Blood Transfusion Reactions Research Articles

A Survey of Acute Transfusion Reactions in Thalassemic Patients in Pakistan: A Single Centre Experience

Background: Blood transfusion reactions are characterized as adverse reactions linked to whole blood or any of its constituent parts, encompassing a spectrum of severity levels, from minor to potentially life-threatening. The administration of blood products is a common practice to enhance the hemodynamic status and overall clinical well-being of patients. However, it's important to note that transfusing blood components comes with potential complications, both infectious and non-infectious in nature. Objective: The current study aim to evaluate the type and frequency of transfusion reactions in thalassemic patients at Hamza Foundation Welfare Hospital and Blood Services, Peshawar. Method: The current study was a descriptive cross-sectional study. The data was collected from 152 participants through a self-generated questionnaire during the 4 months (from April to July 2022) study period. Results: The overall frequency of febrile non-hemolytic reactions (FNHTR), allergic transfusion reactions (ATR), and acute hemolytic transfusion reactions (AHTR) was 84%. Among the 152 participants, 91 (59.8%) were males, and 61 (40.2%) were females. Of the total males, 83 (55.6%) experienced transfusion reactions, while 46 (30%) of the females had transfusion reactions. Specifically, 56 males and 36 females experienced FNHTRs, 22 males and 4 females experienced ATRs, and 5 males and 6 females experienced AHTRs. Fever was observed predominant symptom 69.7% and 52.6% among FNHTR and AHTR, anxiety was predominantly observed in 34.8% in ATRs. Conclusion: Among the transfusion reaction types, FNHTRs emerged as the most common, followed by ATRs and AHTRs. Key words: Febrile Non-Hemolytic Reaction, Allergic Transfusion Reaction, Hemolytic Transfusion Reactions

WP4.6 - Reducing Unnecessary Transfusion of Blood Products – A Quality Improvement Project in a General Surgical Department in a District General Hospital

Abstract Aims To audit adherence of transfusion of blood products against NICE guideline thresholds. To reduce unnecessary blood transfusions following departmental teaching sessions and installation of posters on surgical wards. Methods We retrospectively audited all patients receiving packed red cells transfusions consecutively across two consecutive four-month periods in a general surgery department. Departmental teaching sessions were held after the first audit cycle, supplemented by installation of posters including NICE guideline thresholds on surgical wards. The medical notes for each patient were assessed for pre-transfusion haemoglobin, indication for transfusion, and whether each transfusion was prescribed according to NICE guidelines. Results A total of 112 units of packed red blood cells in 42 patients and 133 units in 43 patients were transfused, respectively, before and after intervention. 45 units (40.2%) were prescribed according to NICE guidelines on first audit, improving to 67 units (50.4%) following intervention. 23 units of blood (20.5% of total) were transfused back-to-back inappropriately on first audit, reducing to 6 units (4.51% of total) after intervention. There were 2 self-limiting transfusion-related reactions (1.79%) on first audit, both in patients transfused above guidance thresholds, and no reactions following intervention. At a raw cost of approximately £135 per unit of donated blood, savings of £1830 were made over a four-month period (£5493pa), not including nursing and administration costs Conclusions Through simple local interventions and stricter adherence to transfusion thresholds, we reduced inappropriate above-threshold blood product transfusions in our hospital. This corresponded to a reduction in unnecessary blood-transfusion reactions and significant hospital savings.

Investigation of the Frequency of Reactions and Consequences of Blood Transfusion in an Academic Center Guilan-Iran

Background: Blood transfusion is a life-saving procedure, but there are always potential risks, such as blood transfusion reactions. Objectives: Considering the importance of the subject and the lack of a similar study in Guilan province, this research was conducted to analyze blood transfusion reactions. Methods: This retrospective descriptive study was conducted at Al-Zahra Hospital in Guilan, Iran, between 2020 and 2022. The files of all patients who received blood products at this center and experienced a reaction were reviewed. A checklist was completed, which included details such as the hospital ward, age, blood group, underlying disease, type of surgery, type of injected product, history of transfusion, history of reaction and allergy, type of reaction, and treatment intervention. Results: During the study period, 4,887 cases received transfusions. Among them, 18 cases (0.36%) showed reactions during transfusion, of which 14 cases (0.35% of total packed cell injections) were related to packed cell injection. Shivering was the most common reaction, occurring in 8 cases (15.38%). The main interventions included the administration of steroids in 10 cases (25%), antihistamines in 7 cases (17.5%), and oxygen therapy in 7 cases (17.5%). Three cases (7.5%) were transferred to the ICU, and in three cases (7.5%), the blood transfusion was stopped. One mortality was reported, and no cases of incompatible blood transfusion were documented. Conclusions: The incidence of reactions to blood product injections at this center appears to be acceptable. However, it was found that the information recording systems were very inefficient, and forms were incompletely filled, which should be addressed and corrected.

