1
|
Sayed Ahmed HA, Kamel N, Mahfouz EM. Insight into hazard and control of transfusion-transmitted infections in Egypt: A narrative review. Transfus Apher Sci 2024; 63:103965. [PMID: 38986352 DOI: 10.1016/j.transci.2024.103965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
Blood transfusion is a critical life-saving medical intervention, but it carries the risk of transfusion-transmitted infections (TTIs) that can lead to serious consequences. TTIs include viral, bacterial, parasitic, and prion infections, transmitted through asymptomatic donor blood, contamination of stored blood products, or transfusion-related immunosuppression. Recognized global agents posing challenges to blood safety include human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV), Syphilis, etc. Emerging pathogens like SARS-CoV-2, hepatitis E, and others present additional risks. The residual risk of TTIs, representing the likelihood of infected donations passing screening tests, varies globally. High-income countries generally show lower prevalence rates than low-income countries. In Egypt, the estimated prevalence rates for HIV, HBV, HCV, and syphilis markers among the donors are 0.23 %, 0.76 %, 2.33 %, and 0.24 %, respectively. In Egypt, specific residual risk estimates are scarce, but prevalence rates for key infections highlight existing challenges. The World Health Organization promotes a global blood safety strategy, advocating for national blood systems, voluntary non-remunerated donors, and quality-assured testing. Despite these measures, the establishment of a haemovigilance system which is critical for monitoring and preventing adverse events, including TTIs, is reported as lacking in Egypt. This highlights the importance of comprehensive surveillance and safety measures in the blood donation process to ensure universal access to safe blood. Primary health care can play a pivotal role in preventing TTIs.
Collapse
Affiliation(s)
- Hazem A Sayed Ahmed
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Noha Kamel
- Department of Clinical Pathology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt; Department of Clinical Pathology, Faculty of Medicine, Horus University, New Damietta, Egypt.
| | - Eman Mohamed Mahfouz
- Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Minia University, Egypt
| |
Collapse
|
2
|
Berg P, Heiden M, Müller S, Meyer B, Witzenhausen C, Ruppert-Seipp G, Kehr S, Funk MB. A national surveillance system for continuous monitoring of blood transfusion safety: German haemovigilance data. Vox Sang 2024. [PMID: 38889998 DOI: 10.1111/vox.13694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND AND OBJECTIVES Haemovigilance (HV) systems aim to improve transfusion outcomes in patients and donor safety. An important question for blood regulators is how to ensure an effective HV system. MATERIALS AND METHODS We retrospectively analysed the HV reports submitted to Paul-Ehrlich-Institut over the last two decades. RESULTS Between 2011 and 2020, 50.86 million units of blood components were used, and 8931 suspected serious donor and recipient adverse reactions (SARs), 874 serious adverse events (SAEs) and 12,073 donor look-backs were reported. Following implementation of specific risk-minimization measures (RMMs) between 2000 and 2010, SAR reporting rates decreased for transfusion-transmitted viral infections (TTVIs), transfusion-related acute lung injury (TRALI) and transfusion-transmitted bacterial infections (TTBIs), while increasing for other serious adverse transfusion reactions. Within this decade, the overall blood component use decreased. CONCLUSION Long-term data collection forms the basis to establish trends and changes in reporting and to evaluate the effect of RMM. Standardized criteria for reaction types, seriousness and imputability assessments and availability of a denominator are important elements. Central data collection and independent assessment allow for monitoring HV data in a nationwide context over time. Stakeholder involvement and transparent feedback on the benefit of RMM will help to achieve the objectives of HV.
Collapse
Affiliation(s)
- Philipp Berg
- Division Safety of Biomedicines and Diagnostics, Paul-Ehrlich-Institut (PEI), Langen, Germany
| | - Margarethe Heiden
- Division Safety of Biomedicines and Diagnostics, Paul-Ehrlich-Institut (PEI), Langen, Germany
| | - Susanne Müller
- Division Safety of Biomedicines and Diagnostics, Paul-Ehrlich-Institut (PEI), Langen, Germany
| | - Britta Meyer
- Division Safety of Biomedicines and Diagnostics, Paul-Ehrlich-Institut (PEI), Langen, Germany
| | - Cornelia Witzenhausen
- Division Safety of Biomedicines and Diagnostics, Paul-Ehrlich-Institut (PEI), Langen, Germany
| | - Gabriele Ruppert-Seipp
- Division Safety of Biomedicines and Diagnostics, Paul-Ehrlich-Institut (PEI), Langen, Germany
| | - Sarah Kehr
- Division Safety of Biomedicines and Diagnostics, Paul-Ehrlich-Institut (PEI), Langen, Germany
| | - Markus B Funk
- Division Safety of Biomedicines and Diagnostics, Paul-Ehrlich-Institut (PEI), Langen, Germany
| |
Collapse
|
3
|
Wood EM, Whitaker BI, Townsend M, Narayan S. How we forecast tomorrow's haemovigilance. Transfus Clin Biol 2024; 31:114-118. [PMID: 38460837 DOI: 10.1016/j.tracli.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2024]
Abstract
The field of haemovigilance continues to develop, building on more than forty years of international experience. This review considers the current scope and activities of haemovigilance around the world and explores aspects of preparation for the advent of new blood products and alternative therapies to transfusion; new tools for data acquisition (including patient- and donor-reported outcomes, and data from 'wearables') and the analysis and communication of haemovigilance results.
