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ABSTRACT Prior to the national shortage of iron dextran in early 2023, it was the most commonly administered intravenous iron infusion at our institution. After the shortage impacted the health system, alternatives such as iron sucrose and sodium ferric gluconate/sucrose were required that utilized lower doses given at more frequent patient visits. Coinciding with their more prevalent use, an increase in iron infusion reactions was observed. Our study analyzed 880 patients who received iron infusions in three Henry Ford Hospital clinics in metropolitan Detroit, Michigan, from July 2022–June 2023. The 74 reactions that occurred were most commonly associated with iron sucrose at the 500 mg dose (41/74, 55.41%, p < 0.0001). Most reactions observed across all iron formulations and doses were mild, with 83.7% being Grade 0 or 1 as defined by the United States Drug Allergy Registry (USDAR) grading scale for immediate reactions. Patients who experienced an infusion reaction were less likely to complete their infusion plans (OR 0.004 for iron dextran, OR 0.128 for iron sucrose, p < 0.0001), with infusions most commonly being completely discontinued thereafter, with a minority pursuing alternative options. More patients with lower number of doses scheduled for iron dextran completed their infusion schedules than those with more doses, but the opposite was seen for iron sucrose. We assessed the impact of the national shortage of iron dextran examining infusion reactions with various iron infusions and doses. [ABSTRACT FROM AUTHOR]

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

Background: Correct classification of transfusion reactions is important not only for effective patient care and donor management but also for accurate tracking of events in hemovigilance systems. We compared the ability of a generative artificial intelligence (AI) system to correctly diagnose hypothetical clinical situations as transfusion reactions in comparison to previous studies reporting the accuracy of transfusion medicine (TM) specialists in assessing these cases. Methods: An AI system was requested to assess 36 case scenarios to provide a diagnosis, severity, and imputability of the transfusion reactions using the CDC National Healthcare Safety Network (NHSN) criteria. Responses were compared to an expert panel's classifications and to the published responses of a panel of TM specialists. Additionally, the AI's responses were compared to the TM specialists' prior attempts to use the TrDDx web‐based algorithm for the five most challenging cases. Results: The AI's classification accuracy varied widely depending on the NHSN category. The AI accurately classified all transfusion‐associated circulatory overload and transfusion‐related acute lung injury cases, exceeding TM specialists' assessments. Conversely, it did not correctly identify any cases in select NHSN categories such as DSTR. Overall accuracy among all diagnostic categories was 48.7% for AI responses versus 72.1% for prior TM specialist responses (p = 0.005). AI‐generated responses included non‐standard terminology, limited severity assessments, and no imputability determinations. Discussion: A generative AI system may have a role in helping healthcare providers to consider transfusion reaction categories that might be missed, but caution is advised in applying the AI's output to transfusion reaction classification at present. [ABSTRACT FROM AUTHOR]

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

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 low titer, while 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 85.44% (88) and >64 was 14.56% (15), whereas in blood group B, IgM anti-A titers of <64 were 65.5% (93) and >64 were 34.5% (49). In blood group O, the percentage of individuals with <64 and >64 titers of IgM anti-A were 52.60% (81) and 47.40% (73), respectively, whereas for anti-B, <64 and >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 <64 can only be transfused across the ABO barrier. As the majority of group A donors had titers <64, group A platelets may be transfused across the ABO barrier in emergency situations. [ABSTRACT FROM AUTHOR]

Objective: Blood transfusion is a life-saving medical intervention. Transfusion reactions are undesirable consequences of this intervention and may present with various findings. Using data from our hospital and hemovigilance procedures that included electronic recording, our aim was to evaluate non-infectious transfusion reactions. Methods: We present reaction data from electronic recordings of blood products transfused between January 2017 and December 2021. Gender, age, symptoms and findings, blood pressure, fever, respiratory and heart rates before and after transfusion were analyzed according to reaction types. Reactions were classified according to clinicians definition. Analysis of the data was carried out using the SPSS 25 package program. Results: While allergic transfusion reactions and febril nonhemolitic transfusion reactions were common transfusion reactions, the most common reaction products were fresh frozen plasma, erythrocyte suspension and platelet suspension respectively. Chills, restlessness, fever, were common signs and symptoms. While allergic transfusion reactions were higher in pediatric patients, there was no difference between genders. The high number of patients who had a previous transfusion among the patients who developed a reaction suggested that exposure did not reduce the risk. More notifications were made after the use of electronic records than in previous years. Conclusion: Electronically recorded hemovigilance data can contribute to an increase in accurate classification and reporting of transfusion reactions and monitoring of blood processes. [ABSTRACT FROM AUTHOR]

