Patterns of Adverse Transfusion Reactions in a Tertiary Care Centre of Rural Bengaluru, South India: A Step Towards Hemovigilance
Keywords:
Blood transfusion, Transfusion related reactions, Hemovigilance
Abstract
Background: “Blood transfusion is like marriage: it should not be entered upon lightly, unadvisedly or wantonly or more often than is absolutely necessary.” This statement from Robert Beal clearly indicates the necessity and potential risk of blood transfusion and thus the importance of “Hemovigilance”. Aims & Objectives: The study was done to collect and analyse the frequency and nature of the transfusion reactions reported at a tertiary care hospital in Rural Bengaluru, Karnataka. Materials & methods: A retrospective review of all transfusion reactions reported to the blood bank at the Transfusion Medicine department between April 2012 and December 2017 was done. All transfusion reactions were evaluated by the blood centre and classified under standard definitions. Results: During the study period, 10114 units were transfused. Out of these 72 (0.71%) cases of post transfusion reactions were reported. Most of our patients reported with transfusion reactions were young adults in the age group of 21-30 years. The most commonly encountered type of reaction was Febrile Non Hemolytic transfusion reaction (FNHTR) in 28 cases. Grade III reactions were reported in 5 cases, Transfusion associated Cardiac Overload (TACO) (3 cases) & anaphylaxis (2 cases). Conclusion: Transfusion reactions encountered in our study varied from innocuous ones like FNHTR to life threatening anaphylactic reactions. This underlines the need for constant monitoring and strict implementation of standard protocols for transfusion of blood and blood products. Our study also highlights the need for pre transfusion counselling and assurance to reduce anxiety among individuals undergoing transfusion.References
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17. Heddle NM, Blajchman MA, Meyer RM, et al. A randomized controlled trial comparing the frequency of acute reactions to plasma removed platelets and prestorage WBC-reduced platelets. Transfusion 2002; 42: 556–66.
18. Alves VM, Martins PRJ, Soares S, Araújo G, Schmidt LC, Costa SSM. Alloimmunization screening after transfusion of red blood cells in a prospective study. Rev Bras HematolHemoter. 2012;34(3):206-11.
19. Dlimi BH, Achenbach S, Strobel J, Eckstein R, Zimmermann R. Prevention and management of transfusion-induced alloimmunization: current perspectives. InternationalJournal of Clinical Transfusion Medicine 2014:2 59–63.
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2. Venkatachalapathy TS. A prospective audit of blood transfusion reactions in tertiary care hospital for the use of blood and blood components. J Blood DisordTransfus. 2012;3:118.
3. Jain A, Kaur R. Hemovigilance and blood safety. Asian J Transfus Sci. 2012 Jul-Dec; 6(2): 137–138.
4. Kato H, Uruma M, Okuyama Y, Fujita H, Handa M, Tomiyama Y et al.Incidence of transfusion-related adverse reactions per patient reflects the potential risk of transfusion therapy in Japan. Am J ClinPathol2013;140:219-224.
5. De Vries RR, Faber JC, Strengers PF. Hemovigilance: An effective tool for improving transfusion practice. Vox Sang.2011;100:60–7.
6. Kumar P, Thapliyal R, Coshic P, Chatterjee K. Retrospective evaluation of adverse transfusion reactions following blood product transfusion from a tertiary care hospital: a preliminary step towards hemovigilance. Asian J TransfusSci. 2013;7(2):109–115.
7. Bhattacharya P, Marwaha N, Dhawan HK, Roy P, Sharma RR. Transfusion-related adverse events at the tertiary care center in North India: an institutional hemovigilance effort. Asian J TransfusSci. 2011; 5(2):164–170.
8. Lubart E, Segal R, Tryhub N, Sigler E, Leibovitz A. Blood transfusion reactions in elderly patients hospitalized in a multilevel geriatric hospital. J of Aging Research 2014:1-3.
9. Pedrosa AK, Pinto FJ, Lins LD, Deus GM. Blood transfusion reactions in children: Associated factors. J Pediatr.2013;89(4):400-6.
10. Sharma DK, Datta S, Amlan G. Study of acute transfusion reactions in a teaching hospital of Sikkim: A hemovigilance initiative. Indian J Pharmacol. 2015; 47(4): 370–374.
11. Vartak UC, Shewale R, Vartak S, Faizal F, Majethia N. Adverse reactions of blood transfusion: a study in a tertiary care hospital. International journal of scientific study.2016;4(2): 90-95.
12. Bassi R, Aggarwal S, Bharadwaj K, Thakur KK. Patterns of adverse transfusion reactions in a tertiary care centre of North india: a step towards hemovigilance. Int J Hematology and Blood transfusion. 2017;33(2):248-253.
13. Hod EA, Zhang N, Sokol SA, Francis RO, Ansaldi D, Francis KP et al. Transfusion of red blood cells after prolonged storage produces harmful effects that are mediated by iron and inflammation. Blood. 2010;115(21):4284-4295.
14. Goodell PP, Uhl N, Mohammed M, Powers AA. Risk of Hemolytic Transfusion Reactions Following Emergency-Release RBC Transfusion.Am J ClinPathol. 2010;134:202-206.
15. Heddle NM. Pathophysiology of febrile nonhemolytictransfusion reactions.Curr OpinHematol. 1999;6:420-426.
16. Sinha RTK, Rai P, Dey A. A retrospective evaluation of adverse transfusion reactions at a tertiary care centre in central India. Journal of Medical Sciences and Health. 2016;2(3):6-12.
17. Heddle NM, Blajchman MA, Meyer RM, et al. A randomized controlled trial comparing the frequency of acute reactions to plasma removed platelets and prestorage WBC-reduced platelets. Transfusion 2002; 42: 556–66.
18. Alves VM, Martins PRJ, Soares S, Araújo G, Schmidt LC, Costa SSM. Alloimmunization screening after transfusion of red blood cells in a prospective study. Rev Bras HematolHemoter. 2012;34(3):206-11.
19. Dlimi BH, Achenbach S, Strobel J, Eckstein R, Zimmermann R. Prevention and management of transfusion-induced alloimmunization: current perspectives. InternationalJournal of Clinical Transfusion Medicine 2014:2 59–63.
20. Proposed standard definitions for surveillance of non infectious adverse transfusion reactions: ISBT Working Party on Hemovigilance, Cape Town 2011.
21. Delaney M, Wendel S, Bercovitz RS, Cid J, Cohn C, Dunbar NM. Transfusion reactions: prevention, diagnosis, and treatment. The Lancet 2016;388:2825-2836.
Published
2019-04-30
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