The Role of EO% and CRP in Risk Factors Analysis of Young Patients with Transfusion Related Adverse Reactions / 中山大学学报(医学科学版)

ObjectiveTo discuss the correlation between young patients’ adverse transfusion reaction and pre-transfusion C reactive protein （CRP） level and EO% （percentage of eosinophils） . MethodsThe observation group was chosen from among sixty-six young patients who experienced transfusion-related adverse events between January 2019 and December 2020. For each patient chosen to be included in the observation group， another patient from the same department， with the same disease and gender， who had been hospitalized in the same month and received the same type of blood product transfusion， but had not experienced any transfusion-related adverse effects， was chosen to be in the control group. We examined and compared their ages， transfusion experiences， allergy backgrounds， EO%， and CRP levels in peripheral blood prior to transfusion. A receiver operating characteristic （ROC） curve was used to examine the diagnostic value of EO% and CRP for transfusion-related adverse events. Simultaneously， a logistic analysis was performed on the risk factors for transfusion-related adverse events. ResultsPre-transfusion CRP was higher in patients with FNHTR in the observation group than it was in patients in the control group； pre-transfusion CRP was also higher in patients with ATR in the observation group than it was in patients in the control group. There were also statistically significant differences between these variables in the percentage of patients with transfusion history and pre-transfusion EO% （ P＜0.05）. For the transfusion of different blood types， there was statistical significance in the occurrence of ATR and FNHTR （ P＜0.05）. For the diagnosis of FNHTR， the CRP area under the ROC curve was 0.889， and the best cut-off value was 18.05 mg/L. For the diagnosis of ATR， the area under the ROC curve was 0.749， and the best cut-off values were 17.60 mg/L. ConclusionPre-transfusion C-reactive protein level is an independent risk factor for FNHTR and ATR in young patients； the predictive value of EO% for adverse blood transfusion reactions is insufficient.

Blood transfusion adverse event management system: construction and application / 中国输血杂志

【Objective】 To establish a blood transfusion adverse event management system and apply it to adverse events management, so as to enhance the ability to identify and process reports as well as prevent adverse events. 【Methods】 According to the errors during the whole process of blood transfusion, the management information system of blood transfusion adverse events was established, and the data of adverse transfusion reactions and adverse transfusion events from 2020 to 2022 were collected according to the system requirements. The system monitoring data and statistical analysis were used to analyze the causes of errors in each link of blood transfusion, sort the incidence of each department, focus on supervising the departments with high frequency of adverse events, and propose effective rectification. 【Results】 The management system counted 51 cases of adverse reactions. The incidence of adverse reactions of plasma (43.1 %, 22/51) was higher than that of red blood cells (39.2 %, 20/51), and the number of allergic reactions was slightly higher than that of febrile non-hemolytic transfusion reaction. Among the 628 cases of adverse transfusion events, blood transport, inbound and storage (TS-A) errors accounted for the highest proportion of 46.2% (290/628), 20.9% (131/628) in post-transfusion disposal and evaluation (TS-G) and 15.8% (99/628) in pre-transfusion evaluation and transfusion application (TS-B). TS-A12 accounted for 63.8 % (185/290) in TS-A errors, which was mainly due to plasma leakage caused by extrusion during transport and the expiration of red blood cells caused by insufficient blood inventory management. TS-B errors mainly focus on the failure to fully assess the bleeding tendency of patients before surgical system surgery, resulting in no or insufficient preoperative blood preparation. Most of the TS-G errors were unqualified medical record. 【Conclusion】 Blood transfusion adverse event management system can help to identify and prevent the occurrence or recurrence of adverse events, formulate targeted rectification and preventive measures, and improve the haemovigilance ability.

