PATIENT SAFETY
June 28, 2024

What is Transfusion-Associated Circulatory Overload (TACO)?

​​​​​​​AUTHOR BIOGRAPHY

Matthew A. Taylor, PhD, Patient Safety Authority
Matthew A. Taylor (MattTaylor@pa.gov) is a research scientist on the Data Science & Research team at the Patient Safety Authority (PSA), where he conducts research, uses data to identify patient safety concerns and trends, and develops solutions to prevent recurrence. He is a core team member of PSA’s Center of Excellence for Improving Diagnosis.


Abstract

TACO has been defined as “acute or worsening respiratory compromise and/or acute or worsening pulmonary [edema] during or up to 12 hours after transfusion, with additional features including cardiovascular system changes not explained by the patient’s underlying medical condition, evidence of fluid overload and a relevant biomarker.”1 Definitions of TACO vary across the literature1,2 and some of its features may overlap with the definition and presentation of transfusion-related acute lung injury (TRALI).2,3 Risk factors for and clinical presentation of TACO are reviewed in several resources1,2,4 and we recommend that clinical staff read references 1, 2, and 4.

Key Words
​pulmonary edema, lung injury, TRALI, red blood cells, hemoglobin

References

  1. Medicines and Healthcare products Regulatory Agency. National Patient Safety Alert: Reducing Risks For Transfusion-Associated Circulatory Overload. MHRA. April 4, 2024. Accessed April 11, 2024. https://www.gov.uk/drug-device-alerts/national-patient-safety-alert-reducing-risks-for-transfusion-associated-circulatory-overload-natpsa-slash-2024-slash-004-slash-mhra
  2. Roubinian N. TACO and TRALI: Biology, Risk Factors, and Prevention Strategies. Hematology Am Soc of Hematol Educ Program. 2018;2018(1):585-594. doi:10.1182/asheducation-2018.1.585
  3. Google Scholar
  4. Cho MS, Modi P, Sharma S. Transfusion-Related Acute Lung Injury. StatPearls. September 15, 2023. Accessed April 11, 2024. https://www.ncbi.nlm.nih.gov/books/NBK507846/
  5. Medicines and Healthcare products Regulatory Agency. FAQ Document to Support the National Patient Safety Alert: “Reducing Risks for Transfusion-Associated Circulatory Overload.” MHRA. April 10, 2024. Accessed April 11, 2024. https://www.shotuk.org/wp-content/uploads/myimages/TACO-Safety-Alert-FAQ-document-April-2024.pdf