Efficacy of transfusion pre-medications on attenuating transfusion reaction in adults: A systematic review and meta-analysis

Abstract Background – Transfusion pre-medications are generally administered in patients prior to blood transfusion. However, the use of transfusion pre-medications is largely experience-based instead of evidence-based. Our meta-analysis aimed to combine the most updated evidence and demonstrate the efficacy of transfusion pre-medications on attenuating transfusion reaction among patients. Material and Method – Pubmed, EMBASE, Cochrane Library, Wanfang database, CNKI, CMB was searched for related articles. Data from transfusion pre-medications treated group and transfusion pre-medications free group was collected. Baseline characteristics between groups were compared using SPSS 19.0. RevMan 5.3 was used to pool the collected data for meta-analysis between groups. OR and SMD were used to demonstrate the outcomes. Results - Eight eligible articles (6 case control studies and 2 RCT) were identified, including 22060 cases. Administered transfusion pre-medications included dexamethasone, chlorpheniramine or promethazine. Baseline characteristics showed no significant difference between groups regarding age and gender. There was no significant difference between transfusion pre-medications treated group and transfusion pre-medications free group concerning the rate of fever, itchy, rash, airway spasm and overall transfusion reaction. Conclusion – Dexamethasone, chlorpheniramine or promethazine is probably not a candidate for prevention of transfusion reaction. Avoiding experienced use of such transfusion pre-medications before blood transfusion may reduce the number of adverse drug reaction and clinical trial is still needed in the future to figure out the treatment for alleviating transfusion reaction.