Search

Objective To analyze the characteristics and related influencing factors of transfusion reactions in pediatric patients, so as to provide evidence for clinical treatment and prevention of transfusion reactions. Methods A retrospective study was conducted on children who received blood transfusions at our hospital from 2019 to 2023 in terms of the incidence, types, time of occurrence, and related influencing factors of transfusion reactions. Results A total of 69 926 transfusions were performed from 2019 to 2023, with 711 cases of transfusion reactions, resulting in an incidence of 1.02%. The incidence of transfusion reactions decreased annually from 2019 (1.89%) to 2022 (0.50%). The incidence of transfusion reactions to apheresis platelets, frozen plasma, suspended leukocyte-depleted red blood cells and cryoprecipitate coagulation factor were 2.16% (551/25 565), 0.50% (92/18 277), 0.25% (65/25 679) and 0.74% (3/405), respectively, with apheresis platelet transfusion of a significantly higher incidence compared to other blood components (P

Introduction: Transfusion of blood Group O and its components with high ABO antibody titers to non O recipients has been shown to cause acute transfusion reactions, especially in platelet transfusions, as platelets contain significant amounts of ABO antigen on their surface as well as Anti-ABO alloisogglutinins in plasma. Aim: To estimate the ABO Anti-A and Anti-B agglutinin titers among blood donors at a tertiary care referral teaching hospital blood centre. Materials and Methods: This cross-sectional observational study was conducted at the Immunohaematology laboratory of the Department of Transfusion Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India, from March 2021 to June 2022. All blood donors presenting to the blood centre were screened for eligibility for blood donation. Donors who fulfilled the eligibility criteria as per the Drugs and Cosmetics Act, 1940, and Rules, 1945 were included. Anti-A and Anti-B titers were determined by the conventional tube method with dilutions of 1 in 2, 1 in 4, 1 in 8, 1 in 16, 1 in 32, 1 in 64, 1 in 128, 1 in 256, 1 in 512, and 1 in 1024. A titer of 64 was considered as a high titer. Results: A total of 399 donors were included in the study, with 393 (98.5%) being males and 6 (1.5%) being females. The mean age of the study population was 28.49 years. Among blood group A, the percentage of individuals with an IgM anti-B titer of 64 was 14.56% (15), whereas in blood group B, IgM anti-A titers of 64 were 34.5% (49). In blood group O, the percentage of individuals with 64 titers of IgM anti-A were 52.60% (81) and 47.40% (73), respectively, whereas for anti-B, 64 titers were 77.92% (120) and 22.08% (34), respectively. Conclusion: It is recommended that a database be maintained in all institutes by estimating antibody titers for every A, B, O blood group donors. Whole blood or platelets from group O donors with IgM Anti-A and Anti-B antibody titers

Objective To analyze the application effect of intelligent information system of transfusion reactions(referred to as the system) in the supervision and management of transfusion reactions. Methods A retrospective analysis was conducted on the clinical data of a total of 67 914 blood transfusion patients in our hospital from January 2018 to August 2023. The patients were divided into the control group (n =36 367, with conventional transfusion management) and the observation group (n =31 547, with management by the system).The incidence of adverse reactions, the supervision and management scores, reporting time and processing time of adverse reactions, and patient satisfaction with blood transfusion in the two groups was observed. Results The incidence of transfusion reactions in the observation group and the control group was 0.23% (72/31 547) and 0.24% (86/36 367), with no statistically significant difference (P>0.05). The quality scores of the reporting, registration, processing and supervision, and the total scores of the observation group were higher than those of the control group:(21.46±2.76) vs (17.38±2.74) points, (21.65±2.80) vs (16.98±3.20) points, (22.30±2.42) vs (18.80±3.15) points, (22.85±2.10) vs (18.55 ± 3.06) points, and (90.38±5.96) vs (75.26 ± 6.10) points, with statistically significant difference(P

