Factors influencing transfusion reactions in paediatric patients: Active haemovigilance data from a children's hospital in India.

Abstract

Background and objectives: Because of inherent differences, reports on paediatric transfusion reactions are more heterogeneous than those seen in the adult population. In this study, we aimed to prospectively (active haemovigilance) study the incidence, clinical presentation and factors influencing transfusion reactions among paediatric patients.

Materials and methods: This was a prospective descriptive study in a teaching children's hospital from the public healthcare system in North India over 1 year. The study involved active monitoring, reporting and analysis of the data related to acute transfusion reactions (i.e., within 24 h of transfusion).

Results: During the study period, there were a total of 5198 transfusions in 1401 paediatric patients (876 male; 525 female); among them, 621 patients received multiple transfusions. A total of 93 acute transfusion reactions were analysed (1.7 for every 100 paediatric transfusions and 6.6 for every 100 paediatric patients transfused) with similar incidences in both genders. Febrile non-haemolytic transfusion reaction (FNHTR; n = 80), followed by allergic reaction (n = 12), was the most common transfusion reaction reported. The incidence of transfusion reactions was significantly higher (p < 0.05) in patients with a history of previous transfusion (12.7) compared to patients receiving transfusion for the first time (1.7). Overall, the majority of transfusion reactions in paediatric populations were due to platelet transfusions (49% of all reported reactions). The majority of FNHTRs were reported with red cell transfusions (51%), whereas the majority of allergic reactions were due to platelet transfusions (63.6%).

Conclusion: The study highlights the need for active surveillance to accurately report and study the factors influencing transfusion reactions in paediatric patients.