Acute transfusion reaction and its associating factors: An insight from Indonesian National Referral Hospital

Abstract

Abstract INTRODUCTION AND AIMS: Remarkable progress has been made in controlling infection, leaving transfusion reaction a great concern following blood administration. Optimal hemovigilance is the key in ensuring transfusion safety, yet many centers’ system is still far below standard. Reported data are lacking from our part of the world, hence we aim to provide an insight into acute transfusion reaction profile from Indonesia’s National Referral Hospital to refine hemovigilance system, especially in a resource-constrained center. SUBJECTS AND METHODS: We collected transfusion data from Kiara, Cipto Mangunkusumo National Referral Hospital, Jakarta, throughout 2018. Data include age, sex, diagnosis, type of blood products received, reaction symptoms, and its severity, along with time to each reaction’s occurrence. We analyzed these data to find any significant association. RESULTS: Throughout 2018, there were a total of 25,798 blood transfusions. Among these, there were 133 of ATR reported (0.52%). Fresh frozen plasma, thrombocyte concentrate (TC), and packed red cells-regular (PRC-R) resulted in the highest reaction incidence where PRC elicited a fair amount of moderate-severe reactions (54.7%) while TC and plasma components mostly in mild reactions (71.4% and 80%). We also found a significant correlation between time to reaction onset with both types of blood products and patient’s diagnosis. CONCLUSIONS: Various recipient’s factors are paramount in predicting ATR and hence preventive strategies should be conducted in a more personalized way. We present the rationale to take into account patient’s diagnosis and types of blood product received to anticipate more serious reactions and in a timely manner.