Background: Acute complications of transfusion are among leading causes of morbidity and mortality in chronically transfused patients. One of the main goals of the blood transfusion is reducing complications, improve blood safety and patient's health care worldwide. The purpose of present study was to investigate the prevalence of acute complications of transfusion in beta thalassemia major (TM) patients in Southeast Iran.Methods: In a prospective study, 23882 transfusions were evaluated in TM patients in thalassemia clinic for acute reactions during 2 years period. Data were collected by forms to record the information related to blood transfusion at the time of reaction occurence. Results: The assessment of the data revealed that 228 TM (0.95%) had acute complications of transfusion. Of 23882 transfusions in TM patients, 211 patients (0.87%) developed allergic reactions, 11 patients (0.04%) were diagnosed with febrile non-hemolytic reaction and 1 patient (0.004%) had experienced acute hemolytic transfusion reaction.Conclusions: The results of current study supports preventive measures for reduction of these complications to improve patient's health. Acute complications occurred may be due to insufficient ability to perform blood bank tests, lack of standard operating instructions and lack of necessary monitoring during the transfusion process. The best way to reduce the risk of blood transfusion reactions is providing special care to the patients during the first 24 hours after transfusion. Creating a consistent and continuous education system with standard operating instructions and establishing an error reporting system leads to improve knowledge about transfusion guidelines and best practices.

Introduction: The knowledge of clinicians regarding blood transfusion services may impact patient care and transfusion outcome. The wide variation in transfusion practices among clinicians leads to inappropriate blood product usage and jeopardizes patient safety. Hence, this survey study aimed to assess knowledge, attitude and practice among the residents and interns of safe blood transfusion. Methods: The online survey was based on self-administered questionnaires of three sections: 1. Demography; 2. Knowledge, and; 3. Attitude and Practice. One point was assigned for the correct response of each question in every section. The knowledge score was further categorized into three categories, depending on the points obtained. The participants were also divided into four groups, depending on their experience. The Kruskal-Wallis test was applied to determine the difference of knowledge and practice scores in three designated groups of residents and interns. A p-value of less than 0.05 was considered to be significant. Result: A total of 247 residents and interns participated in this study. Thirteen participants had an incomplete response. Out of 234 participants, Senior Residents (SR), Junior Residents (JR), and interns were 70, 96 and 68 participants, respectively. The knowledge scores of interns were significantly low, as compared to SRs and JRs. Practice scores of interns were also significantly low, compared to the JRs. However, most of the residents and interns (85%) were aware of the pre-transfusion testing. Conclusion: Therefore, the mandatory incorporation of the transfusion medicine subject in the undergraduate curriculum can help the young budding doctors to better implement the patient blood management.

Background: Red cell transfusion is indicated to increase the oxygen delivering capacity and it cannot be replaced by any pharmacological agent. Although blood transfusion is generally safe, adverse effects can occur; hence, benefits must always overweigh risks of transfusion before decision to transfuse is made. Information about the aims of transfusion, benefits and risks of transfusion, must be explained to the patient and written consent must be obtained. Objective: To assess the awareness about blood transfusion among red cell recipients. Materials and Methods: This prospective descriptive study was carried out at a tertiary care hospital in Sri Lanka. Red cell recipients were questioned about the transfusion episode after been transfused. Results: There were 252 patients in the study, 82 from surgical units and 170 from medical units. 37 (45.12%) patients from surgical units and 79 (46.47%) patients from medical units were explained about the transfusion, before they were being transfused. 66% of patients from surgical units and 55% from medical wards knew their blood group. 77% and 57% of patients were aware about the reason for transfusion in surgical and medical wards, respectively. Moreover, 39% of patients from surgical units and 35% of patients from medical units knew about transfusion transmitted infections. Conclusions: Awareness about the own blood group, reason for transfusion, benefits and risks of transfusion was significantly low in the study group. Therefore, patient education should be improved to understand the benefits and risks to the patient.

Introduction: Erythrocyte phenotyping is a very important test in the adoption of prophylactic measures to reduce transfusion reactions/alloimmunizations in polytransfused patients. The blood group Diego, in its current, form has 22 antigens, of which 4 are immunogenic, being Diª/Dib and Wra/Wrb, while the others are less expressive. The antigen Diª is of low incidence among whites and blacks, however, it is common in the South American indigenous and Asian Mongolian populations. It is also considered a system of clinical importance for its immunogenicity. Method: The present study aimed to carry out a retrospective and descriptive survey of the frequency of the Diª antigen in the blood donor population at the HEMOPA Foundation Coordinating Blood Center from 12/2018 to 1/2000. The data obtained were from the HEMOPA Foundation SBS Progress and SBS WEB Systems databases. Results: During this period, 941,744 blood bags were collected and, of these, 930 bags were phenotyped for the Diª antigen, of which 842 were negative and 88 (9.7%) positive. The research showed that, among the positive donors for the antigen Diª, 88.6% were brown, 3.4%, black and 8%, white. In the statistical analysis, the frequency observed was higher in browns. Conclusion: In the present investigation, we concluded that our region has a relatively higher frequency of the Diª antigen, when compared to the rest of Brazil, and it occurs more often in browns.