Patients with cancer who receive allogeneic red blood cell transfusions are at risk of adverse reactions of varying severity. One of these reactions is immunomodulation, also known as transfusion-related immunomodulation. With the exact mechanism of transfusion related immunomodulation being unclear, storage lesions (both the cellular and cytokine component) are considered a major contributor. Leucocytes are believed to be implicated in storage lesions and immunomodulation. However, the efficacy of leucodepletion in reducing immunomodulation is controversial. The theoretical link between these three interconnected events - storage lesions, immunomodulation and cancer progression remain controversial and poorly understood. This article summarizes the available evidence on efficacy of leucodepletion, storage lesions and transfusion related immunomodulation, while rationalizing the possible association between an immunomodulation triggering transfusion 'dose' in cancer patients and subsequent cancer recurrence. [ABSTRACT FROM AUTHOR]

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.

ABO and Rhesus D (RhD) matching in platelet transfusions varies widely worldwide, since it does not preclude good clinical responses. However, it has been shown that ABO and RhD matching selection for platelet transfusions raises efficacy and safety concerns. The present study aimed to assess and evaluate ABO and RhD matching in platelet transfusions. The present study was part of a national survey that evaluated the platelet units, and ABO and RhD blood group of patients, along with the number of platelet units produced and transfused from May to June, 2015. A total of 13,250 [12,061 random donor platelets (RDPs) and 1,189 single donor platelets (SDPs)] were evaluated. ABO identical platelets were transfused in 58.99±0.88% RDPs and 45.75±2.87% SDPs. ABO major incompatible platelets (with antigen incompatibility) were transfused in 15.92±0.66% RDPs and 24.05±2.47% SDPs. ABO minor incompatible platelets (with plasma incompatibility) were transfused in 19.70±0.71% and 22.96±2.43% RDPs and SDPs, respectively, while a combination of ABO major and minor incompatible platelets (combination of plasma and antigen incompatibility) in 5.38±0.41% and 7.23±1.51%, RDPs and SDPs respectively. A total of 6.69 and 12.29% of RhD-positive RDPs and SDPs were transfused in RhD-negative patients (both P<0.001). On the whole, the analysis of real-world data indicates variations in platelet ABO and RhD matching. Further studies are required to elucidate the real impact in the management of patients, while the upcoming centralization of blood services may also be a decisive step in this direction. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study is to determine the incidence and types of blood transfusion reactions observed in tertiary care hospital. The collection of data was from blood bank of Taj Medical Complex Hospital of Hamdard University, Karachi. Material and Methods: In this retrospective study the patients that received blood transfusion due to any medical reason, age between 18 to 80 years, for the duration of two years, at tertiary care hospital in Pakistan were included. Results: The overall frequency of acute blood transfusion was 0.47%, with 41.6% acute blood transfusion reactions occurring in men and 58.3% in women. The distribution of acute blood transfusion reactions by blood group was 25% in the blood group "A", 36.1% in the blood group "B", 27.7% in the blood group "O" and 11.1% in the blood group "AB". Red cell concentrate was most common component of acute blood transfusion reaction in 86.1% cases. Febrile non haemolytic transfusion reaction was the most common transfusion reaction in 75% cases followed by allergic reactions. Conclusion: Adverse blood transfusion reactions are unavoidable effects of blood transfusions that can be managed when detected timely. Establishment of a proper hemovigilance system will be vital in providing better care for the patients. [ABSTRACT FROM AUTHOR]

