Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbora","family":"Jacobsen","sequence":"additional","affiliation":[{"name":"Norwegian Medical Product Agency  Oslo Norway"},{"name":"Department of Immunology and Transfusion Medicine St. Olav University Hospital  Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tor","family":"Hervig","sequence":"additional","affiliation":[{"name":"Stavanger University Hospital  Stavanger Norway"},{"name":"Norwegian Centre for Blood Preparedness  Bergen Norway"},{"name":"Department of Clinical Science, Faculty of Medicine University of Bergen  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Are","family":"Engum","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Haukeland University Hospital  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8823-2719","authenticated-orcid":false,"given":"Torunn Oveland","family":"Apelseth","sequence":"additional","affiliation":[{"name":"Department of Immunology and Transfusion Medicine Haukeland University Hospital  Bergen Norway"},{"name":"Norwegian Centre for Blood Preparedness  Bergen Norway"},{"name":"Department of Clinical Science, Faculty of Medicine University of Bergen  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d8ystein","family":"Flesland","sequence":"additional","affiliation":[{"name":"Norwegian Medical Product Agency  Oslo Norway"},{"name":"Division of Surgery Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yasu.2023.04.006"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000004000"},{"issue":"3","key":"e_1_2_10_4_1","first-page":"S105","article-title":"Current transfusion practice and need for new blood products to ensure blood supply for patients with major hemorrhage in Europe","volume":"63","author":"Apelseth TO","year":"2023","journal-title":"Transfusion"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12998"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-022-01051-z"},{"issue":"1","key":"e_1_2_10_7_1","first-page":"S22","article-title":"A whole blood based resuscitation strategy in civilian medical services: experience from a Norwegian hospital in the period 2017\u20132020","volume":"61","author":"Hagen KG","year":"2021","journal-title":"Transfusion"},{"issue":"1","key":"e_1_2_10_8_1","first-page":"S22","article-title":"The Norwegian blood preparedness project: a whole blood program including civilian walking blood banks for early treatment of patients with life\u2010threatening bleeding in municipal health care services, ambulance services, and rural hospitals","volume":"62","author":"Apelseth TO","year":"2022","journal-title":"Transfusion"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.15184"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usaf080"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13031-024-00635-z"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.13441"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2023.02.010"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2021.10.003"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2024.161892"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/XCS.0000000000001440"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1989.29890020439.x"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781118689943"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/biot.200800182"},{"key":"e_1_2_10_20_1","first-page":"280","article-title":"Leukocytes in blood transfusion: adverse effects and their prevention","volume":"5","author":"Chu RW","year":"1999","journal-title":"Hong Kong Med J"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1309\/D3F7BXH466AE3G0P"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1978.18478251249.x"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-007-2875-1"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/tme.12582"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2013.09.013"},{"key":"e_1_2_10_26_1","volume-title":"Overv\u00e5kning av blod i Norge \u2010 transfusjonskomplikasjoner","author":"Flesland O","year":"2004"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.13354"},{"key":"e_1_2_10_28_1","volume-title":"Blodtransfusjonstjenesten i Norge \u2010 Statistikk","author":"Hoang T","year":"2015"},{"key":"e_1_2_10_29_1","first-page":"502","article-title":"Blood transfusion\u2010associated anaphylaxis in perioperative\u2010 and non\u2010perioperative patients in Western Norway 2002\u20132021","volume":"22","author":"Erikstein BS","year":"2024","journal-title":"Blood Transfus"},{"key":"e_1_2_10_30_1","volume-title":"Working Party on Haemovigilance \u2010 Proposed standard definitions for surveillance on non infectious adverse transfusion reactions [monograph on the internet]","author":"ISBT","year":"2011"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1927.10502953"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2017008805"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.607211"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-06-640995"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12045"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01313-6"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2015.01.009"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2022.103408"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1975.15275122809.x"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.16158"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.09.018"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1962.tb13445.x"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e318164f03d"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1309\/VXY1ULAFUY6E6JT3"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70193","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/trf.70193","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70193","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T05:30:06Z","timestamp":1781069406000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.70193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,29]]},"references-count":43,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/trf.70193"],"URL":"https:\/\/doi.org\/10.1111\/trf.70193","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,29]]},"assertion":[{"value":"2026-02-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}