Collapse
Affiliation(s)
- Erica M Wood
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia; Department of Clinical Haematology, Monash Health, Clayton Road, Clayton, Victoria 3168, Australia.
| | - Barbee I Whitaker
- Office of Biostatistics and Pharmacovigilance, Center for Biologics Evaluation and Research, Food and Drug Administration, Center for Biologics Evaluation and Research, 10903 New Hampshire Avenue, White Oak-71, Silver Spring, MD 20993, USA.
| | - Mary Townsend
- Vitalant, 9503 E Via de Ventura, Scottsdale, AZ 85259, USA.
| | - Shruthi Narayan
- Serious Hazards of Transfusion (SHOT), NHS Blood and Transplant, Manchester Blood Centre, Manchester M13 9LL, United Kingdom.
| |
Collapse
|
4
|
Townsend M, Maryuningsih Soedarmono YS, Narayan S, Ashford P, Wood EM, Whitaker BI. Haemovigilance resources available for everyone: A report from the International Haemovigilance Tools Collaborative Project. Vox Sang 2024; 119:277-281. [PMID: 38126141 DOI: 10.1111/vox.13570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/06/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND AND OBJECTIVES Haemovigilance systems are intended to collect and analyse data, and report findings relating to transfusion complications, such as blood product safety, procedural incidents, and adverse reactions in donors and patients. A common problem among developing haemovigilance programs is the lack of resources and tools available to countries striving to establish or enhance their haemovigilance system. MATERIALS AND METHODS World Health Organization, in collaboration with International Society for Blood Transfusion (ISBT), International Haemovigilance Network and other haemovigilance experts embarked on a Haemovigilance Tools Project to collect and provide materials and resources to assist with the stepwise implementation of haemovigilance. RESULTS AND CONCLUSIONS Resources are housed as a virtual compendium on the ISBT website under the Haemovigilance Working Party. These are managed by a subcommittee of the Working Party and are freely available and downloadable to all without requiring ISBT membership.
Collapse
Affiliation(s)
| | | | - Shruthi Narayan
- NHS Blood and Transplant, Bristol, UK
- Manchester Blood Centre, Plymouth Grove, Manchester, UK
| | | | - Erica M Wood
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Haematology, Monash Health, Clayton, Victoria, Australia
| | - Barbee I Whitaker
- Division of Analytics and Benefit Risk Assessment, Office of Biostatistics and Pharmacovigilance, Center for Biologics Evaluation and Research, Silver Spring, Maryland, USA
| |
Collapse
|
5
|
White SK, Walker BS, Schmidt RL, Metcalf RA. The incidence of transfusion-related acute lung injury using active surveillance: A systematic review and meta-analysis. Transfusion 2024; 64:289-300. [PMID: 38116828 DOI: 10.1111/trf.17688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 11/30/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Transfusion-related acute lung injury (TRALI) is a leading cause of transfusion-related mortality. A concern with passive surveillance to detect transfusion reactions is underreporting. Our aim was to obtain evidence-based estimates of TRALI incidence using meta-analysis of active surveillance studies and to compare these estimates with passive surveillance. STUDY DESIGN AND METHODS We performed a systematic review and meta-analysis of studies reporting TRALI rates. A search of Medline and Embase by a research librarian identified studies published between January 1, 1991 and January 20, 2023. Prospective and retrospective observational studies reporting TRALI by blood component (red blood cells [RBCs], platelets, or plasma) were identified and all inpatient and outpatient settings were eligible. Adult and pediatric, as well as general and specific clinical populations, were included. Platelets and plasma must have used at least one modern TRALI donor risk mitigation strategy. A random effects model estimated TRALI incidence by blood component for active and passive surveillance studies and heterogeneity was examined using meta-regression. RESULTS Eighty studies were included with approximately 176-million blood components transfused. RBCs had the highest number of studies (n = 66) included, followed by platelets (n = 35) and plasma (n = 34). Pooled TRALI estimates for active surveillance studies were 0.17/10,000 (95% confidence intervals [CI]: 0.03-0.43; I2 = 79%) for RBCs, 0.31/10,000 (95% CI: 0.22-0.42; I2 = <1%) for platelets, and 3.19/10,000 (95% CI: 0.09-10.66; I2 = 86%) for plasma. Studies using passive surveillance ranged from 0.02 to 0.10/10,000 among the various blood components. DISCUSSION In summary, these estimates may improve a quantitative understanding of TRALI risk, which is important for clinical decision-making weighing the risks and benefits of transfusion.