Background: Acute complications of transfusion are among the leading causes of morbidity and mortality in chronically transfused patients. One of the main goals of blood transfusion is to reduce complications and improve blood safety and patient health care worldwide. The present study aimed to investigate the prevalence of acute complications of transfusion beta-thalassemia major (TM) patients in Southeast Iran. Methods: In a prospective study, 23882 transfusions were evaluated in TM patients of a thalassemia clinic for acute reactions during a two-year period. Data were collected by forms to record the information related to blood transfusion at the time of reaction occurrence. Results: The assessment of the data revealed that 228 TM patients (0.95%) had acute complications of transfusion. Among 23882 TM patients undergoing transfusion, 211 (0.87%) developed allergic reactions, 11 (0.04%) were diagnosed with febrile non-hemolytic reaction, and one patient (0.004%) had experienced acute hemolytic transfusion reaction. Conclusion: The results of the current study support preventive measures for the reduction of these complications to improve patients’ 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 to provide 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. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to investigate nurse perspectives on transfusion‐related adverse reaction reporting practices. Background: Transfusion‐related adverse reaction reporting is an essential component of hemovigilance in Canada, but reporting rates vary and under‐reporting of minor transfusion‐related adverse reactions exists. To our knowledge, this is the first report of nursing transfusion‐related adverse reaction reporting attitudes. Design: This qualitative descriptive study explored the nursing practices and perspectives of transfusion‐related adverse reaction reporting by conducting one‐on‐one interviews with nurses (n = 25) working in adult oncology inpatient and outpatient units. Methods: Data were thematically analysed; data collection ended when saturation was reached. The COREQ checklist was used to guide this study. Results: The study revealed that the nursing practices of transfusion‐related adverse reaction reporting are not standardised to meet the institutional reporting guidelines. Under‐reporting of febrile reactions exists at this institution. Major concepts uncovered included the factors impacting nurses' transfusion‐related reporting practices, as well as barriers and facilitators to transfusion reporting. Conclusion: A practice change in transfusion‐related adverse reaction reporting is needed to achieve optimal hemovigilance at this institution. Using the barriers and facilitators identified in this study, institutions can better inform future interventions by employing strategies like TR reporting education in order to improve reporting of transfusion‐related adverse reactions in this hospital and other similar institutions. Relevance to clinical practice: This study informs clinical practice and decision‐making for nurses and nursing educators who manage blood transfusion administration procedures. [ABSTRACT FROM AUTHOR]

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.

Background and Objectives: Clinicians sought to ascertain what frequency of vital signs best detects blood transfusion reactions. This review discusses early and delayed blood product transfusion reaction detection through the lens of scientific literature. Methods: A comprehensive appraisal of published literature was conducted using Integrative Research Review methodology through June 2022 not limited to English or research in Cumulative Index to Nursing and Allied Health Literature, Cochrane Library of Systematic Reviews, Medline and PubMed. Results: Full‐text articles in the final sample included four articles discussing vital signs detecting blood transfusion reactions and four articles reporting the importance of adding physical assessments for early reaction detection. None of the studies provided evidence regarding how often vital signs should be monitored to detect transfusion reactions. No studies included identical screening components for detecting blood product transfusion reactions. Main themes emerged including variations in what was included in vital signs, importance of respiratory assessment, inclusion of physical assessment, nurse documentation and reporting compliance, and patient and family inclusion in transfusion reaction recognition. Conclusion: Vital sign components varied across reviewed studies. Respiratory rate and pain were not always included in 'vital signs' to identify transfusion reactions. Only low‐level data and no clinical trials loosely informing frequency of vital sign monitoring to transfusion reaction detection were found. Respiratory (to include oxygen saturation, lung sounds and respiratory rate) and pain assessment emerged as crucial to acute and delayed transfusion reaction recognition. The disconnect between 'vital signs' and the varied vital sign components reported to detect transfusion reactions in scientific literature requires further exploration. [ABSTRACT FROM AUTHOR]

Background and Objectives: Immune‐mediated acute or delayed transfusion reactions occur when there is immunological incompatibility between transfused blood products and recipient's antibodies. Acute haemolytic transfusion reactions occur within 24 h and are delayed after 24 h up to 10 days following transfusion, whereas post‐transfusion purpura (PTP) typically occurs 7–10 days post‐transfusion. We present a case of a previously transfused and recently post‐partum female who developed both delayed haemolytic transfusion reaction (DHTR) and PTP. Case Report: A 42‐year‐old woman, G2P1, with non‐alcoholic liver disease, portal hypertension and previous transfusion history with allogeneic anti‐E, developed a severe DHTR and PTP following a complicated post‐partum course and multiple transfusions. The antenatal and initial post‐partum pre‐transfusion antibody screens were negative. Subsequently five red cell antibodies, including anti‐c, anti‐Fya, anti‐Jkb and anti‐S and the reappearance of anti‐E were, however, identified during follow‐up investigations along with the anti‐platelet antibody HPA‐3a and human leukocyte antigen class I antibodies. Anti‐E, anti‐Jkb and anti‐S were eluted from the circulating red blood cells. Conclusion: To our knowledge, there have been only two other case reports of DHTR and PTP occurring in the same patient. [ABSTRACT FROM AUTHOR]