Objective: Hemovigilance covers the entire transfusion chain, from the collection of the blood product and its components to the monitoring of adverse reactions. The aim of our study was to perform a process validation for the hemovigilance system of our hospital and to evaluate patients who developed blood transfusion reactions. Method: University of Health Sciences Turkey, Dr. Behçet Uz Child Health and Diseases Training and Research Hospital; among the patients who received blood transfusion between January 2019 and December 2019, 238 patients were identified by systematic sampling method. Blood components used in patients undergoing treatment in different clinics; Examining the physician and nurse observation notes and the data in the hospital information system, whether the transfusion process is appropriate; It was evaluated by hospital hemovigilance coordinator, hemovigilance nurse, pediatric hematologist and pediatric intensive care specialist. Results: Of the 238 randomly selected patients, 122 (51.3%) were male and 116 (48.7%) were determined as female. The median age was 91 (14-180) months. In the evaluation of the transfusion process; Only 1 patient (0.4%) was observed to exceed the optimal transfusion time. No error was detected in other blood transfusion processes. It was observed that 8 (3.3%) of the patients who underwent transfusion had a transfusion reaction. Conclusion: In our study, it was found that there is no significant problem in recognizing, applying and reporting transfusion reactions before and during transfusion applications. In our country, there is no previous study on hemovigilance process validation. Prospective process validations are required.

BACKGROUND: Tracking transfusion reactions is essential to improve patient safety. Under-reporting of transfusion reactions was suspected in our institution. To evaluate this phenomenon, we followed an active surveillance protocol for transfusion reactions for 3 months in 2016 and compared transfusion reaction rates during that period with 2015 and 2017. METHODS: The study was carried out in a tertiary care hospital over 3 months in 2016. Investigators visited hospital units and collected data on all patients who received a transfusion in the preceding 24 h. Further details were obtained about all cases that are suspected to have had a transfusion reaction. Transfusion reactions were defined according to the definitions provided by National Healthcare Safety Network Biovigilance Component Hemovigilance Module Surveillance Protocol 2016. Rates that were obtained through active surveillance were compared through appropriate statistical methods with transfusion reaction rates obtained through passive reporting from 2015 and 2017. RESULTS: During the study period, a total of 47 transfusion reactions were captured through active surveillance and passive reporting (transfusion reaction rate 0.79%). There was a statistically significant difference between these rates in comparison with rates detected in similar months from 2015 (0.26%) and 2017 (0.17%). CONCLUSIONS: Active surveillance for transfusion reactions is an effective method for improving rates of the detection of suspected transfusion reactions. The phenomenon of under-reporting of transfusion reactions requires thorough evaluation by transfusion medicine professionals to introduce targeted solutions and improve reporting rates.

Chronic transfusion, used to manage clinically significant forms of thalassemia, carries complication risks including iron overload, alloimmunization, and allergic or hemolytic reactions. Dissemination and implementation of evidence-based guidelines for minimizing these risks are complicated by the small numbers and increasing dispersion of the thalassemia population. This elevates patients' role in understanding and communicating with providers about treatment. The present study sought to assess thalassemia patients' knowledge of transfusion, complications, and guidelines; their experience of clinicians' following guidelines; and their perspectives on ways to store and share personal transfusion data. A convenience sample of 32 patients participated in structured interviews. Most, if not all, understood iron overload, chelation therapy, blood typing, and cross-matching. Awareness of each of five of evidence-based transfusion guidelines that were discussed ranged from 72 to 88%. Patients expressed privacy concerns about each of three data storage options, slightly less for a registry than for a wallet card or smartphone app. The registry also avoided concerns that the other options placed extra burden on patients. Recommendations include increased education on the meaning and significance of packed, washed red blood cells, leuko-reduction, and detailed cross-matching, and implementation of a nationwide registry to make transfusion data available to providers anywhere at the point of care. Registry implementation should be sensitive to patients' privacy and security concerns, but also help them appropriately weigh those against safety benefits. These actions could help reduce transfusion complications in thalassemia by improving patient efficacy and increasing adherence to evidence-based guidelines.