Evaluation of leukocyte depletion of packed red blood cells for the prevention of clinically observed transfusion reactions at a medical center in Eastern Taiwan

ABSTRACT Objectives: The incidence of febrile nonhemolytic transfusion reactions (FNHTRs) is correlated with the level of cytokines released by donor leukocytes in blood bags during storage, which is the most common transfusion reaction. The study aimed to reveal whether the use of leukocyte-poor red blood cells (LPRBCs) can reduce the incidence of transfusion reactions to promote patient safety. Materials and Methods: From January 2014 to June 2022, 158,122 blood transfusion reports were collected from a medical center in Eastern Taiwan. Data were categorized into three groups according to usage prepromotion use of LPRBCs (January 2014–April 2016), promotion use of LPRBCs (May 2016 to February 2018), and full utilization of LPRBCs (March 2018 to June 2022). According to the American Association of Blood Bank Common Transfusion Reaction Reporting Form version 2.0 reporting system, FNHTRs were classified as moderate transfusion reactions. We used these data to analyze the association between LPRBC use and transfusion reaction rate. Results: At our hospital, the LPRBC usage rate from January 2014 to April 2016, May 2016 to February 2018, and March 2018 to June 2022 was 5.37%, 34.82%, and 56.45%, respectively. The total transfusion reaction rate from January 2014 to April 2016 was 1.66%, whereas the moderate reaction rate was 1.29%. The total transfusion and moderate reaction rates from May 2016 to February 2018 were 1.41% and 1.00%, whereas those from March 2018 to June 2022 were 0.95% and 0.63%, respectively. The total transfusion and moderate reaction rates from March 2018 to June 2022 decreased by 42.8% and 51.2%, respectively, compared with those from January 2014 to April 2016. We further compared the incidence of transfusion reactions caused by packed red blood cells (PRBC) and LPRBC products in different years. The results showed that between 2014 and 2022, the types of blood transfusion reaction caused using PRBC and LPRBC products are the mild transfusion reaction rate of 0.20%/0.20%, the moderate transfusion reaction rate of 1.61%/0.69%, the severe transfusion reaction rates 0.38%/0.16%, and the total transfusion reaction rates 2.19%/1.05%. Conclusion: Our study results indicate that both total transfusion and moderate reaction rates significantly decreased with increasing LPRBC usage rate. Based on our data analysis, LPRBC is more effective in reducing moderate and severe transfusion reactions than PRBC.

Enhancing clinical insight: Implementing validated questionnaires for comprehensive assessment of clinician expertise in transfusion medicine practices

BackgroundBlood 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 methodsA 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. ResultsThe 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. DiscussionStudy 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.

Comparison of Therapeutic Effect of Apheresis Platelets and Buffy Coat-Derived Platelet Concentrates.

The study aimed to investigate the difference in clinical efficacy between apheresis platelets and buffy coat-derived platelet concentrates infusion in patients with hematological diseases. A total of 218 patients with hematological diseases were enrolled in Xi'an Central Hospital, from January 2023 to October 2023, and randomly divided into two groups: 109 patients were treated with apheresis platelet transfusion (AP group) and 109 patients with buffy coat derived platelet concentrates (BC-PC group). Platelet counts were measured before and 24 hours after transfusion, and the corrected platelet ascending number (CCI) and platelet recovery rate (PPR) were calculated. The clinical efficacy and blood transfusion reaction were observed. After 24 hours of platelet transfusion, there was no significant difference in the platelet count between the AP and BC-PC groups (p > 0.05). However, CCI and PPR significantly differed between the two groups (p < 0.05). Moreover, the incidence of transfusion reaction in the AP group was significantly lower than in the BC-PC group. The clinical efficacy of buffy coat-derived platelet concentrates is lower than that of apheresis platelets, but it can also improve the patient's condition and quality of life. Therefore, clinicians could rationally use BC-PC, according to the actual situation of the patients.

Impact of a cell salvage device on blood transfusions to dogs undergoing surgery at a referral veterinary hospital.