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 AND OBJECTIVES:Many hospitals require transfusions to be discontinued when vital signs stray from predetermined ranges, regardless of clinical symptoms. Variations in vital signs may be unrelated to transfusion, however, and needlessly stopping a transfusion may delay medical care while increasing donor exposures and healthcare costs. We hypothesized that a detailed study of vital sign changes associated with transfusion of blood product by component, including those associated with potential reactions (complicated) and those deemed to be uncomplicated, would establish a useful framework of reference for treating clinicians and transfusion services alike. MATERIALS AND METHODS:A retrospective electronic record review of transfusion service and transfusion recipient data was completed on 3852 inpatient transfusion episodes over a 6-month period at four academic tertiary care hospitals across the United States. Vital signs pre- and post-transfusion were recorded by trained clinical research nurses. Serious reactions were adjudicated by a panel of transfusion medicine experts. RESULTS:In both uncomplicated transfusions (n = 3765) and those including an adverse reaction (n = 87), vital sign fluctuations were generally modest. Compared to uncomplicated transfusions, transfusions complicated by febrile reactions were associated with higher pretransfusion temperature and higher pretransfusion pulse rates. Episodes of transfusion circulatory overload were associated with higher pretransfusion respiration rates compared to uncomplicated transfusions. CONCLUSION:Most transfusions are associated with only modest changes in vital signs. Pretransfusion vital signs may be an important yet previously understudied predictor of vital sign changes during transfusion. The optimal role of vital sign assessment during blood transfusion deserves further study.

ABSTRACT: Audience: This scenario was developed to educate emergency medicine residents on the diagnosis and management of acute hemolytic transfusion reactions in the emergency department. The case is appropriate for senior medical students and advanced practice providers. The principles of crisis resource management, teamwork, and communication are also incorporated into the case. Introduction: Patients who present with suspected acute hemolytic transfusion reactions require rapid diagnosis and management, as well as a thorough evaluation for other differential diagnoses, such as DIC (disseminated intravascular coagulation), TTP (thrombotic thrombocytopenic purpura), and sepsis. The possibility of acute hemolytic transfusion must be entertained early, as it carries significant morbidity including the risk of developing acute hemolytic anemia, acute renal failure, DIC, shock, and/or death.1 The mortality rate of acute hemolytic transfusion reactions can reach 44%, and it accounts for 20% of all transfusion-related mortalities.2,3 Given this significant morbidity and mortality, early recognition and management are paramount in the emergency department (ED) to avoid clinical deterioration and death. Objectives: By the end of this simulation session, the learner will be able to: 1) Recognize the clinical signs and symptoms associated with transfusion reactions. 2) Discuss necessary systems-based management of potential transfusion reactions, such as notifying the blood bank and evaluating to see if another patienta accidentally received a wrong unit of blood. 3) Discuss the management of various transfusion reactions. 4) Appropriately disposition the patient to an intensive care unit (ICU) or stepdown unit. 5) Effectively communicate with team members and nursing staff during the resuscitation of a critically ill patient. Method: This session is conducted using high-fidelity simulation, followed by a debriefing session and lecture on the diagnosis and management of transfusion reactions. Debriefing methods may be left to the discretion of participants, but the authors have utilized advocacy-inquiry techniques. Topics: Medical simulation, acute hemolytic transfusion reaction, transfusion reactions, hematology, emergency medicine.

Background and Objectives: The field of transfusion medicine started out with whole blood transfusion to treat severe anaemia and other deficiencies, and then transitioned to component therapy, largely leaving the practice, and experiences, of whole blood transfusions behind. Currently, the field is circling back and whole blood is gaining ground as an alternative to massive transfusion protocols. Materials and Methods: Herein we describe a severely anaemic paroxysmal nocturnal haemoglobinuria (PNH) patient initially suspected of suffering from renal haemorrhage, receiving a standard low‐titre group O whole blood transfusion during pre‐hospital transportation. Results: Following the transfusion, the patient suffered a clinically unmistakable haemolytic transfusion reaction requiring supportive treatment in the intensive care unit. Clinical observations are consistent with an acute haemolytic reaction. The haemolysis was likely due to minor incompatibility between the plasma from the transfused whole blood and the patient's PNH red cells. Recovery was uneventful. Conclusion: This revealed an unappreciated contraindication to minor incompatible whole blood transfusion, and prompted a discussion on the distinction between whole blood and erythrocyte concentrates, the different indications for use and the importance of emphasizing these differences. It also calls attention to patient groups where minor incompatibility can be of major importance. [ABSTRACT FROM AUTHOR]