Jaleah Hawkins,1 Richard H Aster,2,3 Brian R Curtis2,3 1Versiti, Blood Center of Michigan, Grand Rapids, MI, USA; 2Versiti, Blood Center of Wisconsin, Milwaukee, WI, USA; 3Blood Research Institute, Milwaukee, WI, USACorrespondence: Brian R CurtisVersiti, Blood Center of Wisconsin, P.O. Box 2178, Milwaukee, WI 53201-2178, USATel +1 414 937 6087Fax +1 414 937 6242Email brcurtis@versiti.orgAbstract: Post transfusion purpura (PTP) is an uncommonly reported post transfusion adverse event that can present with severe thrombocytopenia; sometimes resulting in significant bleeding and hemorrhage. Its diagnosis can be elusive given its substantial symptomatic overlap with other thrombocytopenic syndromes. Underdiagnosis and underreporting make the true incidence of disease difficult to define. While clinical suspicion is key, laboratory evidence of platelet-targeted antibodies and identification of the antigen(s) they recognize are necessary to confirm the diagnosis. A curious aspect of PTP is paradoxical destruction of both transfused and autologous platelets. Although the first case was reported over 50 years ago, this aspect of PTP pathogenesis is still not fully understood and is widely debated. Several theories exist, but conclusive evidence to support most is lacking. Despite limited understanding of disease incidence and etiology, treatment with IVIG (Intravenous Immunoglobulin) has become standard practice and can be highly effective. Although recurrence is rare, precautions should be taken if patients with a history of PTP require transfusions in the future.Keywords: thrombocytopenia, platelet antibodies, transfusion reactions

Introduction: Thrombocytopenia is one of the most common complications in chronic liver disease and perioperative transplant patients requiring multiple units of platelets transfusion. Aim: This study was undertaken to find out the effectiveness of platelet additive solution (PAS) suspended apheresis platelets in such patients and to compare the in vitro quality of PAS suspended, and plasma suspended apheresis platelets. Materials and Methods: This is a prospective study conducted in the Transfusion Medicine Department of multiorgan transplant center in South India from April 2016 to April 2017. AntiA and antiB isoagglutinin titers were analyzed in O group SSP+ suspended apheresis platelet concentrates (PCs) and response of both SSP+ suspended, and plasma suspended apheresis PCs were analyzed in patients by checking the corrected count increment (CCI). Results: Among 200 single donor platelet (SDP) products, 111 (55.5%) were SSP suspended and 89 (44.5%) were plasma suspended. There were no adverse transfusion reactions in SSP+ suspended PCs. Among 24 individuals with paired plasma suspended and SSP+ suspended SDP products, no statistically significant difference was found in CCI at 24 h. There was a statistically significant difference between pre- and post-anti-A and anti-B titers (P < 0.001). Ten donor units (23.2%) had titer ≥64 for anti-A and anti-B. Conclusion: The ex vivo storage of SDP in PAS offers several advantages in the harvesting of additional plasma for use as transfusable product and reduction of allergic reactions besides maintaining the quality control of platelets.

Background: Use of blood and its components is lifesaving. However, their use is often associated with adverse events. Objective: To analyze the pattern of adverse reactions associated with transfusion of blood and its components in pediatric and surgical patients at a tertiary care teaching hospital. Materials and Methods: Patients receiving transfusion of blood or its components in a randomly selected unit each from Departments of Pediatrics, including thalassemia OPD and surgery, were monitored intensively for a period of 6 months. Clinical course, management, outcome, causality, severity, seriousness, and preventability of observed transfusion reactions (TRs) were analyzed. Results: A total of 411 pediatric and 433 surgical patients received 594 and 745 transfusions respectively during the study period. Of these, TRs were observed in 69 (11.6%) children and 63 (8.4%) surgical patients. Majority of reactions in children (48, 69.5%) and surgical patients (51, 80.9%) were acute, developing within 24 h of transfusion. TRs were observed with packed cells (13.2%), cryoprecipitate (10%), platelet concentrate (14.3%) and fresh frozen plasma (1.3%) in pediatric patients and with packed cells (7.2%), whole blood (25%) and platelet concentrate (62.5%) in surgical patients. Most common TRs included febrile nonhemolytic TRs (FNHTRs) and allergic reactions. Reactions were more frequent in patients with a previous history of transfusion or those receiving more than one transfusion and in children, when transfusion was initiated after 30 min of issue of blood component. Majority of reactions were managed with symptomatic treatment, were nonserious, moderately severe, probably preventable and probably associated with the suspect blood component in both populations. Conclusion: Transfusion reactions in children and surgical patients are commonly observed with cellular blood components. Majority of reactions are acute and nonserious. FNHTRs and allergic reactions are the most common transfusion reactions. Risk of transfusion reactions is more in patients receiving multiple transfusions.