To determine the number of homologous blood transfusions received by canine surgical patients after introducing a cell salvage device (CSD), trends in surgeries requiring blood transfusion, and the incidence of transfusion reactions. Retrospective study. Single referral hospital. All dogs having surgery at a single center (November 2015 to February 2021). Medical records of dogs having surgical treatment, including those that received either an autologous or homologous blood transfusion, were reviewed. The surgical patients were the baseline population, and the 2 transfusion groups were compared within this population to analyze the trends. A total of 37 and 86 dogs received autologous and homologous blood transfusions, respectively. There was an upward trend in the number of total monthly blood transfusions. No significant increase in the monthly number of homologous transfusions was observed before or after acquisition of the CSD. There was also an upward trend in total monthly surgeries, including those with higher risks of hemorrhage. Dogs receiving homologous blood transfusions had a higher incidence of clinical signs consistent with transfusion reactions (6.98%). An upward trend in autologous blood transfusions was seen with the introduction of a CSD. Hospitals with large surgical caseloads at high risk of hemorrhage may see a decreased need for outsourced blood products with the use of the CSD. The device can lead to a more responsible use of an increasingly scarce resource and decrease the risk of a blood transfusion reaction in dogs.

Complex delayed blood transfusion reaction: A case report.

Inefficient blood transfusions present a significant challenge, leading to the wastage of crucial blood resources and increased medical expenses. This study aims to address this issue by providing a comprehensive analysis of a case involving an ineffective clinical transfusion and outlining the significance of identifying multiple alloantibodies in resolving transfusion challenges. We present a detailed follow-up on a patient treatment journey, highlighting the critical role of identifying multiple alloantibodies through various methodologies in addressing the transfusion problem. Subsequently, a strategic intervention was implemented, leading to a successful patient outcome. This study underscores the importance of conducting a thorough analysis of ineffective transfusions and implementing scientifically formulated transfusion plans based on rational explanations. Such an approach not only improves hemoglobin levels but also contributes to better patient outcomes, thereby reducing blood resource wastage and medical costs.

Determination of the Knowledge Level of Nurses and Midwives Working at A University Hospital About Transfusion of Blood and Blood Products

OBJECTIVES: Blood transfusion is actually a tissue transplant and the possible complications are of vital importance. Thus, the healthcare personnel, who will perform the transfusion, should be trained in this regard. The aim of the present study is to determine the knowledge level of the nurses and midwives working at our hospital, about transfusion. BACKGROUND: Blood transfusion is one of the most common and risky procedures in hospitals. Therefore, complications related to blood transfusion should be known to all nurses and midwives. In this study, we found that the in-service training of the participants about transfusion and education levels is important in terms of determining the adequacy of this training. In addition to the level of education, knowledge and skills about transfusion have an important place. METHODS: A total of 534 healthcare professionals working at the Medical Faculty Hospital of Sivas Cumhuriyet University were included in the study. 514 (96.3%) of them were nurses and 20 (3.7%) were midwives. The questionnaire includes 9 questions about personal information, 9 questions on knowledge about pre-transfusion, 7 questions on the process of blood transfusion, 6 questions on blood and blood products, and 3 questions about the blood transfusion reaction. According to the scores taken in the questionnaire, the participants were divided in two sub-groups as group I (0-85) and group II (86-100). RESULTS: Mean age of the participants was 30.28±7.60 (18-55) years. In the questionnaire, correct answer rate of the participants was 93.28% in questions about nursing responsibilities before transfusion, 95.2% in questions about transfusion process, 94.5% in questions about identifying and managing transfusion reactions, and 71.71% in questions about knowledge levels of blood and blood products. CONCLUSION: Transfusion of blood and blood products is a complex process requiring a specific knowledge level. In general, it can be asserted that the nurses and midwives working at the hospital have good transfusion skills in parallel to their education, previous in-service transfusion training and their transfusion and reaction experiences.

Is every reaction a blood transfusion reaction? An inside story

Is every reaction a blood transfusion reaction? An inside story

A Systematic Review of Three Biomarkers to Aid in the Assessment of Outcomes for Children and Young People with Cancer that are Febrile Neutropenic