Background and Objectives: Di‐ethyl‐hexyl‐phthalate (DEHP) is currently the main plasticizer used for whole blood collection systems. However, in Europe, after May 2025, DEHP may no longer be used above 0.1% (w/w) in medical devices. DEHP stabilizes red cell membranes, thereby suppressing haemolysis during storage. Here we compared in vitro quality parameters of red cell concentrates (RCCs) collected and stored in DEHP‐, DINCH‐ or DINCH/BTHC‐PVC hybrid blood bags with saline‐adenine‐glucose‐mannitol (SAGM) or phosphate‐adenine‐glucose‐guanosine‐saline‐mannitol (PAGGSM) storage solution. Last, we performed haemovigilance surveillance for RCC collected in DINCH‐PVC and stored in PAGGSM/BTHC‐PVC. Materials and Methods: In vitro quality parameters of RCC were determined during 42 days of storage. Haemovigilance surveillance was conducted to compare the frequency and type of transfusion reaction. Results: Haemolysis levels were increased in SAGM/BTHC‐PVC as compared to SAGM/DEHP‐PVC (0.66% ± 0.18% vs. 0.36% ± 0.17%). PAGGSM storage solution was able to adequately suppress haemolysis to levels observed during storage in SAGM/DEHP‐PVC, both in BTHC‐PVC (0.38% ± 0.12%), and to a slightly lesser extent in DINCH‐PVC (0.48% ± 0.17%). A total of 1650 PAGGSM/BTHC‐PVC and 5662 SAGM/DEHP‐PVC RCC were transfused yielding a transfusion reaction frequency of 0.24% (95% CI 0.0000–0.0048) and 0.44% (95% CI 0.0027–0.0061) respectively. Conclusion: The in vitro quality of RCC stored in PAGGSM/BTHC‐PVC and SAGM/DEHP‐PVC is comparable. There is no indication that transfusion of erythrocytes stored in PAGGSM/BTHC‐PVC results in increased transfusion reaction frequency. These initial results provide a basis for further clinical evaluation to narrow down the confidence interval of transfusion reaction frequency. [ABSTRACT FROM AUTHOR]

Background and Objectives: Although it remains controversial, premedication before transfusion is a common clinical practice to prevent transfusion‐associated adverse reactions (TAARs) in Taiwan. Thus, we aimed to investigate whether premedication prevented outpatients from developing TAARs and whether an educational programme could improve the understanding of physicians related to the unnecessary use of premedication, and this could elicit changes in their prescribing activities without affecting the occurrence of TAARs. Materials and Methods: Clinical data from outpatients receiving transfusion therapy, including predisposing diseases, histories of transfusion and TAARs, premedication and the occurrence of TAARs in the period April 2017 to October 2018, were retrospectively obtained. The evidence‐based transfusion programme implemented to educate physicians was started in January 2018. Results: A total of 5018 blood units were transfused to 803 outpatients, with 2493 transfusion events reported in the study interval. The most frequently transfused component was leukocyte‐reduced packed red cells (n = 4338), followed by leukocyte‐reduced apheresis platelets (n = 540) and other blood components. The overall premedication rate significantly decreased from 92.4% to 76.7% after the educational programme (p < 0.001). There was no remarkable change in the occurrence of TAARs per patient event between the periods before and after the educational programme (1.11% vs. 1.14%, p = 0.964). Besides, it was shown that the occurrence of TAARs was associated with the history of TAARs and inversely related to multiple transfusions, but not premedication. Conclusion: Decreased premedication was not associated with increased incidence of TAARs in outpatients; these findings provide important evidence to support the need to revise clinical practices in the era of leukocyte‐reduced blood products. [ABSTRACT FROM AUTHOR]

Background: A direct antiglobulin test (DAT) checks for antibody or complement on the surface of RBCs and is often done following a transfusion reaction. While passive anti-A and anti-B antibodies are known to cause positive DATs, the extent this occurs following transfusion is unknown.Study Design and Methods: DAT results, ABO type, eluate information, and blood product information were recorded on 1097 transfusion reactions at a large academic hospital over 8 years. The effect of patient blood type, product type, and plasma compatibility of blood product transfused on DAT results were determined. Statistical significance was determined using Chi-squared testing.Results: Patient ABO blood type was a strong predictor of a positive DAT, with type O patients having 6.7% positive rate and non-O patients having a positive rate of 20.6% (p < .0001). Plasma compatibility of the product was a strong predictor of a positive DAT, with plasma compatible transfusions having a 9.4% positive rate while plasma incompatible transfusions were positive 44% of the time (p < .0001). Elution studies found that anti-A/B antibodies were the most common antibody identified. Platelets were more likely to be associated with a positive DAT when compared with RBC transfusions (p < .05).Conclusions: These results demonstrate the patient ABO type and plasma incompatibility are strong predictors of positive DAT results following a transfusion reaction. Anti-A and anti-B antibodies are estimated to account for about 50% of positive DATs in this study. [ABSTRACT FROM AUTHOR]