Leukoreduction (LR) is a technique that consists of reducing the number of leukocytes in whole blood or blood components that can contribute to decreasing storage lesions and the occurrence of post-transfusion complications. We propose that using a blood bag with pre-storage leukocyte filtration is sufficient for blood conservation under field conditions. Ten healthy Nelore cows were used. Whole blood was sampled from each animal and stored at 2 to 6 °C in CPD/SAG-M (citrate phosphate dextrose bag with a saline, adenine, glucose, mannitol satellite bag) triple bags (Control) and in CPD/SAG-M quadruple bags with a leukocyte filter (Filter). At baseline and after 7, 14, 21, 28, 35, and 42 days (D0, D7, D14, D21, D28, D35, and D42, respectively), complete hematological, blood gas, and biochemical evaluations were determined. The filtered bag removed 99.3% of white blood cells from cattle blood, and the entire filtration process was performed in the field. There was a reduction in the number of red blood cells (RBCs) in both groups from D14 onward, with a decrease of 19.7% and 17.1% at D42 for the Control and Filter bags, respectively. The hemoglobin (Hb) concentration had variation in both groups. Potassium, pO2, pCO2, and sO2 increased, and sodium, bicarbonate, and pH decreased during storage. The filtered bag was efficient in removing white cells from cattle whole blood and could be used under field conditions. Blood stored after LR showed differences (p < 0.05) in blood gas analysis towards a better quality of stored blood (e.g., higher pH, lower pCO2, higher sO2). Further experimental studies are required to prove that blood without white cells results in a decrease in transfusion reactions in cattle.

Aims: In this study we have evaluated the various adverse reactions related to transfusion occurring in our institution as a pilot institutional effort toward a hemovigilance program. This study will also help in understanding the problems faced by blood banks/Transfusion Medicine departments in implementing an effective hemovigilance program. Materials and Methods: All the adverse reactions related to transfusion of whole blood and its components in various clinical specialties were studied for a period of 1 year. Any transfusion-related adverse event was worked up in accordance with guidelines laid down by the Directorate General of Health Services (DGHS) and departmental standard operating procedures. Results: During the study period from November 1, 2011 to October 31, 2012, 45812 components were issued [30939 WB/PRBC; 12704 fresh frozen plasma (FFP); 2169 platelets]. Risk estimation per 1000 units of red cells (WB/PRBC) transfused was estimated to be: 0.8 for febrile nonhemolytic transfusion reaction (FNHTR), 0.7 for allergic reaction, 0.19 for acute hemolytic transfusion reaction (AcHTR), 0.002 for anaphylactoid reactions, 0.1 for bacterial sepsis, and 0.06 for hypervolemia and hypocalcemia. 0.09 is the risk for delayed transfusion reaction and 0.03 is the risk for transfusion-related acute lung injury (TRALI). Risk estimate per 1,000 units of platelets transfused was estimated to be 1.38 for FNHTR, 1.18 for allergic reaction, and 1 in case of bacterial sepsis. Risk estimation per 1,000 units of FFP was estimated to be 0.15 for FNHTR and 0.2 for allergic reactions. Conclusions: Factors such as clerical checks at various levels, improvement in blood storage conditions outside blood banks, leukodepletion, better inventory management, careful donor screening, bedside monitoring of transfusion, and documentation of adverse events may decrease transfusion-related adverse events. Better coordination between transfusion specialists and various clinical specialties is the need of the hour and it will help in making the whole transfusion chain safe and effective. There is a need for a hemovigilance program at the national level so that true incidence and the spectrum of adverse events due to transfusion are known and policies formulated to minimize the risks associated with it.