For paediatric patients with cancer, febrile neutropenia (FN) is the most common complication of treatment. It requires inpatient hospitalisation and treatment with empirical broad-spectrum antibiotics. Approximately 20-30% of febrile neutropenic patients have a documented infection, thus needing antibiotics. For the rest, it is suggested that the cause of FN could be a viral or fungal infection, the malignancy itself, drug related or the result of a blood transfusion reaction as examples, therefore not requiring antibiotics. With no risk-stratification tool in use in practice to distinguish between patients who are at high or low risk of bacterial infections, recent studies have focused on identifying clinical and laboratory markers for this. This systematic review will focus on three biomarkers, C-reactive protein (CRP), presepsin (sCD14-ST) and lactate, to find their sensitivities and specificities for diagnosing bacterial infections and thus help determine the risk of poor outcomes for patients with FN. This review has systematically searched for relevant primary research papers. These studies have been critically appraised using a validated critical appraisal tool. Data from these studies were then extracted using a data extraction form, and evidence summarised. The findings have been interpreted, and the implications to practice and research are discussed. 1051 febrile neutropenic episodes from 743 children from different countries were analysed. In the majority of studies (75%), acute lymphoblastic leukaemia was the most frequent diagnosis. Eight of the studies in this review are looking at CRP. Two studies are looking at lactate, and five review presepsin. Lactate is a sensitive and specific biomarker with a lactate level ≥ 2mmol/L and &gt;2.5mmol/L showed sensitivities of 81% and 80% and specificities of 83% and 92.1%, respectively. Presepsin and CRP had mixed results for its sensitivity and specificity. Lactate and CRP are useful biomarkers for assessing the outcomes of children with FN and could be added to a CDR. This review cannot confirm that presepsin is a useful biomarker for practice and, therefore, cannot justify adding it to a CDR.

Blood transfusion reactions and risk of acute kidney injury and major adverse kidney events

BackgroundBlood transfusion reactions may have a negative impact on organ function. It is unknown whether this association holds true for acute kidney injury (AKI). Therefore, we conducted a cohort study to assess the association between transfusion reactions and the incidence of AKI and major adverse kidney events.MethodsIn this retrospective cohort study, we included patients who received transfusion of blood products during hospitalization at the Hospital Civil of Guadalajara. We analyzed them according to the development of transfusion reactions, and the aim was to assess the association between transfusion reactions and AKI during long-term follow-up.ResultsFrom 2017 to 2021, 81,635 patients received a blood product transfusion, and 516 were included in our study. The most common transfusion was red blood cell packaging (50.4%), fresh frozen plasma (28.7%) and platelets (20.9%); of the 516 patients, 129 (25%) had transfusion reactions. Patients who had transfusion reactions were older and had more comorbidities. The most common type of transfusion reaction was allergic reaction (70.5%), followed by febrile nonhemolytic reaction (11.6%) and anaphylactoid reaction (8.5%). Most cases were considered mild. Acute kidney injury was more prevalent among those who had transfusion reactions (14.7%) than among those who did not (7.8%), p = < 0.01; those with AKI had a higher frequency of diabetes, vasopressors, and insulin use. Transfusion reactions were independently associated with the development of AKI (RR 2.1, p = < 0.02). Major adverse kidney events were more common in those with transfusion reactions. The mortality rate was similar between subgroups.ConclusionIn our retrospective cohort of patients who received blood product transfusions, 25% experienced transfusion reactions, and this event was associated with a twofold increase in the probability of developing AKI and some of the major adverse kidney events during long follow-up.Graphical abstract

Blood Transfusion Reaction Reporting at a Tertiary Care Hospital: A Cross Sectional Study.

Blood transfusion is the infusion of whole blood or its components into the veins of the patient to improve tissue oxygenation and maintain hemostasis. Besides its clinical use, it can pose a risk of transfusion complications with different factors. The aim of this study was to assess blood transfusion complications, and associated factors among transfused adult patients at Tertiary care Hospital, Hyderabad, 2022. An institution-based cross-sectional study design was conducted on a total of 182 patients from March 20 to June 15, 2022. Patients were enrolled in the study using consecutive sampling method. The socio-demographic and clinical data were collected using a structured questionnaire and data extraction sheet, respectively. About 3 ml of anti-coagulated blood and 30 ml of urine samples were collected to assess transfusion complications. CBC and Coombs test were performed from blood and urinalysis from urine, respectively. Chi-square, Fisher's exact test, and binary logistic regression were done using SPSS version 25. P-values less than 0.05 are declared as statistically significant. An acute transfusion reaction (ATR) was encountered in 12 (6.6%) patients. It was 4.13, 7.78 and 3.96 times more likely to occur among patients with a previous history of transfusion, abortion, and transfused blood stored for more than 20 days compared to their counterparts, respectively. In addition, the odds of developing ATR increase by 2.07 as the number of transfused blood units increases by 1 unit. The incidence of acute transfusion reactions was high. During transfusion, clinicians should closely monitor patients who had history of transfusion, abortion, transfused old blood and more than 1 unit.

