Hypotensive reactions associated with platelet transfusions and angiotensin-converting enzyme inhibitors

Background and Objectives: To determine the cause of hypotensive reactions associated with platelet transfusions in coronary artery bypass surgery patients. Materials and Methods: Platelet transfusion reactions that occurred during a 3-month period were retrospectively reviewed. Results: Eighteen transfusion reactions occurred in 16 patients. Sixteen of the reactions were hypotensive, and occurred in 14 patients transfused with platelets through negatively charged bedside leukocyte reduction filters. All 14 patients had received angiotensin-converting enzyme (ACE) inhibitors prior to transfusion. Conclusion: Preliminary findings suggest a new type of transfusion reaction associated with the use of negatively charged leukocyte reduction filters during platelet transfusions to patients on ACE inhibitors.