Background: Blood transfusion is a cornerstone of modern healthcare, pivotal in saving countless lives annually. However, inadequate knowledge among healthcare providers can lead to serious complications. Despite the availability of assessment tools like the Biomedical Excellence for Safer Transfusion (BEST) test, there is a need for indigenous-validated questionnaires to address knowledge gaps effectively. This study aimed to evaluate bedside transfusion medicine knowledge among clinical residents using a validated questionnaire, focusing on knowledge gaps., Study Design and Methods: A cross-sectional study was conducted at a tertiary care referral center in Northern India. The questionnaire, developed based on national and international transfusion guidelines, was validated by an expert panel, and administered to 245 clinical residents. The questionnaire covered six domains related to transfusion medicine: blood component storage, blood bank procedures, transfusion-transmitted infections, administration of blood components, transfusion reactions, and transfusion practices., Results: The study revealed varying levels of knowledge across specialties and residency years. Overall, residents scored 61 % in transfusion medicine knowledge, with Pediatrics residents demonstrating the highest scores. The incremental increase in knowledge from first to third-year residents underscores the value of continuous, experience-based learning throughout the residency period., Discussion: Study highlights significant knowledge gaps in bedside transfusion practices among clinical residents, emphasizing the need for structured educational interventions. Tailored programs, integrated into undergraduate and postgraduate curricula, are essential to improve transfusion safety and patient outcomes. Addressing these gaps can lead to better bedside transfusion practices, reducing risks and improving the quality of patient care., Competing Interests: Declaration of Competing Interest There are no conflicts of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: The 2019 SCARED study developed the Biomedical Excellence for Safer Transfusion (BEST) criteria in an effort to standardize the decision to culture residual units in the context of suspected septic transfusion reactions (STRs). The goal of this study was to apply the BEST criteria to determine the effect on the transfusion reaction decision to culture.Methods: This retrospective, single-center, cross-sectional study assessed adult transfusion reactions identified in calendar years 2013 to 2020. Reactions following transfusion of RBCs, platelets, and plasma were included, and the decisions to culture following strict application of BEST criteria were compared with decisions to culture in actual practice.Results: In total, 1,068 transfusion reactions were reported and 200 (19%) suspected STRs were cultured, all with negative results; 303 (28%) reactions would have been cultured per strict application of the BEST criteria. Concordance between actual culture decision and BEST criteria recommendation was 62% for cultured components and 79% for components that were not cultured.Conclusions: BEST criteria provide objective recommendations of when to culture residual units implicated in suspected STRs, but strict application of these criteria may result in increased culture rates. Clinical correlation to aid in the decision to culture is recommended. [ABSTRACT FROM AUTHOR]

Background and Objectives: Exchange transfusion is a valuable treatment option in sickle cell disease (SCD) and is preferred over simple transfusion as it removes abnormal haemoglobin S (HbS) levels and reduces complications. This meta‐analysis aims to evaluate the efficacy and safety profile of automated red cell exchange (aRBX) procedure over manual red cell exchange transfusion (MET) in SCD patients. Materials and Methods: A standard meta‐analysis protocol was developed, and after performing a comprehensive literature search in PubMed/MEDLINE, Cochrane and International Clinical Trial Registry Platform (ICTRP), reviewers assessed eligibility and extracted data from nine relevant studies. A random effects model was used to estimate the pooled effect size calculated from the mean difference in HbS percentage, serum ferritin level and risk ratio for the adverse events. Quality assessment was done using the risk‐of‐bias assessment tool, and a summary of observations was prepared using standard Cochrane methodology with GradePro GDT. Results: The random‐model analysis revealed a mean difference of 4.10 (95% CI: −3.29–11.49; Z = 1.09; p = 0.28) for HbS percentage, mean difference of 435.29 (95% CI: −73.74–944.32; Z = 1.68; p = 0.09) for serum ferritin and pooled risk ratio of 1.35 (95% CI: 0.63–2.87; Z = 0.77; p = 0.44) for adverse events. Conclusion: This meta‐analysis did not reveal any significant benefit of aRBX in reducing HbS percentage and attenuating the serum ferritin level when compared with MET. There was also no significant increased risk of adverse events detected in association with aRBX. [ABSTRACT FROM AUTHOR]

