Abstract

Background: In this modern era, hemovigilance has emerged as a branch of pharmacovigilance that checks the occurrence & recurrence of reactions to blood and blood derived products and provides guidelines for their prevention.

Aim and Objectives: In this study, we have attempted to understand the pattern of Adverse Transfusion Reactions (ATRs) to different blood components according to genders, blood groups & blood components; to propose a model for the study of the same and to find out the incidence of such reactions. 

Material and Methods: The study was carried out in a tertiary care teaching hospital. We prospectively observed transfusion of 892 units of different blood components to 445 patients over a period of 30 days: average 2 transfusions per patient & 29.73 transfusions per day.  Patients showing various adverse reactions to transfusion of these blood components were analyzed with a questionnaire specially designed, taking the reference of Suspected Adverse Drug Reaction Reporting Form (CDSCO).

Results: We observed that the overall incidence of ATRs in 892 transfusions is 5.27% (p=0.05). Both, women and men, are equally affected.  A+ve, B+ve & O+ve are the blood groups frequently showing transfusion reactions. O+ve blood group shows higher susceptibility than B+ve blood group. Patients having a past history of blood transfusions are particularly susceptible to develop adverse reactions to further transfusions. The main culprits of these reactions are Fresh Frozen Plasma(FFP), Human Red Blood Cells (HRBC), Single Wash Human Red Blood Cells (SWHRBC) with the incidence being highest for FFP and lowest for SWHRBC. Acute Febrile Reactions are the most commonly encountered reactions followed in frequency by dyspnoea & orthopnoea with acute hemolytic reactions being a rarity due to stringent precautions. We also noted a case of Transfusion associated Acute Lung Injury (TRALI) and two cases of skin rashes. We have documented certain odd reactions whose references could not be found in the literature.

Conclusion: Most commonly encountered reactions were Acute Febrile Reactions followed in frequency by dyspnoea and orthopnoea. Acute Hemolytic Reactions and Transfusion associated Acute Lung Injury (TRALI) were rare events. We have been able to propose a model for the study of pattern of such reactions. With proper use of this model we conclude that the susceptibility of a particular blood group in a particular gender to a particular blood component can be found out. There can be an underestimation of the true incidence of transfusion reactions because of underreporting which can be improved by hemovigilance system.

Keywords: Hemovigilance, Acute Transfusion Reactions, Blood groups, Blood components.