Non-infectious Causes of Blood Transfusion Reactions: A Tertiary Hospital Review

Non-infectious Causes of Blood Transfusion Reactions: A Tertiary Hospital Review

Provision of Timely Alternative Multidisciplinary Protocols for Patients Refusing Blood or Blood Products

Blood components and products are life-saving therapeutics but with inherent, life-threatening risks. There are patients who do not accept blood products for different reasons, including fear of blood borne viruses, transfusion reactions and religious beliefs. It is important to determine the standard of care and outcomes for such patients, within any clinical setting. The aim of this audit was to evaluate adherence to the agreed standard of care for patients who do not accept blood transfusion. Methods All patients who refused transfusions between 2019 and 2021 were included. Scanned forms and Electronic Patient Records were used to gather data. Expected care standards were: (1) a multidisciplinary team (MDM) led alternative care plan, agreed at least 3 weeks prior to the intervention/ procedure, to prepare for blood loss, and (2) that the MDM should involve: either a surgeon or physician, anaesthetist (if the treatment is surgical or antenatal), haematologist or transfusion practitioner and the patient. Results There were 195 patients referred to MDMs, of which 105 were surgical (54%), 52 were interventional (27%) and 38 were antenatal (19%). Of these, 188 (96%) were sent before a procedure (or birth) with the remaining 7 (4%) referred for ongoing treatment of medical patients, i.e. with severe anaemia. In 72 patients (38%) the MDM did take place ≥3 weeks before the procedure (similar to the results from the first cycle of the audit, in 2017-18 = 40%). Almost 85% (165) of MDM included all relevant stakeholders. Discussion The delay in timely referral for MDM led alternative care plan was likely due to a lack of awareness of transfusion policies, and potentially could lead to cancellation of the procedure or unavailability of alternative protocols in an emergent scenario during surgery or intervention. Conclusion Improvement was required for safer procedures and outcomes, by investment in training, regular refreshers/ updates for staff and electronic protocols/ prompts.

Effect of RhD and RhE sample phenotypic blood transfusion on the prognosis of hepatocellular carcinoma.

This study aimed to analyze the therapeutic effects and clinical outcomes of HCC patients, who received both RhD and RhE same phenotypic blood transfusion during perioperative period. Microcolumn gel technology (MGT) was used to detect Rh blood group phenotyping in 98 HCC patients. Patients received RhD and RhE same phenotypic transfusion were defined experimental group, and those received only RhD same phenotypic but RhE different phenotypic transfusion were included in control group. Hemoglobin (Hb) and hematocrit (HCT) before and after perioperative transfusion were analyzed. The occurrence of adverse transfusion reactions were observed. Survival analysis was performed using the Kaplan-Meier method. After the transfusion treatment, the Hb (118.9 ± 34.8 g/L vs 99.6 ± 26.9 g/L) and HCT [(34.0 ± 7.6)% vs (29.9 ± 8.8)%] of experimental group and the Hb (104.3 ± 36.2 g/L vs 94.8 ± 25.0 g/L) of control group were significantly higher than those before blood transfusion, respectively (all P < .05). In addition, Hb and HCT in experimental group were significantly higher than those in the control group after transfusion (P < .05). For the adverse blood transfusion reactions, the incidence of backache was reduced in the patients received Rh same phenotypic transfusion compared with those in control group (1.9% vs 15.2%, P = .024). The overall survival of patients in experimental group was better than that in control group (log-rank P = .036). Our study indicated that both RhD and RhE same phenotypic transfusion significantly increased Hb and HCT and reduced backache incidence than RhE different phenotypic transfusion in HCC patients. The overall survival of patients was improved by RhD and RhE same phenotypic transfusion.