Background: Patients with hematological diseases are polytransfused and often immunocompromised, therefore susceptible to transfusion reactions (TR). This study aims to document the incidence of TRs in adult hematological patients and assess the effect of changes in the production of blood components and transfusion practice on their occurrence. Study design and methods: Retrospective observational analysis of TRs reported from 1993 to 2019 was performed. For the analysis of the effect of changes on the incidence of TRs, the evaluated time was divided into two periods: the 1st period before the introduction of changes in production, when leukoreduced blood components were used only selectively, and the 2nd period, when semi‐automated method of production and universal leukoreduction was introduced. Results: The decrease in the incidence of TRs was observed for both red blood cell (RBC) and platelet concentrate (PC) transfusions in the 2nd period. Since platelet additive solution has been used, a further decrease in the incidence was reported. The decrease in incidence was also observed for delayed hemolytic/serological transfusion reactions and for transfusion‐transmitted bacterial infections. Four cases of incorrect blood transfusions were uniquely related to the hematological patients, caused by antigen loss and transfusion ordering after ABO‐incompatible hematopoietic stem cell transplantation. Discussion: Our results provided evidence that the introduction of tools offered by modern transfusion medicine: universal leukodepletion, plasma replacement with additive solutions, sensitive laboratory techniques, prophylactic antigen matching policy, informatization, and automatization, decreased the incidence of TRs and improved transfusion safety. [ABSTRACT FROM AUTHOR]

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.

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. [ABSTRACT FROM AUTHOR]

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

Blood transfusion is a life-saving procedure widely used in healthcare. However, complications such as transfusion reactions may occur. Knowledge of these reactions is essential for patient safety. Nurses play a crucial role in this process by identifying complications and adverse reactions early on. A lack of professional competence in blood transfusion can lead to errors and serious complications, such as death. The aim of this study was to present evidence of the content validity of a simulated clinical scenario on transfusion reactions for teaching and learning for nursing students. This methodological study was carried out in three phases: (1) development of the simulated scenario of a transfusion reaction; (2) analysis of evidence of content validity by experts ( n = 11); and (3) determination of satisfaction and self-confidence in the use of the simulated scenario by the nursing students ( n = 45). The Content Validity Index was 94%. After the scenario had been developed, the content was validated and approved by 100% of the experts. All the items in the simulated scenario obtained agreement scores above 0.90. The simulated scenario was validated in terms of content and can be used to teach the management of transfusion reactions.

The transfusion of blood products is a widely used practice but comes with the risk of transfusion-associated adverse events and fatalities. The primary aim of this study was to evaluate if strict adherence to transfusion guidelines would lead to a decrease in the rate of transfusion reactions that occurred when blood products were given outside of established indications. Hospital-wide educational programs and dedicated electronic transfusion order sets were used to encourage adherence to guidelines. A secondary aim of this study was to evaluate if a decrease in the incidence of transfusion reactions also lead to a decrease in associated healthcare costs. [ABSTRACT FROM AUTHOR]

Background/objectives: Transfusion reactions (TRs) may cause or contribute to death. Cardiopulmonary TRs are distressing, and collectively account for most transfusion fatalities, though the degree to which they alter survival more broadly is unclear. Deaths (and their timing) after TRs may provide further insights. Materials/Methods: Adult (tri‐hospital network) haemovigilance data (2013–2016) recorded referrals with conclusions ranging from unrelated to transfusion (UTR) to entities such as: septic TRs, serologic/haemolytic reactions, transfusion‐associated circulatory overload (TACO), transfusion‐associated dyspnoea (TAD), transfusion‐related acute lung injury (TRALI), allergic transfusion reaction (ATR), and others. For (in‐ or out‐patient) visits involving suspected TRs (VISTRs), all‐cause mortalities (% [95% confidence interval]) and associated time‐to‐death (TTD) (median days, [interquartile range]) were compared. Diagnoses were defined inclusively (possible‐to‐definite) or strictly (probable‐to‐definite). Results: Of 1144 events, rank order VISTR mortality following (possible‐to‐definite) TRs, and associated TTDs, were led by: DHTR 33% [6–19], 1 death at 123d; TRALI 32% [15–54], 6 deaths: 3d [2–20]; BaCon 21% [14–31], 17 deaths: 10d [3–28]; TACO 18% [12–26], 23 deaths: 16d [6–28]; TAD 17% [11–26]: 18 deaths, 6d [3–12]. Higher‐certainty TRs ranked similarly (DHTR 50% [9–91]; BaCon 29% [12–55], 4 deaths: 12d [3–22]; and TACO 25% [16–38], 15 deaths: 21d [6–28]). VISTR mortality after TACO or TRALI significantly exceeded ATR (3·3% [2·4–5·8], P < 0·00001) but was not different from UTR events (P = 0·3). Conclusions: Only half of cardiopulmonary TRs constituted high certainty diagnoses. Nevertheless, cardiopulmonary TRs and suspected BaCon marked higher VISTR mortality with shorter TTDs. Short (<1 week) TTDs in TAD, BaCon or TRALI imply either contributing roles in death, treatment refractoriness and/or applicable TR susceptibilities in the dying. [ABSTRACT FROM AUTHOR]

