THE INCIDENCE OF TRANSFUSION REACTIONS IN INCOMPATIBLE TRANSFUSED BLOOD IN SOME BLOOD TRANSFUSION CENTRES IN OWERRI MUNICIPAL

ABSTRACT

Objective: To determine the incidence of transfusion reactions in incompatible transfused blood at Some Transfusion Centres in Owerri Municipal. Methods: This was a three years and seven months (from January 2005 till July 2008) retrospective review of all the transfusion reactions that were reported to the transfusion service at Some Transfusion Centres in Owerri Municipal. All the reactions were clinically evaluated by the blood bank physician. Transfusion reactions occurring during or within four hours after transfusion were evaluated and classified by standard and recognized definitions defined by American Association of Blood Banks. Results: The acute transfusion reactions (ATRs) reported during the study period were 212. However, out of these 212 ATRs, 182 ATRs were confirmed by blood bank physician, and included febrile non haemolytic reactions [89 (41.9%)], allergic reaction [73 (34.4%)], isolated hypotension [3 (1.4%)], haemolytic reaction [4 (1.8%)] and bacterial contamination [2 (0.9%)]. Eleven (5.1%) ATRs were unclassifiable and were thus labeled as non-specific reaction. Conclusion: The frequency of transfusion reactions in our patients was found to be 0.082%. Febrile non haemolytic reaction was the most frequent transfusion reaction followed by allergic reaction. This may be an under reported figure. There is a need for establishing a haemovigilance system for critical analysis of blood transfusion events (JPMA 60:832; 2010).

CHAPTER ONE

1.0 INTRODUCTION

Transfusion of blood products is often required with the aim of improving the blood counts and clinical condition of the patients. However, transfusion can lead to serious adverse effects including infectious and non-infectious complications. With the improvements in donor screening and infectious diseases testing, the risk of infectious complications has declined in the past few decades. But the risks of non- infectious complications have become more apparent. These non- infectious complications can occur rapidly after transfusion (acute) or many days and/ or weeks after transfusion (delayed).1 Acute transfusion reactions (ATRs) occur within 24 hours of administration of transfusion and most of them occurs within the first four hours. Commonly encountered ATRs include acute haemolytic reaction, febrile non-haemolytic reaction, allergic reaction, volume overload, bacterial contamination and isolated hypotension.2 These ATRs have different etiology, clinical presentation and severity. However, most of these reactions are usually mild and transient.

The frequency of ATRs is estimated to be 0.2% to 10%2-4 and are responsible for death in approximately 1 per 250,000. Haemovigilance consists of reporting of all the complications related to transfusion so that these can be avoided in the future. Various haemovigilance programmmes have been developed and implemented in several countries including Canada, United Kingdom and France; and they publish their annual reports of adverse events associated with blood transfusion.4-The aim of these programmmes is to have a system of surveillance and thus lower the risks associated with transfusion. Unfortunately, there is no such programmme in Owerri Municipal and the reporting of transfusion hazards is not mandatory. Also there is under reporting by the medical staff and thus most of the minor adverse events do not come to attention and therefore the exact incidence of various types of transfusion reactions is not known.
Keeping this in mind, the primary objective of the study was to determine the frequency and type of ATRs occurring in hospitalized patients who required transfusion at a tertiary care center in In Owerri Municipal.

1.1 OBJECTIVE OF THE STUDY

1. To examine the incidence of transfusion reactions in incompatible transfused blood
2. To investigate on the possible causes of transfusion reactions
3. To examine the possible ways to reduce the complications in blood transfusion

REFERENCES

1. Gauvin F, Lacroix J, Robillard P, Lapointe H, Hume H. Acute transfusion reactions in the pediatric intensive care unit. Transfusion 2006; 46: 1899-908.

2. Kleinman S, Chan P, Robillard P. Risks associated with transfusion of cellular blood components in Canada. Transfus Med Rev 2003; 17: 120-62.

3. Callum JL, Pinkerton PH. Transfusion reactions. In: Callum JL, Pinkerton PH. Bloody easy: blood transfusions, blood alternatives and transfusion reactions, a guide to transfusion medicine. Toronto (Ontario): Sunnybrook & Women’s College Health Sciences Centre, 2005; pp 34-65.