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Study of acute transfusion reactions in a teaching hospital of Sikkim: A hemovigilance initiative.

Sharma DK, Datta S, Gupta A - Indian J Pharmacol (2015 Jul-Aug)

Bottom Line: Blood transfusions are inherently associated with risks ranging in severity from minor to life-threatening.The lack of leukoreduction facilities in our hospital could be a likely cause for the same.The use of leukoreduced WB and PRBCs could possibly reduce the overall incidence of ATRs in general and febrile nonhemolytic transfusion reactions in particular.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacology, Sikkim Manipal University, Sikkim Manipal Institute of Medical Sciences, Tadong, Gangtok, East Sikkim, Sikkim, India.

ABSTRACT

Objective: Blood transfusions are inherently associated with risks ranging in severity from minor to life-threatening. Continuous monitoring of transfusion related complications can promote understanding of factors contributing to transfusion reactions and help to formulate necessary remedial measures. This study was designed to analyze the frequency and nature of transfusion reactions reported to the blood bank of a remote North East Indian teaching hospital.

Materials and methods: All acute transfusion reactions (ATRs) reported to the blood bank over a period of 20 months (May 2013 to January 2015) were reviewed and analyzed. The risk of transfusion reactions associated with each individual component was assessed.

Results: A total of 3455 units of whole blood and component transfusions were carried out of which a total of 32 (0.92%) ATRs were encountered. Packed red blood cells (PRBCs) (n = 15, P = 0.06) and whole blood (WB) (n = 13, P = 0.83) were most commonly implicated. Allergic reaction was the most frequent transfusion reaction encountered (65.6%), seen most commonly with PRBC (risk of 0.76%, P = 0.42), and WB (risk of 0.68%, P = 0.63) transfusions. This was followed by febrile reactions (28.1%), which were seen more commonly with PRBCs (risk of 0.57%, P = 0.016). No reactions were observed with platelet transfusions.

Conclusion: The overall incidence of transfusion reactions in this hospital is slightly higher than those having more advanced transfusion facilities in India. The lack of leukoreduction facilities in our hospital could be a likely cause for the same. The use of leukoreduced WB and PRBCs could possibly reduce the overall incidence of ATRs in general and febrile nonhemolytic transfusion reactions in particular.

No MeSH data available.


Related in: MedlinePlus

Relative frequency of departments reporting acute transfusion reactions
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Figure 2: Relative frequency of departments reporting acute transfusion reactions

Mentions: A total of 3455 units of whole blood and component transfusions were carried out in the study duration, out of which a total of 32 (0.92%) ATRs were encountered. Table 3 depicts the demographic characteristics of the recipients reported with transfusion reactions. The age of the recipients ranged from 14 to 88 years, with the mean age of females (43.7 years) slightly lower than that of males (44.3 years). There was a female preponderance (59.4%) in the frequency of transfusion reactions, over males (40.6%). However, this difference was not significant (P = 0.13, χ2 = 2.25). Transfusion with packed red blood cell (PRBC) was most commonly associated with adverse reactions (15 reactions out of a total of 1042 transfusions; P = 0.06, χ2 = 3.52), followed by whole blood (WB) transfusions (13 reactions out of a total of 1467 transfusions; P = 0.83, χ2 = 0.045) [Table 1]. A total of 650 units of fresh frozen plasma (FFP) transfusions were carried out that finally resulted in four reactions (P = 0.36, χ2 = 0.84). No reactions were encountered with platelet, cryoprecipitate, and cryo poor plasma transfusions. Allergic reaction was the most frequently encountered transfusion reaction (65.6%) [Figure 1], which was most commonly seen with PRBCs (risk of 0.76%; P = 0.42, χ2 = 0.63) and WB (risk of 0.68%; P = 0.63, χ2 = 0.23) [Table 2]. This was followed by febrile nonhemolytic transfusion reactions (FNHTRs) (28.1%), which was seen more commonly with PRBCs (risk of 0.57%; P = 0.016, χ2 = 5.7). There was one reaction each of anaphylaxis and pulmonary embolism, following WB and PRBC transfusions, respectively. No hemolytic reactions were encountered in the study period. The mean volume of blood at which transfusion reaction had occurred was 192.5 ± 95.7 ml [Table 4]. Figure 2 shows the relative frequency of transfusion reactions according to the department in which the recipients were being treated, and the adverse event reported. Most common manifestations included urticaria and itching (n = 14 each), followed by fever (n = 9), dyspnea (n = 7), and increased pulse rate (n = 6) [Figure 3]. Less frequent manifestations included hypotension, muscle aches, headache, and hypertension.