Collapse
Affiliation(s)
- Sandra K White
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
| | | | - Robert L Schmidt
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
- ARUP Laboratories, Salt Lake City, Utah, USA
| | - Ryan A Metcalf
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
- ARUP Laboratories, Salt Lake City, Utah, USA
| |
Collapse
|
6
|
Sudha R, Goel I, Katiyar P, Misra G, Roshan R, Sharma N, Sharma SK, Katiyar A. Haemovigilance in India during the COVID-19 pandemic. J Glob Health 2023; 13:03030. [PMID: 37733601 PMCID: PMC10513120 DOI: 10.7189/jogh.13.03030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023] Open
Affiliation(s)
- Rati Sudha
- P.G. Department of Zoology, ANS College, Magadh University, Patna-803123, Bihar, India
- Joint first authorship
| | - Isha Goel
- ICMR-AIIMS Computational Genomics Center, Indian Council of Medical Research, Ansari Nagar, New Delhi-110029, India
- Joint first authorship
| | - Poonam Katiyar
- NCC-Pharmacovigilance Program of India (PvPI), Indian Pharmacopoeia Commission, Raj Nagar, Ghaziabad-201002, Uttar Pradesh, India
- ESI Dispensary, Employees State Insurance Scheme, Labour Department, Government of Uttar Pradesh, Mohan Nagar, Ghaziabad-201007, India
- Joint first authorship
| | - Gauri Misra
- Molecular Diagnostics and COVID-19 Kit Testing Laboratory, National Institute of Biologicals, Noida-201309, Uttar Pradesh, India
| | - Reema Roshan
- International Health Division, Indian Council of Medical Research, Ansari Nagar, New Delhi-110029, India
| | - Naveen Sharma
- Bio-Medical Informatics Division, Indian Council of Medical Research, Ansari Nagar, New Delhi-110029, India
| | - Saurabh K Sharma
- School of Computer and Systems Sciences, Jawaharlal Nehru University, Mehrauli, New Delhi-110029, India
- Joint senior authorship
| | - Amit Katiyar
- Bioinformatics Facility, Centralized Core Research Facility, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India
- Joint senior authorship
| |
Collapse
|
7
|
Nitsche E, Dreßler J, Henschler R. Systematic Workup of Transfusion Reactions Reveals Passive Co-Reporting of Handling Errors. J Blood Med 2023; 14:435-443. [PMID: 37576590 PMCID: PMC10422960 DOI: 10.2147/jbm.s411188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 06/19/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Reporting of transfusion reactions is good practice and required by many guidelines. Errors in the transfusion chain can also lead to severe patient reactions and depend on active error reporting. We aimed to characterize transfusion incidents and asked whether workup of transfusion reactions may also contribute to revealing logistical errors. Methods Transfusion medical records from 2011 to 2019 at our tertiary medical centre, as well as forensic autopsy reports, digitized sections, and court records from 1990 to 2019 were analysed. A total of 230,845 components were transfused between 2011 and 2019 at our own institution. Results Overall, 322 transfusion incidents were reported. Of these, 279 were from our own institution, corresponding to a frequency of 0.12% of all transfusions. The distribution of reaction types is consistent with the literature, with allergic reactions (55.9%), febrile-non-hemolytic reactions (FNHTR, 24.2%), hemolytic reactions (3.4%) and other types at smaller frequencies (<3%). Twenty-nine (10.4%) of the 279 reports revealed logistical errors, including hemoglobin above guideline threshold (4.3%), incorrect or non-performed bedside tests (3.2%), inadequate patient identification (2.5%), laboratory and issuing errors, missed product checks or failure to follow recommendations (1.1% each). Eight of 29 (27.5%) of the logistical errors were detected by serendipity during workup of incident reports. In addition, 8/932 autopsy cases under code A14 (medical treatment errors) were found to be transfusion-associated (0.9%). Conclusion Systematic workup of transfusion incidents can identify previously undetected errors in the transfusion chain. Passive reporting of errors through the recording of side effects may serve as a tool to assess more closely assess the frequency and quality of handling errors in real life, and thus serve to improve patient safety.
