Subject(s)
Humans , Blood Group Incompatibility/diagnosis , Blood Group Incompatibility/etiology , Blood Group Incompatibility/physiopathology , Blood Group Incompatibility/therapy , Blood Transfusion/adverse effects , Antigen-Antibody Reactions , Anemia, Hemolytic, Autoimmune/etiology , Anemia, Sickle Cell/etiology , Antigens, Human Platelet/immunology , Wounds and Injuries/blood , Blood Group Incompatibility/epidemiology , Purpura, Thrombocytopenic/etiology , Purpura, Thrombocytopenic/physiopathology , Chimerism/classification , Nucleic Acid Amplification Techniques/trendsABSTRACT
Of 163,403 recorded cases of anesthesia in the Thai Anesthesia Incidents Study (THAI Study), transfusion errors occurred thrice. Case #1: a 68-year-old male, blood group A, undergoing hepatectomy, received two units of PRC and four units of FFP (all units were group A), but two of the FFP units were given to the wrong patient because the caregiver did not check the patient-identification on all of the blood bags. Case #2: a 42-year-old female, blood group A, undergoing emergency exploratory laparotomy, received 250 mL of group B-blood. Skin rashes, a clue for diagnosis of transfusion error were observed in the postoperative period. The error occurred because the caregiver did not check the patient-identification before starting the transfusion. Case #3: a 42-year-old female, blood group O, undergoing hysterectomy, received 430 mL of group AB-blood. More blood was requested in the ICU and it was discovered that the new bag was group O instead of AB. Mislabeling of the blood sample at the first blood request accounted for the error even though blood group O was recorded on the patient's OPD chart. The first two patients developed minor adverse reactions (grade 1) whereas the third developed a severe reaction (grade 3). All of the patients responded well to treatments. Accordingly, the system for preventing transfusion errors has been improved at both hospitals.
Subject(s)
Adult , Aged , Anesthesia , Blood Group Incompatibility/etiology , Blood Transfusion/adverse effects , Female , Humans , Male , Medical Errors , Middle Aged , ThailandABSTRACT
OBJECTIVE: Uncross-matched blood either group specific or Group O is advocated in patients with exsanguinating haemorrhage when cross-matched blood cannot be made available rapidly. The risk of using uncross-matched blood is not known clearly. The purpose of this study is to attempt to quantify the risk of major transfusion reactions resulting from the use of uncross-matched group specific blood. METHOD: The cross-matching record of Patan hospital for the period of two years was analysed looking at the number of units that had major or minor incompatibility among all the cross-matching done during this period. RESULT: A total of 6027 units were cross-matched in two years. Only one unit of blood was found to have both major and minor incompatibility. All other units of blood taken out from the freeze for the purpose of cross-matching matched the patients blood. This puts the risk of having major transfusion reaction from incompatible blood when using uncross-matched group-specific blood at 1 in 6000. CONCLUSION: Using uncross-matched group specific blood in patients with severe haemorrhage, when delay in transfusion can put life at risk, is justifiable and needs to be encouraged.
Subject(s)
Attitude of Health Personnel , Blood Group Antigens , Blood Group Incompatibility/etiology , Blood Grouping and Crossmatching , Blood Transfusion/adverse effects , Emergency Treatment , Hemorrhage/therapy , Humans , Nepal , Risk , Safety ManagementABSTRACT
Se definen como A intermedio (Aint) los hematíes que comparten caracteres con A1 y A2. Existen diferencias cualitativas y cuantitativas en los epitopes A. Los hematíes A1 son aglutinados por la lectina de Ulex Europaeus (anti-H), en tanto los hematíes Aint son débilmente aglutinados por ambas de manera inesperada. Se realizó una búsqueda de individuos Aint en una población hospitalaria de acuerdo con la reacción con las lectinas mencionadas. Se evaluó el proceso de aglutinación producida mediante una técnica cinética. Se estudiaron 557 muestras, resultando 285 O (51,1 por ciento), 216 A (38,8 por ciento), 45 B (8,1 por ciento), 8 A1B (1,4 por ciento) y 3 A2B (0,6 por ciento). Las muestras A se subdividieron en 173 A1, (80,2 por ciento), 31 A2 (14,3 por ciento) y 12 Aint (5,5 por ciento). Se observó, en las curvas de cinética, diferencia de reacción entre los hematíes de grupo A1 Aint y A2. Nuestros resultados concuerdan con observaciones previas sobre la marcada heterogeneidad de los hematíes Aint. El reconocimiento de de variantes débiles del grupo A reviste importancia cuando se presentan reacciones transfusionales hemolíticas y en la práctica forense. Importa señalar que el valor de este estudio es relevante, en Inmunogenética Poblacional, por su contribución al conocimiento del mestizaje con poblaciones negras