Meta analysis of the effect of pre-transfusion prophylactic medication on the incidence of adverse reactions to blood transfusion / 中国输血杂志

ABSTRACT

【Objective】 To systematically evaluate the correlation between pretransfusion prophylactic medication and the incidence of adverse reactions to blood transfusion(ARBT) by Meta analysis. 【Methods】 The relevant literature concerning the effect of pretransfusion prophylactic medication on the incidence of ARBT was searched via Pubmed, Embase, Cochrane Library, CNKI, WanFang Data, and VIP databases, with the date duration from database creation to May 9, 2021. The literature was independently screened by two researchers according to the inclusion and exclusion criteria, relevant data information was extracted, quality evaluation was performed, and Meta analysis was performed using RevMan 5.3 software. 【Results】 A total of 36 publications were finally included, involving 137 996 transfusion recipients, of which 62 581 were administered medication before transfusion while 75 415 not. And1742 patients experienced ARBT. Meta analysis results showed that the incidence of ARBT in the pre-transfusion medication group was not statistically different from that in the non-medication group {[RR=0. 88, 95% CI(0.76, 1.01), P>0.05]}, the incidence of febrile reactions was lower in the pre-transfusion group than in the control {[RR=0. 72, 95% CI(0.61, 0.86), P0.05] vs [RR=0. 24, 95% CI(0.03, 2.13), P>0.05]. Pre-transfusion use of dexamethasone, isoproterenol, and niclosamide had no preventive effect on ARBT, i. e. [RR=0. 91, 95% CI(0.79, 1.04), P>0.05] vs [RR=0. 83, 95% CI(0.68, 1.01), P>0.05] vs [RR=1.21, 95% CI(0.69, 2.10), P>0.05]. 【Conclusion】 The incidence of ARBT in the pre-transfusion prophylaxis group was not significantly different from that in the control without considering the patient's history of transfusion, history of ARBT, and use of leukocyte-deleted blood products. The incidence of febrile reactions in the pre-transfusion medication group was lower than that in the control, and further studies in larger randomized controlled trials of higher quality still need to be established due to the suboptimal quality of the included literature and study size. Strictly grasping the indications for blood transfusion, strengthening the monitoring and awareness of ARBT, and using life-saving drugs rationally remain the key clinical concerns.