Adverse Reactions to Blood Components- A Twelve-Year Retrospective Study- A Step towards Prevention

Abstract

Introduction: The transfusion of blood and blood components is a life-saving procedure in clinical practice. However, it is associated with risks that can range from trivial self-limited Allergic Reactions (AR) to life endangering anaphylactic or haemolytic transfusion reactions. Aim: To analyse the pattern and incidence of transfusion related adverse events and to develop preventive strategies. Materials and Methods: This was a retrospective, observational study conducted at Department of Pathology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India, on data of Adverse Transfusion Reactions (ATR) reported to the blood bank over a period of 12 years from January 2006 to December 2018. The ATRs were analysed with respect to gender, type of blood component, and nature of the reaction. The data collected were tabulated and the analysis was done using percentages. Results: A total of 1,60,914 units of Whole Blood (WB) and blood components were issued during the study period. A 271 adverse reactions (129 reactions in females and 142 reactions in males) were documented constituting 0.168% of the total products issued, majority were due to packed red cells (0.29%). The incidence of AR was the maximum, accounting for 63.1% of the reactions (n=171, 75 in females and 96 in males) followed by Febrile Non Haemolytic Transfusion Reactions (FNHTR) which were 33.57% (n=91, 42 in males and 49 in females). There were four cases of Transfusion Associated Acute Lung Injury (TRALI), all in males, accounting for 1.48% of the reactions, three cases of anaphylactoid reactions (2 in females and 1 in male) accounting for 1.11% of the total reactions and two cases of haemolytic transfusion reaction (0.73%). Conclusion: The frequency of adverse reactions in the present study is 0.168% (271 out of 1, 60,914 units), majority were due to packed red cells (0.29%). No adverse reactions due to bacterial contamination occurred during the study period. It is important to ensure education of nursing staff, interns, and residents regarding the correct procedure of blood transfusion, identification of adverse reactions and appropriate remedial measures for the same.