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1.
Transfus Clin Biol ; 19(2): 57-9, 2012 Apr.
Article in French | MEDLINE | ID: mdl-22503459

ABSTRACT

Post-transfusion hemochromatosis is a major concern in patients with chronic transfusion (i.e. more than 20 red blood cell concentrates). While the monitoring of infectious complications and transfusion accidents is clearly one of the missions of haemovigilance, hemochromatosis is not yet subject to such a systematic monitoring. We therefore wanted to assess the incidence of this complication in the context of a general hospital (hospital of Aix) and propose the establishment of a screening and a comprehensive monitoring of post transfusion hemochromatosis.


Subject(s)
Erythrocyte Transfusion/adverse effects , Ferritins/blood , Hemochromatosis/diagnosis , Aged , Aged, 80 and over , Automation , Biomarkers , France/epidemiology , Hemochromatosis/blood , Hemochromatosis/etiology , Hospitals, General/organization & administration , Hospitals, General/statistics & numerical data , Humans , Incidence , Mass Screening , Myelodysplastic Syndromes/complications , Myelodysplastic Syndromes/therapy , Software , Transfusion Reaction
2.
Transfus Clin Biol ; 17(5-6): 318-30, 2010 Dec.
Article in French | MEDLINE | ID: mdl-21055992

ABSTRACT

The purpose of this retrospective observational multicenter study was to assess appropriateness of red blood cell (RBC) transfusion, according to the French national guidelines (Agence française de sécurité sanitaire des produits de santé) published in 2002. Six hundred and thirty-nine RBC transfusions from nine institutions have been randomly selected and analysed. The data collected are issued from different specialities. Patients' characteristics, occurrences of transfusion, admission, pre-transfusion, post-transfusion and discharge haemoglobin concentrations have been collected. Two physicians (who are in charge) must evaluate the appropriateness of pre-transfusion, discharged haemoglobin concentrations, quantity and quality of transfused RBC. The mean pre-transfusion haemoglobin concentration was 7.89 ± 1.24, the median number of transfused RBC was two (extremes: 1-16), the mean discharge haemoglobin concentration was 10.14 ± 1.30 (-5 days after the end of transfusion). The pre-transfusion and discharge haemoglobin concentrations were higher if the patient presented a co-morbidity factor. Ninety-three percent of pre-transfusion and 79% of discharge haemoglobin concentrations are in accordance with the guidelines. According to the physicians, the RBC transfusions are too "precocious" when pre-transfusion haemoglobin concentration is above nine and the anaemia is asymptomatic. 50% of RBC transfusion with discharge haemoglobin concentration above 10 is not excessive. In case of acute anaemia, the pre-transfusion and discharge haemoglobin concentrations are higher and RBC transfusion excessive. In this study, the trigger haemoglobin concentration is "restrictive", but the target haemoglobin concentration is "liberal" with a high-discharge haemoglobin concentration. Inappropriate RBC transfusions are mainly due to over-transfusion.


Subject(s)
Erythrocyte Transfusion , Prescriptions/statistics & numerical data , Adult , Aged , Aged, 80 and over , Anemia/therapy , Child , Emergencies , Female , France , Guideline Adherence , Hemoglobins/analysis , Hemorrhage/therapy , Humans , Male , Middle Aged , Postoperative Hemorrhage/therapy , Practice Guidelines as Topic , Prescriptions/standards , Retrospective Studies , Sampling Studies , Treatment Outcome , Unnecessary Procedures
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