Definition:
The reactions assessed are isolated febrile type (not associated with other specific reaction categories), allergic and hypotensive reactions occurring up to 24 hours following a transfusion of blood or components, for which no other obvious cause is evident.
SHOT has collected data on febrile, allergic and hypotensive reactions (FAHR) since 1996. Originally, this category was called acute transfusion reactions (ATR).
Since 2012 SHOT has excluded ‘mild reactions’, and now only collects data on moderate or severe reactions according to the International Society for Blood Transfusion/International Haemovigilance Network (ISBT/IHN) definitions.
SHOT Transfusion Safety Standards
The SHOT Transfusion Safety Standards were released in July 2025, and these replace recommendations in the Annual SHOT Reports. More details on these can be found at: https://www.shotuk.org/transfusion-safety/transfusion-safety-standards/
Recommendations from recent Annual SHOT Reports (prior to 2024)
Give appropriate targeted treatment and if needed, preventative cover for future transfusion
Haematology registrars should receive training in classification, appropriate investigation and management of transfusion reactions in the laboratory induction at the start of their programme
Action: Hospital transfusion teams, Haematology training programme directors
Please see the individual SHOT chapters at the end of the page for other previous recommendations which remain relevant.
FAHR Resources
This video on Febrile and Allergic reactions gives an overview of how to recognise, assess and manage acute reactions, and how to look after patients if they need further transfusion. It also covers which reactions should be reported, both locally and nationally.
This SHOT Meet the Experts FAHR webinar was held on 28 January 2026. It reviews the 2024 Annual SHOT Report data and key findings, followed by practical guidance on getting management right and improving the quality of investigation. The session also explores why high‑quality SHOT FAHR reporting is essential and how organisations can improve accuracy and consistency. This webinar supports transfusion safety and helps embed learning into local practice.
FAHR Annual Report Chapters
To access the chapter click either on the cover of the Annual SHOT Report or the link below the picture