The recognition and management of transfusion reactions (TRs) are critical to ensure patient safety during and after a blood transfusion. Transfusion reactions are classified into acute transfusion reactions (ATRs) or delayed transfusion reactions, and each category includes different subtypes. Different ATRs share common signs and symptoms which can make categorisation difficult at the beginning of the reaction. Moreover, TRs are often under-recognised and under-reported. To ensure uniform practice and safety, it is necessary to implement a national haemovigilance system and a set of national guidelines establishing policies for blood transfusion and for the detection and management of TRs. In Oman, there are currently no local TR guidelines to guide physicians and hospital blood banks. This paper summarises the available literature and provides consensus guidelines to be used in the recognition, management and reporting of ATRs.

Transfusion of blood and its components has undergone technological advancement, and its use is increasing both perioperatively as well as in the Intensive Care Unit. The separation of blood into its various components has made it very economical as blood donated from a single donor can be utilized for many recipients at the same time. However, the transfusion of blood and its components do carry the inherent risk of various transfusion reactions as well as transmission of infections. The indications for transfusion should be strictly adhered to for preventing nonjudicious use. The health care persons involved in transfusion should be well aware of implications of the mismatched transfusion and should be able to provide treatment if such mishaps do occur. A health care professional should carefully weigh the benefits of blood transfusion against the risks involved before subjecting the patients to the transfusion. This manuscript aims to comprehensively review the current evidence based approaches in blood and component transfusion which are being followed in anesthesiology and intensive care practice.

Audience: This exercise is appropriate for all emergency medicine learners (residents and medical students) and learners from other specialties (internal medicine, family medicine, anesthesia). Introduction: About 85 million red blood cell units are transfused worldwide each year. Transfusion reactions can complicate up to 8% of blood transfusions and can range from benign to life threatening. An emergency physician must be able to discuss the risks and benefits of blood transfusion with patients, as well as manage the associated complications of blood transfusion. Objectives: At the end of this didactic session, the learner will be able to: 1) list the various transfusion reactions and their approximate incidence; 2) understand the pathophysiology behind each transfusion reaction; 3) describe the management for each type of transfusion reaction; and 4) discuss the plan for prevention of future transfusion reactions. Method: This is a classic team based learning exercise (cTBL).

Background: Adverse transfusion reactions can cause morbidity and death to patients who receive a blood transfusion. Blood transfusion practice in Mulago Hospital, Kampala, Uganda is analyzed to see if and when these practices play a role in the morbidity and mortality of patients. Materials and Methods: An observational study on three wards of Mulago Hospital. Physicians, paramedics, nurses, medical students and nurse students were observed using two questionnaires. For comparison, a limited observational study was performed in the University Medical Centre Groningen (UMCG) in Groningen, The Netherlands. Results: In Mulago Hospital guidelines for blood transfusion practice were not easily available. Medical staff members work on individual professional levels. Students perform poorly due to inconsistency in their supervision. Documentation of blood transfusion in patient files is scarce. There is no immediate bedside observation, so transfusion reactions and obstructions in the blood transfusion flow are not observed. Conclusion: The poor blood transfusion practice is likely to play a role in the morbidity and mortality of patients who receive a blood transfusion. There is a need for a blood transfusion policy and current practical guidelines.

Blood transfusion in patients with sickle cell disease (SCD) is limited by the development of alloantibodies to erythrocytes. In the present study, the frequency and risk factors for alloimmunization were determined. Transfusion records and medical charts of 828 SCD patients who had been transfused and followed at the Belo Horizonte Blood Center, Belo Horizonte, MG, Brazil, were retrospectively reviewed. Alloimmunization frequency was 9.9% (95% CI: 7.9 to 11.9%) and 125 alloantibodies were detected, 79% of which belonged to the Rhesus and Kell systems. Female patients developed alloimmunization more frequently (P = 0.03). The median age of the alloimmunized group was 23.3 years, compared to 14.6 years for the non-alloimmunized group (P < 0.0001). Multivariate analyses were applied to the data for 608 hemoglobin (Hb) SS or SC patients whose number of transfusions was recorded accurately. Number of transfusions (P = 0.00006), older age (P = 0.056) and Hb SC (P = 0.02) showed independent statistical associations with alloimmunization. Hb SC patients older than 14 years faced a 2.8-fold higher (95% CI: 1.3 to 6.0) risk of alloimmunization than Hb SS patients. Female Hb SC patients had the highest risk of developing alloantibodies. In patients younger than 14 years, only the number of transfusions was significant. We conclude that an increased risk of alloimmunization was associated with older patients with Hb SC, specially females, even after adjustments were made for the number of transfusions received, the most significant variable.