A CLINICOHAEMATOLOGICAL PROFILE OF ADVERSE TRANSFUSION REACTIONS AND ITS ASSOCIATION WITH BLOOD COMPONENTS

Different blood components are associated with various types of adverse transfusion reactions and are linked to several factors including the number, rate and volume of transfusions. The given study was conducted to study the relationship between various transfusion reactions and its causative factors. This study was a prospective study carried out over eighteen months on all patients who received a blood transfusion and blood components including various adverse reactions and events related to transfusion. These were correlated with tests for compatibility including general blood picture ,tests for haemolysis ,hematuria and haemoglobinuria, Coombs Test (Direct and Indirect), culture along with relevant clinical details of the patient. Out of a total of 31451 units of blood issued, 47 adverse transfusion reactions were noted with a maximum number in the age group of > 18 years (87.3%) with M: F being 1.6: 1 .0.24% of adverse transfusion reactions were by Packed red blood cell transfusion and mostly were immediate transfusion with a mean volume of 100 ml and mean time of 20 minutes. Febrile Non Hemolytic Transfusion Reaction (FNHTR) was the most common Adverse Transfusion Reaction (ATR)(0.128%) with 2 cases positive for Direct Coombs Test. A thorough serological and immunological examination and the addition of methods like buffy coat reduction and leucocyte filtration help in reducing the incidences of hemolytic transfusion reactions and transmitted infections and establishing a hemovigilance system help in the attainment of the goal of safe transfusion

Reducing the under-reporting rate of adverse transfusion reactions: Application of 5W+ 1H method combined with ECRS analysis principle / 中国输血杂志

【Objective】 To investigate the application of 5W+ 1H combined with ECRS analysis principle in reducing the under-reporting rate of adverse reactions to blood transfusion (ARBT). 【Methods】 The causes of under-reporting rate of ARBT were analyzed using 5W+ 1H combined with ECRS analysis principle in Department of Hematology, and the countermeasures and intervention measures were carried out. The under-reporting rate of ARBTs before(January 2018 to December 2019, control) and after(January 2016 to December 2017, test) the interventions was compared. 【Results】 After the application of 5W+ 1H combined ECRS analysis principle, the under-reporting rate of ARBTs decreased significantly(17.39% test vs 37.67% control) (P<0.05). 【Conclusion】 The application of 5W+ 1H combined ECRS analysis principle can effectively reduce the under-reporting rate of ARBT, improve the report management of it, and improve the safety of the blood products.

Acute blood transfusion reaction in a tertiary care hospital in Southern Punjab, Pakistan

Background: Blood transfusion is a lifesaving process but carries many risks. Majority of these had been reduced with better diagnostic and management strategies. But the risk of non-infectious adverse transfusion reactions though reduced but cannot be eliminated. Hemovigilance is the system to monitor such reactions.Methods: The objective of current study was to know the frequency of adverse transfusion reactions and to compare it with local and international data. Retrospective cross-sectional descriptive study was done in Ibn-e- Sina hospital. Adverse transfusion reactions reported to blood bank was analysed according to hospital protocol.Results: Out of 6050 blood transfusions 23 (0.38%) develop adverse transfusion reactions. Febrile nonhemolytic transfusion reaction was the commonest adverse event and whole blood was the component implicated.Conclusions: Adverse transfusion reactions are non-infectious complications of blood transfusion which in spite of all efforts cannot be avoided. Frequency of adverse transfusion reactions in our study was 0.38% and Febrile nonhemolytic transfusion reaction was commonest reported reaction type. Hemovigilance system is necessary to monitor, investigate and control such activities.

Proposal of Evaluation Method for Leukoreduction Blood Filter and Evaluation of Domestic Filter / 대한수혈학회지

BACKGROUND: A leukoreduction filter was recently developed in Korea to reduce various kinds of adverse transfusion reactions. The objective of this study was to propose a domestic evaluation system for leukoreduction filters and to apply this evaluation system to assess the newly developed leukoreduction filter. METHODS: We prepared packed red blood cells from 60 units of whole blood (400 mL) collected from 60 normal individuals and evaluated the efficacy of the newly developed filter (FINECELL, KOLON INDUSTRIES, Gumi, Korea) and a control filter (RCM1, Haemonetics, MA, USA). To verify the evaluation system, we assessed the filtration time, residual leukocyte count, RBC recovery, RBC hemolysis, hemoglobin concentration, and hematocrit using a control filter RCM1 and compared the results with those of an evaluation performed by the American Red Cross (ARC) in 2013. We then evaluated the efficacy of the test filter FINECELL using the methods established in this study and compared the results with those of the control filter RCM1. RESULTS: The results of the current study were similar to those of the ARC with the control filters. The test filters developed in Korea were not inferior to commonly used control filters regarding residual leukocyte count, RBC recovery, and RBC hemolysis at 35 days after filtration. All of the results in the evaluation satisfied the international standards. CONCLUSION: These results of this study showed that the efficacy of the newly developed domestic leukoreduction filter were satisfactory and will contribute to improvement of quality of blood components in Korea.