Blood transfusion is a key intervention for decreasing morbidity and mortality in many cases and, besides its importance, potentially fatal consequences of incompatible transfusion are a great risk to patients. This study evaluated the incidence and specificity of erythrocyte alloantibodies in multi-transfused patients enrolled at an important Regional Blood Center. This was a single-center retrospective cohort study that eveluated patients enrolled at a Regional Blood Center in a period of four years. A total of 29,128 patient samples were screened, out of which 79 (0.27%) were multiple-transfused patients with alloantibodies identified. The most common alloantibody found was anti-E (22.55%) followed by anti-D (14.71%), anti-C (5.88%), anti-c (5.88%), anti-e (1.96%) and anti-Cw (0.98%). We also identified combinations of alloantibodies (25.32%), 5.88% of which showed an IgG autoantibody isolated or combined with alloantibodies. The most frequent reason for the need of blood transfusion included cases of surgery, emergency and urgency (36.71%). A low rate of development of alloantibodies in multi-transfused patients was found, which could be a consequence of the implementation of red blood cell phenotyping for patients who may receive frequent transfusions, as in the case of some hematological neoplasms and hemoglobinopathies. However, the most common alloantibodies identified were against the Rh and/or Kell systems, with high clinical significance since both can cause delayed hemolytic transfusion reactions. Thus, the implementation of reliable antibody screening tests and the transfusion of phenotyped units for selected patients in all transfusion services represent important measures to increase transfusion safety. [ABSTRACT FROM AUTHOR]

Background and Objectives Blood transfusion like other medical interventions has some complications known as blood transfusion reactions. The record of these reactions is helpful in their management and patients treatments. This study has aimed to evaluate the rate of the reactions due to the transfusion of blood components among blood recipients who have had complications in hospitals of Hamadan. Materials and Methods In this cross sectional and retrospective study, the data of all 116 completed reports of possible reactions after transfusion of blood and blood components during 2018 and 2019 were inserted in to SPSS software version 16. The Data were analyzed using T-test, Chi-square and Fisher's exact test. The significance level was determined as p < 0.05. Results Based on the results, in a specialized blood hospital and four general hospitals, allergic reactions make the most common complication with 63 cases (53.4%) followed by febrile non hemolytic reactions with 28 cases (24.1%). A meaningful correlation was observed between RBC containing blood components and febrile non hemolytic reactions (p = 0.02). 68 patients (58.6% cases) had a history of transfusion of blood products and 78 patients (67.2%) had no history of blood disease. Conclusions Allergic and febrile non hemolytic reactions had the highest prevalence in blood recipients. The administration of products containing RBC was related to febrile non hemolytic reactions of recipients. [ABSTRACT FROM AUTHOR]

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 and objectives: Septic transfusion reactions are a principal cause of transfusion‐related mortality. The frequency of detectable bacterial contamination is greater in platelets compared to other blood components because platelets are stored at room temperature. Most strategies outlined in the September 2019 FDA guidance require both aerobic culture (AC) and anaerobic culture (AnC) testing. We performed a systematic review and meta‐analysis in an effort to provide the best available estimate of the effectiveness of AnC. Materials and methods: Our analysis was performed according to published guidelines. Broad and context‐specific meta‐analyses of bacterial detection rates in platelets by AnC were performed to assess the practical effectiveness of AnC as a risk control measure. Results: Seven studies with a total of 1 767 014 tested platelet components were included for analysis. With exclusion of positives due to Cutibacterium/Propionibacterium species and redundancy due to AC results, AnC detected 0·06 contamination events per thousand (EPT) components tested, twofold lower than the AC (0·12 EPT). Conclusion: Excluding Cutibacterium/Propionibacterium species, AnC detects occasional bacterial contamination events that are not detected by AC (~1 in 17 000 platelet components). [ABSTRACT FROM AUTHOR]