Acute transfusion reactions have been found to occur during or within 24 hours of transfusion. The aim of this work is to describe the main characteristics of acute reactions reported in a Brazilian transfusion service. A preprinted report form was used to evaluate the age and sex of the transfusion recipients, blood component requested, medical specialty involved and transfusion-related signs and symptoms, transfusionists performed a direct observation during the transfusion and in a period of four hours following transfusion. Data were prospectively collected for 90 days from 30 hospitals and health facilities supplied by the the Service of Hematology and Hemotherapy of São José dos Campos. Acute reactions were recognized as febrile nonhemolytic, allergic, fluid overload, transfusion-related acute lung injury (TRALI), anaphylatic and metabolic reactions. In a total of 8,378 transfusions, 46 acute reactions were recorded (5.5 per 1000 units transfused, 28 febrile nonhemolytic, 12 allergic, 5 anaphylatic and 1 fluid overload). TRALI and metabolic reactions were not detected. The majority (27) was associated with RBCs followed by PLTs 11, FFP 6 and partial units 2. The median age of the recipients was 43 years (3 months to 83 years, 23 males and 23 females). Overall, 12 (26.1%) events were recorded in oncology, 12 (26.1%) in medicine and 7 in intensive care unit departments. This study provides baseline acute transfusion reaction information for a specific period of time in a Brazilian transfusion service.As reações transfusionais agudas ocorrem durante ou em um período de até 24 horas após a transfusão de hemocomponentes. O objetivo deste estudo foi descrever as principais reações transfusionais agudas em um serviço de hemoterapia brasileiro. Através de um formulário próprio contendo a idade e o sexo dos receptores, os hemocomponentes solicitados, as especialidades médicas envolvidas e os sinais e sintomas relacionados, os transfusionistas registraram os eventos durante a transfusão e até quatro horas após seu término. Colheram-se dados de 30 hospitais e clínicas atendidos pelo Serviço de Hematologia e Hemoterapia de São José dos Campos em um período de 90 dias. As reações agudas foram definidas como febril não hemolítica, alérgica, sobrecarga volêmica, TRALI, anafilática e metabólica. Em um total de 8378 transfusões, 46 reações foram registradas (5,5 por 1000 unidades transfundidas) sendo 28 do tipo febril não hemolítica, 12 do tipo alérgica, 5 do tipo anafilática 1 do tipo sobrecarga volêmica. Reações do tipo TRALI não foram observadas. 27 reações foram associadas com a transfusão de concentrado de hemácias, 11 com a transfusão de concentrado de plaquetas, 6 com a transfusão de plasma fresco congelado e 2 com a transfusão de concentrado de hemácias para recém-nascidos. Dentre os receptores com reações, a mediana das idades foi de 43 anos (3 meses a 83 anos) sendo 23 do sexo masculino e 23 do sexo feminino. 12 reações (26,1%) foram provenientes do setor de Oncologia, 12 (26,1%) do setor Clínica Médica e 7 do setor Unidade de Terapia Intensiva. Este estudo descreve as reações transfusionais agudas registradas em um período de tempo específico provenientes de um serviço de hemoterapia brasileiro.

The recognition and management of transfusion reactions (TRs) are critical to ensure patient safety during and after a blood transfusion. Transfusion reactions are classified into acute transfusion reactions (ATRs) or delayed transfusion reactions, and each category includes different subtypes. Different ATRs share common signs and symptoms which can make categorisation difficult at the beginning of the reaction. Moreover, TRs are often under-recognised and under-reported. To ensure uniform practice and safety, it is necessary to implement a national haemovigilance system and a set of national guidelines establishing policies for blood transfusion and for the detection and management of TRs. In Oman, there are currently no local TR guidelines to guide physicians and hospital blood banks. This paper summarises the available literature and provides consensus guidelines to be used in the recognition, management and reporting of ATRs.

