{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T03:16:16Z","timestamp":1783653376693,"version":"3.55.0"},"reference-count":75,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T00:00:00Z","timestamp":1780704000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T00:00:00Z","timestamp":1780704000000},"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":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute pain transfusion reaction (APTR) is a rare, under\u2010recognized condition of unknown etiology. It can cause significant distress in recipients, necessitating symptomatic management and, occasionally, hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>Here, we present an APTR event in an adult subject with transfusion\u2010dependent thalassemia (TDT). Patient and returned red blood cell (RBC) unit samples from this one, and additionally from preceding and subsequent transfusions, were compared with patient and unit reference groups, matched for genetic profile and storage duration, respectively, using laboratory, morphological, and multi\u2010omics approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The patient had a pre\u2010transfusion hemoglobin concentration of 10.7\u2009g\/dL and evidence of coagulation and fibrinolysis. Following APTR, the patient RBCs showed acute oxidative stress, increased adhesiveness, phosphatidylserine exposure, and membrane\u2010specific proteostatic failure. Multi\u2010omics analyses revealed overexpression of biological response modifiers, like gamma\u2010aminobutyric acid derivatives, RANTES\/DARC, and ongoing ephrin\u2010B reverse signaling. The implicated RBC unit displayed advanced storage lesions with overexpression of ophthalmate and STEAP3, among others, metabolic aging not matching its \u201cchronological age\u201d, and differential expression of potential immune mediators and neuromodulators. Functional enrichment analysis linked the differential proteome profile of the unit with RBC dysfunction and neuropathy. APTR\u2010related pathologies showed only partial resolution over a two\u2010week period, indicating sustained disturbances in proteostasis and hypercoagulability, as evidenced, among other markers, by thrombospondin binding to patient RBCs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study identified a series of patient and RBC unit stress markers and conditions potentially linked to APTR. These hypothesis\u2010generating variables and molecular signatures may facilitate prospective evaluation and mechanistic investigation of suspected APTR cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.70227","type":"journal-article","created":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T12:34:13Z","timestamp":1780749253000},"page":"1299-1315","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acute pain transfusion reaction in a patient with thalassemia: In\u2010depth characterization of short\u2010 and long\u2010term phenotypes"],"prefix":"10.1111","volume":"66","author":[{"given":"Georgia","family":"Tzafa","sequence":"first","affiliation":[{"name":"Department of Biology, School of Science National and Kapodistrian University of Athens (NKUA)  Athens 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