Analysis of Allergic Transfusion Reactions at a Children's Tertiary Care Center

Background: Transfusion reaction adverse events are a relatively rare occurrence in the United States. This is due to specific blood safety measures such as appropriate collection, preparation, testing, storage, and distribution of blood components as well as appropriate monitoring of patients receiving these transfusions. Several years of data have been collected by our institution's blood bank. Through our analysis, we have been able to describe the rate of transfusion- associated adverse events in pediatric patients at Children's Hospital of Michigan from 2018-2022. Objectives: The aim of this retrospective chart review was to assess the rate of allergic blood transfusion complications and reactions among pediatric patients at Children's Hospital of Michigan in Detroit, Michigan. Materials and Methods: An institution-based retrospective chart review was conducted for a total of 43,210 transfusions over a span of five years from 2018-2022. Results: There were a total of 43,210 transfusions. A total of 26,669 of these products were red blood cell (RBC) transfusions, 10,447 were platelets, 4,392 were plasma, and 1,702 were cryoprecipitate (combined plasma and cryoprecipitate was 6,094). A reported reaction was encountered in 176 of the 43,210 transfusions. These reported reactions were part of the patients' underlying diseases. A true acute transfusion reaction (ATR) was encountered in 116 of the 43,210 transfusions. Of the 116 transfusions, 66 (56.9%) were classified as allergic reactions. About 61% of those reactions were skin manifestations (urticaria, itching), 9% were respiratory symptoms (dyspnea, tachypnea), and the remaining 30% were both skin and respiratory symptoms. Of the total amount of RBC transfusions, 35 (0.131%) resulted in an allergic reaction. Similarly, 19 (0.182%) platelet and 12 (0.197%) plasma transfusions resulted in ATRs. ATRs were most associated with plasma, followed by platelets and RBC transfusions. Combining all transfusions received, these represented a total of 66 (0.153%) allergic transfusion reactions. These results are demonstrated in Figure 1. Conclusion: ATRs were observed in 0.268% of total transfusions (allergic reactions (0.153%) and other reactions (0.115%)) that occurred over the course of five years at our institution. This is about 1 in 655 blood components transfused that was associated with an allergic reaction (more commonly with plasma &amp;gt; platelets &amp;gt; packed RBCs). The rate of allergic reactions is less than what was reported by National Blood Collection and Utilization Survey 2017 (0.282%). This rate is also less than what is reported for children (0.53%) and adults (0.26%) in a meta-analysis (Wang Y, Sun W, Wang X, et al. Comparison of transfusion reactions in children and adults: A systematic review and meta-analysis. Pediatr Blood Cancer. 2022;69(9):e29842.). These lower rates could be secondary to changes in blood processing and under-reporting.

Evaluation of Blood Transfusion-Related Reactions of Blood Recipients in Hamadan Besat Hospital Patients during 2020- 2022

Background: Blood transfusion has some complications known as transfusion-related reactions. Accurate identification and recording of these reactions is more important for their management and prevention. This study aimed to evaluate blood transfusion-related reactions in blood recipients in patients in Hamadan Besat hospital during 2020-2022. Methods: In this cross-sectional study, the data of 400 patients who had complications after receiving blood and blood components were collected in terms of hemolytic and non-hemolytic blood transfusion reactions. Data were collected from patients’ medical records and standard blood transfusion checklists and analyzed by SPSS version 26 software using the chi-square test and Fisher’s exact test. Results: Red blood cell (RBC), 70.25%, random donor platelet (RDP), 10.3%, and fresh frozen plasma (FFP), 9.5%, were the most transfused blood components. Blood transfusion reactions were allergic reactions (53.5%), febrile non-hemolytic transfusion reaction (FNHTR) (24%), dyspnea (10.25%), hemolytic reactions (HR) (4.5%), hypotension (4.25%), transfusion-associated cardiovascular overload (TACO) (1.75%), and other reactions (2.75%). A significant relationship was also observed between receiving components containing RBC, including whole blood (WB0), RBC concentrate, and leukoreduced RBC, and the incidence of FNHTR (P=0.001). Conclusion: Based on the findings of the present study, allergic reaction and FNHTR were the most common complications after blood transfusions. Blood transfusion-related reactions could be predicted, managed, and possibly prevented by considering the relationship between the type of reaction and the type of transfused blood components.

CE: Recognizing Transfusion-Associated Circulatory Overload.

Transfusion-associated circulatory overload (TACO) is the leading cause of transfusion-related deaths in the United States, accounting for more than 30% of fatalities reported to the Food and Drug Administration between 2016 and 2020. However, TACO is widely considered to be an underdiagnosed and underreported complication of blood transfusions, and its exact incidence is unknown. One of the reasons for this is a lack of recognition of TACO and its signs and symptoms, especially as the definition of TACO has been updated twice since 2018 without full dissemination to nurses, who are responsible for bedside care of patients during and following blood transfusions. This article seeks to bridge this gap by discussing the updated definitions and signs and symptoms of TACO, as well as the management of this treatable blood transfusion reaction.

Prevalence of Acute Complications of Transfusion in Children with β-thalassemia Major in Southeast Iran: A Prospective Study

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.