Study of acute transfusion reactions in a teaching hospital of Sikkim: A hemovigilance initiative.

Sharma DK, Datta S, Gupta A - Indian J Pharmacol (2015 Jul-Aug)

Relative frequency of departments reporting acute transfusion reactions
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4527056&req=5

Figure 2: Relative frequency of departments reporting acute transfusion reactions
Mentions: A total of 3455 units of whole blood and component transfusions were carried out in the study duration, out of which a total of 32 (0.92%) ATRs were encountered. Table 3 depicts the demographic characteristics of the recipients reported with transfusion reactions. The age of the recipients ranged from 14 to 88 years, with the mean age of females (43.7 years) slightly lower than that of males (44.3 years). There was a female preponderance (59.4%) in the frequency of transfusion reactions, over males (40.6%). However, this difference was not significant (P = 0.13, χ2 = 2.25). Transfusion with packed red blood cell (PRBC) was most commonly associated with adverse reactions (15 reactions out of a total of 1042 transfusions; P = 0.06, χ2 = 3.52), followed by whole blood (WB) transfusions (13 reactions out of a total of 1467 transfusions; P = 0.83, χ2 = 0.045) [Table 1]. A total of 650 units of fresh frozen plasma (FFP) transfusions were carried out that finally resulted in four reactions (P = 0.36, χ2 = 0.84). No reactions were encountered with platelet, cryoprecipitate, and cryo poor plasma transfusions. Allergic reaction was the most frequently encountered transfusion reaction (65.6%) [Figure 1], which was most commonly seen with PRBCs (risk of 0.76%; P = 0.42, χ2 = 0.63) and WB (risk of 0.68%; P = 0.63, χ2 = 0.23) [Table 2]. This was followed by febrile nonhemolytic transfusion reactions (FNHTRs) (28.1%), which was seen more commonly with PRBCs (risk of 0.57%; P = 0.016, χ2 = 5.7). There was one reaction each of anaphylaxis and pulmonary embolism, following WB and PRBC transfusions, respectively. No hemolytic reactions were encountered in the study period. The mean volume of blood at which transfusion reaction had occurred was 192.5 ± 95.7 ml [Table 4]. Figure 2 shows the relative frequency of transfusion reactions according to the department in which the recipients were being treated, and the adverse event reported. Most common manifestations included urticaria and itching (n = 14 each), followed by fever (n = 9), dyspnea (n = 7), and increased pulse rate (n = 6) [Figure 3]. Less frequent manifestations included hypotension, muscle aches, headache, and hypertension.

Bottom Line: Blood transfusions are inherently associated with risks ranging in severity from minor to life-threatening.The lack of leukoreduction facilities in our hospital could be a likely cause for the same.The use of leukoreduced WB and PRBCs could possibly reduce the overall incidence of ATRs in general and febrile nonhemolytic transfusion reactions in particular.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacology, Sikkim Manipal University, Sikkim Manipal Institute of Medical Sciences, Tadong, Gangtok, East Sikkim, Sikkim, India.

ABSTRACT

Objective: Blood transfusions are inherently associated with risks ranging in severity from minor to life-threatening. Continuous monitoring of transfusion related complications can promote understanding of factors contributing to transfusion reactions and help to formulate necessary remedial measures. This study was designed to analyze the frequency and nature of transfusion reactions reported to the blood bank of a remote North East Indian teaching hospital.

Materials and methods: All acute transfusion reactions (ATRs) reported to the blood bank over a period of 20 months (May 2013 to January 2015) were reviewed and analyzed. The risk of transfusion reactions associated with each individual component was assessed.

Results: A total of 3455 units of whole blood and component transfusions were carried out of which a total of 32 (0.92%) ATRs were encountered. Packed red blood cells (PRBCs) (n = 15, P = 0.06) and whole blood (WB) (n = 13, P = 0.83) were most commonly implicated. Allergic reaction was the most frequent transfusion reaction encountered (65.6%), seen most commonly with PRBC (risk of 0.76%, P = 0.42), and WB (risk of 0.68%, P = 0.63) transfusions. This was followed by febrile reactions (28.1%), which were seen more commonly with PRBCs (risk of 0.57%, P = 0.016). No reactions were observed with platelet transfusions.

Conclusion: The overall incidence of transfusion reactions in this hospital is slightly higher than those having more advanced transfusion facilities in India. The lack of leukoreduction facilities in our hospital could be a likely cause for the same. The use of leukoreduced WB and PRBCs could possibly reduce the overall incidence of ATRs in general and febrile nonhemolytic transfusion reactions in particular.

No MeSH data available.


Related in: MedlinePlus