Transfusion safety: Is there a difference between reported reactions in low-to-middle income and high-income countries?

Blood Transfusion Developed Country Developing Country Hemovigilance Transfusion reaction

Journal

Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis
ISSN: 1473-0502
Titre abrégé: Transfus Apher Sci
Pays: England
ID NLM: 101095653

Informations de publication

Date de publication:
19 Mar 2024
Historique:
received: 15 04 2023
revised: 17 03 2024
accepted: 19 03 2024
medline: 30 3 2024
pubmed: 30 3 2024
entrez: 29 3 2024
Statut: aheadofprint

Résumé

Transfusion safety may be becoming dependent on the financial resources made available for transfusion structures and may vary between high-income countries (HIC) and low-to-middle-income countries (LMIC). To assess whether there is a difference in the reported TR between these two groups of countries, we examined TR reported in Tunis the capital of Tunisia, a LMIC, and compared their frequency with reported TR in HIC. Data of TR were collected from transfusion incident report (TIR) forms declared by healthcare facilities in Tunis between 2015 and 2019. They were analysed and compared to reported TR in France (ANSM) and UK (SHOT). The incidence of TR was 70.6/100 000 blood components (BP) issued. A third of TR (36.8%) occurred at night. Febrile non-hemolytic transfusion reactions (43.7%) and allergic reactions (35%) were the most reported TR respectively 22.4/100 000 BP and 17.9/100 000 BP. The rate of ABO incompatibilities was 1.96/100 000 red blood cell units (RBC): they were all caused by human error. The rates of TRALI, TACO and bacterial contaminations were respectively 1.26/100 000 BP, 1.4/100 000 RBC and 0.7/100 000 BP. While advanced technologies applied to transfusion have improved transfusion safety, this study shows that their impact has been relatively minor, as reported TR in LMIC are still comparable to those in HIC. ABO-incompatibilities are still higher in LMIC: this should be addressed by reinforcing the training of all healthcare personnel involved in transfusion medicine.

Sections du résumé

BACKGROUND AND OBJECTIVES OBJECTIVE
Transfusion safety may be becoming dependent on the financial resources made available for transfusion structures and may vary between high-income countries (HIC) and low-to-middle-income countries (LMIC). To assess whether there is a difference in the reported TR between these two groups of countries, we examined TR reported in Tunis the capital of Tunisia, a LMIC, and compared their frequency with reported TR in HIC.
MATERIALS AND METHODS METHODS
Data of TR were collected from transfusion incident report (TIR) forms declared by healthcare facilities in Tunis between 2015 and 2019. They were analysed and compared to reported TR in France (ANSM) and UK (SHOT).
RESULTS RESULTS
The incidence of TR was 70.6/100 000 blood components (BP) issued. A third of TR (36.8%) occurred at night. Febrile non-hemolytic transfusion reactions (43.7%) and allergic reactions (35%) were the most reported TR respectively 22.4/100 000 BP and 17.9/100 000 BP. The rate of ABO incompatibilities was 1.96/100 000 red blood cell units (RBC): they were all caused by human error. The rates of TRALI, TACO and bacterial contaminations were respectively 1.26/100 000 BP, 1.4/100 000 RBC and 0.7/100 000 BP.
CONCLUSION CONCLUSIONS
While advanced technologies applied to transfusion have improved transfusion safety, this study shows that their impact has been relatively minor, as reported TR in LMIC are still comparable to those in HIC. ABO-incompatibilities are still higher in LMIC: this should be addressed by reinforcing the training of all healthcare personnel involved in transfusion medicine.

Identifiants

pubmed: 38553365
pii: S1473-0502(24)00080-6
doi: 10.1016/j.transci.2024.103916
pii:
doi:

Types de publication

Journal Article

Langues

eng

Pagination

103916

Informations de copyright

Copyright © 2024. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Conflict of Interest The authors have no conflict of interest.

Auteurs

Mohamed Amine Hmida (MA)

Faculty of Medicine of Tunis - University Tunis El Manar, Djebal Lakhdar Street, 1006 Tunis, Tunisia; Hematology Laboratory, La Rabta University Hospital, La Rabta, 1007 Tunis, Tunisia. Electronic address: mohamedamine.hmida@etudiant-fmt.utm.tn.

Sonia Mahjoub (S)

Faculty of Medicine of Tunis - University Tunis El Manar, Djebal Lakhdar Street, 1006 Tunis, Tunisia; Hematology Laboratory, La Rabta University Hospital, La Rabta, 1007 Tunis, Tunisia.

Leila Ben Hamed (L)

National Blood Transfusion Center, 13 Djebel Lakhdhar Street, Bab Sabdoun, 1006 Tunis, Tunisia.

Najet Mojaat (N)

Central Unit of Blood Transfusion and Blood Banks, Djebel Lakhdhar Street, Bab Sabdoun, 1006 Tunis, Tunisia.

Abdessalem Bahloul (A)

Hematology Laboratory, Charles Nicolle University Hospital, 9 avril 1938 Street, Bab Saadoun, 1007 Tunis, Tunisia.

Slama Hmida (S)

National Blood transfusion Center, 13 Djebel Lakhdhar Street, Bab Sabdoun, 1006 Tunis, Tunisia.

Classifications MeSH