Background: To determine the frequency and types of blood transfusion reactions during pregnancy. Methods: In this descriptive study 1754 consecutive pregnant women during a period of twelve months, were included. All reactions were reported to the blood bank. Frequency of blood transfusion reactions, type of transfusion reactions, morbidity, complication or mortality was noted. Results: Out of total cases of anaemia (1754), the patients having blood transfusions were 26.6% (n=468). Out of 468 post transfusion reactions were observed in 20.9%. Transfusion reactions were categorized as hemolytic reactions in 4.9% , nonhemolytic reactions in 4.2% and febrile reactions in 11.7%. Out of 98 cases of blood transfusion reactions two cases expired due to severe hemolytic reaction . Conclusion: Blood transfusion for the treatment of anaemia should be reserved only for hemodynamically unstable patients or any other co morbidity during pregnancy.

Background. The decision, made by transfusion medicine specialist, for the extent of investigation of the transfusion reaction is based on the clinical course of transfusion reaction, reported by the patient´s physician. Immunohaematological tests are used for testing of compatibility in red blood cells antigen and rarely also in platelet and leucocyte antigens. Evaluation of reported transfusion reactions includes repeated checking of patient identification, of issued component and of the compatibility in AB0 blood groups between the patient and the donors. In cases of suspected immune haemolysis, direct antiglobulin test and antibody screening is performed from the patient´s posttransfusion sample of blood. Whenever, due to the signs and simptoms of transfusion reaction and the results of testing, immune haemolysis is possible, additional immunohaematological tests are done.Conclusions. Specialist of transfusion medicine determines the type of transfusion reaction regarding the clinical course, the response to the treatment and the results of checking and testing. The evaluation is finished with a report for the patient´s physician with further instructions. In addition, a report for the Consulting Service for Blood Component Users in Blood Transfusion Centre of Slovenia is issued. Described routine procedures of evaluation help us in the detection of the possible mistakes in the transfusion process and in the determination of the type of transfusion reaction.

A partir del año 2003, en el Hospital Docente Provincial “Comandante Faustino Pérez” se inició el control y análisis de los efectos adversos de la transfusión de sangre, mediante el reporte y estudio de todas las reacciones transfusionales, para conocer su frecuencia, tipo y gravedad, así como su relación con el componente utilizado, los días de extraído y el sexo del receptor. Se reportaron los errores detectados y subsanados antes del proceder. Este estudio se realizó bajo la asesoría y control del Banco de Sangre Provincial “Minerva Duarte”, como parte de la vigilancia sobre los productos sanguíneos y la cadena transfusional, con el objetivo de disminuir los efectos adversos e incrementar la seguridad transfusional. Los datos obtenidos demuestran disminución del número de reacciones adversas, de 52 en el 2002 a 14 en el 2005. Las más frecuentes fueron la febril no hemolítica y las alérgicas; la más grave resultó la contaminación bacteriana. Los errores más frecuentes subsanados antes de la transfusión fueron por equivocación del grupo en la bolsa a transfundir. El componente que más reacciones originó fue el concentrado de hematíes y el sexo femenino fue el que más reacciones presentó. El estudio permitió la adopción de medidas correctivas y preventivas para disminuir las reacciones e incrementar la seguridad transfusional en el centro hospitalario.From 2003 on, it was started the control and analysis of the adverse effects of blood transfusion at “Comandante Faustino Pérez” Provincial University Hospital by the report and study of all the transfusion reactions in order to know their frequency, type and severity, as well as their relation to the component used, the date of the extraction, and the sex of the recipient. The errors detected and corrected before the procedure were reported. This study was conducted under the counselling and control of “Minerva Duarte” Provincial Blood Bank as part of the vigilance of the blood products and the transfusion chain aimed at reducing the adverse effects and at increasing transfusion safety. The data obtained showed a decrease of the number of adverse reactions from 52, in 2002, to 14, in 2005. The most common reactions were the non-hemolytic febrile reactions and the allergic reactions, whereas the most serious was bacterial contamination. The most frequent amended mistakes before transfusion were those made by the group with the transfusion bag. The packed cells proved to be the component that originated the greatest amount of reactions. Females had more reactions. The study allowed to take corrective and preventive measures to lower the reactions and improve the transfusion safety in the hospital.