[Factsheets: support in the analysis of recipients' adverse reactions]. / Fiches techniques: aide à l'analyse des effets indésirables receveurs.

In order to help the analysis of adverse effects of transfusion, factsheets have been written by working groups of the French agency for the safety of health products ANSM. Each factsheet deals with a blood transfusion side effect and is composed of five parts, including pathophysiological mechanisms, diagnostic criteria, management recommendations, etiologic investigations and rules for filing the notification form to ANSM. Since 2006, 11 factsheets have been published on the French haemovigilance network website. The major characteristics of the two last sheets published "post-transfusion purpura" and "non erythrocyte incompatibility reaction" are presented, followed by the updated card for "allergy". These factsheets give relevant guidelines allowing better evaluation of recipients' adverse reactions, particularly their diagnosis, severity and accountability. They also could initiate studies among European and international haemovigilance networks.

[Interest of transfusion safety e-learning for nurses: assessment after two years]. / Intérêt de l'e-formation pour les infirmières qui transfusent: bilan après deux ans.

In front of increasing organizational difficulties, health institutions opted for a transfusion safety e-learning training. Hindsight of two years, an initial assessment highlights success factors and desirable improvements.

[Post-transfusion pulmonary oedema: the French hemovigilance network classification method]. / Œdèmes pulmonaires transfusionnels: classification des cas notifiés en hémovigilance.

Pulmonary oedema after transfusion of blood products may be hydrostatic (transfusion-associated circulatory overload [taco]) or exsudative (transfusion-related acute lung injury [trali]). Both conditions have been recognized as major hazards to transfusion recipients. Risk characterization is necessary to improve safety and to monitor trends in the national blood transfusion system. A collaborative multidisciplinary working group of the French National Hemovigilance Committee has proposed an analysis framework for case definitions and classification. The method relies on internationally used definitions and is adapted to the codification procedures used in the french transfusion incident reports electronic data management.

[Supplying surgery blocs in red cell concentrates: a collective approach to improve practices]. / Approvisionnement des blocs opératoires en concentrés érythrocytaires: une démarche collective d'amélioration des pratiques.

The need to adapt red blood cells concentrates management in surgery blocs and resuscitation to the changes of the legal framework has lead to a collective approach to improve practices. Gathered by the regional hemovigilance coordinators of the Drass Ile-de-France (regional office of health and social actions), representatives of doctors' ordering transfusions and hemovigilance correspondents of the Assistance publique-Hôpitaux de Paris and representatives of the EFS (French blood establishment) Ile-de-France, together with representatives of the Afssaps (French health products safety agency), have coordinated an assessment of local transfusion practices in surgery blocs and resuscitation that have to be compliant. Each hospital then offered local improvement actions, approved by regional and national instances. We present this original and collective approach of assessing practices leading to offers that both respond to a legal framework and improve blood products flows without damaging transfusion security.

[Irregular antibodies. A comparative study of 2 series of 20,000 subjects: one with a conventional identification test, the other with gel-test]. / Recherche d'anticorps irréguliers. Etude comparative sur 2 séries de 20,000 sujets, l'une avec identification en technique tube, l'autre en gel-test.

The results of irregular antibody screening in two successive series of 21485 and 19819 individuals were retrospectively analysed. All the irregular antibody screenings were performed with an autoanalyser according to Rosenfield and Lalezary [1, 2] but red cell antibody identification tests were not the same: conventional manual tests in the first series and gel-test Diamed in the second one. In spite of a bigger number of identification tests performed in the second series, the percentage of patients with irregular antibodies was approximately the same (2.27% and 2.22%) in each series. Analysis of identified specificities shows in the second series the increase of immune antibodies (+ 42.3%) especially antibodies with anti-Rh specificity and the decline of natural antibodies (- 28.9%) essentially of anti-Lewis b and P1 antibodies. The sensitivity of both the gel-test and the autoanalyser screening for identification of immune antibodies are more or less the same. The sensitivity of gel-test probably gives a safer transfusion but increases the workload of both the laboratory and the blood bank delivery service.