• SHOT
• blood transfusion
• guidelines
• transfusion transmitted infections

Transfusion of blood and blood products to infants and children is not without risk. In recent years, the risks of blood transfusion have been highlighted by the reports of the Serious Hazards of Transfusion scheme (SHOT), which collects data on adverse events related to transfusion. There continues to be concerns about transfusion transmitted infection, most recently in relation to variant Creutzfeldt-Jakob disease (vCJD). At the same time, new guidelines have recently been published to optimise transfusion practice for children.^1,2 This editorial addresses some of the risks and benefits of transfusion therapy in children, concentrating on aspects that may be less familiar to paediatricians.

Since the development of the blood transfusion services during and after the Second World War, we have perhaps come to take the provision of this valuable resource for granted. The advent of plastic bags enabled separation of a unit of blood into component parts—the ready availability of platelet concentrates allowed intensification of chemotherapy regimens and contributed towards improved survival and reduced morbidity. The National Blood Service currently collects about 2.5 million donations of blood from voluntary unremunerated donors in the UK every year, but only about 3% of the blood and blood products are transfused to children under 16 years of age.³ Most blood is transfused to people more than 60 years of age whose life expectancy is frequently reduced due to their underlying diseases. The consequences of transfusion transmitted infections, many of which have a long latent period before clinical expression, to neonates and young children with a normal life expectancy will be much more significant than to the elderly. In UK hospitals we expect that blood will be available for any child in need, and that its transfusion is safe and effective. Quite apart from a consideration of the …