Title: Review of Blood Transfusion Reactions in a Tertiary Hospital Blood Bank

Authors: Dr Vanamala Alwar, Dr Sitalakshmi S, Dr Shanthala Devi AM, Dr Poornima Rao, Dr Latha Fathima Shaju, Dr Parimala Puttaiah

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i1.14

Abstract

Background: Transfusion of blood components are vital therapeutic procedures in clinical medicine. However patients may still be at risk of adverse effects of transfusions. Analysis of all untoward effects of blood transfusion must be monitored in order to correct their cause and prevent recurrence. This study was designed to analyse the incidence and spectrum of adverse effects of blood transfusion so as to initiate measures to minimize risks and improve overall transfusion safety.

Methods: In the present study, we totally reviewed data over 12 years. All the acute transfusion reactions of blood components, that were reported to the hospital blood bank were included. Reactions due to Platelets and delayed transfusion reactions were excluded. The transfusion reaction workup done for these reported cases included; verification of patient identity and clinical records, examination of blood transfusion set and bag, ABO and Rh blood grouping, cross matching (pre & post transfusion samples)and urine analysis.

Results:  Of the total 293023 transfusions during the study period, 417 (0.14%) acute transfusion reactions (ATR) were reported. The commonest type of reaction noted were of the allergic type (ANHTR) (n=303; 72.6%), followed by febrile non hemolytic transfusion reactions(FNHTR)(n=104;24.9%), 8 (1.9%)hemolytic transfusion reactions(HTR).2 cases of the NHTRs presented with clinical suspicion of TRALI. All the HTRs were due to packed red cell (PC) transfusions. 324 NHTRs were due to red cell transfusions, 85 due to infusion of plasma.

Conclusions: The NHTRs were far more in number (esp the ANHTRs),effective leucodepletion holds the key. HTRs were completely preventable but far more dangerous clinically. A strict protocol needs to be followed not only in the blood bank, but also in other relevant procedures like; pre transfusion sampling, storage outside blood banks, bed side patient identification and monitoring of transfusion to ensure blood safety and reduce such adverse effects

Keywords: Transfusion reactions, hemolytic, non-hemolytic.

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Corresponding Author

Dr Vanamala Alwar

Department of Transfusion Medicine and Immunohematology, St John’s Medical College Hospital

Sarjapur Road, Bangalore560034

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