Transfusion-Associated Circulatory Overload (TACO) Cumulative Data

Definition:

TACO is defined as acute or worsening respiratory compromise and/or acute or worsening pulmonary oedema during or up to 12 hours of 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.

Data collection on TACO began in 2008, and although reported numbers have steadily increased since that time, it is thought that TACO remains under-reported.

In 2016 the pre-transfusion TACO checklist was introduced, and has been modified and refined since then. The latest version of this can be found in the most recent Annual Report chapter, and also in the Figures pdf in the Resources section below.

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)

Perform a gap analysis and implement the recommendations of the NPSA alert on TACO (MHRA and SHOT, 2024). This incorporates ongoing SHOT recommendations and access to further guidance and supporting resources

Action: Hospital Trusts/Health Boards

Please see the individual SHOT chapters below for other previous recommendations which remain relevant.