Before transfusing a patient with a history of allergic reactions, what is the safest approach?

Administering antihistamines prior to transfusion is considered the safest approach for a patient with a history of allergic reactions. This premedication can help mitigate potential allergic responses that might occur during the transfusion process. Patients who have experienced allergic reactions in the past may be more prone to such reactions when receiving blood products again, so taking preventive measures is crucial.

Using antihistamines can either block histamine release or counteract the effects of histamine already released, thus lowering the risk of an allergic reaction during the transfusion. This can provide added security, especially in patients with documented sensitivity to allergens or components in blood products.

Other approaches, such as transfusing without premedication, could increase the likelihood of an allergic reaction occurring, while leukocyte-reduced components may not specifically address allergic sensitivities unless they pertain to white blood cell components. Irradiated blood products also serve a different purpose, primarily focused on preventing transfusion-associated graft-versus-host disease, rather than managing allergic reactions. Therefore, antihistamines are the most suitable choice to enhance patient safety before transfusion.