Frequency and Pattern of Noninfectious Adverse Transfusion Reactions at a Tertiary Care Hospital in Korea

BACKGROUND: Although transfusion is a paramount life-saving therapy, there are multiple potential significant risks. Therefore, all adverse transfusion reaction (ATR) episodes require close monitoring. Using the computerized reporting system, we assessed the frequency and pattern of non-infectious ATRs. METHODS: We analyzed two-year transfusion data from electronic medical records retrospectively. From March 2013 to February 2015, 364,569 units of blood were transfused. Of them, 334,582 (91.8%) records were identified from electronic nursing records. For the confirmation of ATRs by blood bank physicians, patients' electronic medical records were further evaluated. RESULTS: According to the nursing records, the frequency of all possible transfusion-related events was 3.1%. After the blood bank physicians' review, the frequency was found to be 1.2%. The overall frequency of febrile non-hemolytic transfusion reactions (FNHTRs) to red blood cells (RBCs), platelet (PLT) components, and fresh frozen plasmas (FFPs) were 0.9%, 0.3%, and 0.2%, respectively, and allergic reactions represented 0.3% (RBCs), 0.9% (PLTs), and 0.9% (FFPs), respectively. The pre-storage leukocyte reduction significantly decreased the frequency of FNHTRs during the transfusion of RBCs (P<0.01) or PLTs (Pfalling dots0.01). CONCLUSIONS: The frequency of FNHTRs, allergic reactions, and "no reactions" were 22.0%, 17.0%, and 60.7%, respectively. Leukocyte-reduction was associated with a lower rate of FNHTRs, but not with that of allergic reactions. The development of an effective electronic reporting system of ATRs is important in quantifying transfusion-related adverse events. This type of reporting system can also accurately identify the underlying problems and risk factors to further the quality of transfusion care for patients.

Analysis of 81 cases with clinical adverse transfusion reaction / 中国基层医药

Objective To reduce the probability of adverse transfusion reaction and ensure the safety of transfusion according review the clinical cases.Methods The record of adverse transfusion reaction was retropectivly analyzed.Results 81 cases were occured adverse reactions caused by transfusion in 38 490 cases of our hospital, with the rate of 0.21%,including 52 cases of anaphylactic transfusion reaction and 29 cases of febrile non -hemolytic transfusion reaction.There wasn't statistically significant difference among of those blood components(χ2 =3.849,P >0.05).Conclusion We should renovate the scientific and reasonable concept of blood transfusion,encourage autolo-gous transfusion,strictly abide by the lows and regulations realated to transfusion,the probability of adverse transfusion reaction would be reduced.

Two Cases of Transfusion-related Acute Lung Injury Triggered by HLA and Anti-HLA Antibody Reaction

Transfusion-related acute lung injury (TRALI) is a serious adverse transfusion reaction that is presented as acute hypoxemia and non-cardiogenic pulmonary edema, which develops during or within 6 hr of transfusion. Major pathogenesis of TRALI is known to be related with anti-HLA class I, anti-HLA class II, or anti-HNA in donor's plasma. However, anti-HLA or anti-HNA in recipient against transfused donor's leukocyte antigens also cause TRALI in minor pathogenesis and which comprises about 10% of TRALI. Published reports of TRALI are relatively rare in Korea. In our cases, both patients presented with dyspnea and hypoxemia during transfusion of packed red blood cells and showed findings of bilateral pulmonary infiltrations at chest radiography. Findings of patients' anti-HLA antibodies and recipients' HLA concordance indicate that minor pathogenesis may be not as infrequent as we'd expected before. In addition, second case showed that anti-HLA class II antibodies could be responsible for immunopathogenic mechanisms, alone.