Collapse
Affiliation(s)
- Elisabeth Nitsche
- Department of Forensic Medicine, Institute of Legal Medicine, University of Leipzig, Leipzig, Saxony, Germany
- Department of Quality Control, Institute of Transfusion Medicine, University Hospital Leipzig, Leipzig, Saxony, Germany
| | - Jan Dreßler
- Department of Quality Control, Institute of Transfusion Medicine, University Hospital Leipzig, Leipzig, Saxony, Germany
| | - Reinhard Henschler
- Department of Forensic Medicine, Institute of Legal Medicine, University of Leipzig, Leipzig, Saxony, Germany
| |
Collapse
|
8
|
Wood EM, Whitaker BI, Townsend M. Haemovigilance: Giving it our best SHOT! Vox Sang 2023; 118:260-262. [PMID: 36807587 DOI: 10.1111/vox.13411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/23/2023]
Affiliation(s)
- Erica M Wood
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Department of Clinical Haematology, Monash Health, Melbourne, Australia
| | - Barbee I Whitaker
- Office of Biostatistics and Pharmacovigilance, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA
| | | |
Collapse
|
9
|
Vuk T, Politis C, de Angelis V, Lozano M, Haddad A, Laspina S, Garraud O. Education in transfusion medicine, Part III - The importance of haemovigilance education. Transfus Clin Biol 2023; 30:294-302. [PMID: 36773797 DOI: 10.1016/j.tracli.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/12/2023]
Abstract
According to the literature, there are significant differences in the availability of education and training in transfusion medicine worldwide, with significant heterogeneity in the existing curricula. Recognising the need for education with the aim of achieving globally standardised competencies in transfusion medicine, a group of experts collaborating in the European and Mediterranean Initiative in Transfusion medicine (EMITm) proposed a process of incremental training and education. Subsequent to two previous papers published by this group on general education in transfusion medicine, this paper specifically refers to the field of education in haemovigilance. This topic is of particular importance when one considers the role of haemovigilance in improving the safety of transfusion practice, and the fact that this role can only be realised through the cooperation of all participants in the transfusion chain. In addition to promoting the importance of education in haemovigilance, this paper provides an overview of the available literature on this topic and proposes an education programme on haemovigilance for medical students and residents.
Collapse
Affiliation(s)
- Tomislav Vuk
- Croatian Institute of Transfusion Medicine, Zagreb, Croatia.
| | - Constantina Politis
- Coordinating Centre for Haemovigilance and Surveillance of Transfusion, National Public Health Organization, Athens, Greece
| | | | - Miquel Lozano
- Department of Hemotherapy and Hemostasis. ICMHO, University Clinic Hospital, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Antoine Haddad
- Department of Clinical Pathology and Blood Bank, Sacré-Coeur Hospital, Lebanese University, Beirut, Lebanon; Lebanese American University, Beirut, Lebanon
| | | | - Olivier Garraud
- SAINBIOSE-INSERM_U1059, Faculty of Medicine, University of Saint-Etienne, Saint-Etienne, France
| | | |
Collapse
|
10
|
Vuk T, Politis C, Laspina S, Lozano M, Haddad A, de Angelis V, Garraud O. Thirty years of hemovigilance - Achievements and future perspectives. Transfus Clin Biol 2023; 30:166-172. [PMID: 36216308 DOI: 10.1016/j.tracli.2022.09.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 09/30/2022] [Indexed: 02/04/2023]
Abstract
Since its emergence in the early 1990s, hemovigilance has gradually evolved from a blood safety concept focused on surveillance of adverse reactions and events in patients, to a well-defined system that monitors the entire transfusion chain and improves its safety. The importance of hemovigilance has been recognized globally in a relatively short time, but the level of its implementation varies significantly between countries. The cooperation of international organizations has significantly contributed to the promotion, implementation, and education in this field. Thanks to initiatives taken, the safety of transfusion practice has been improved in many segments, primarily related to the risks of adverse events in recipients of blood components. In parallel with changing transfusion practice, the hemovigilance process has also matured. In addition to the reduction of existing risks and the early detection of emerging risks, hemovigilance has also embraced the principles of patient blood management. Research in hemovigilance is more increasingly focused on specific categories of patients, specific blood components and methods of their preparation, rare reactions, and transfusion efficacy and efficiency. A proactive approach and use of big data can play an important role in achieving these goals. Additional and sustained efforts should be made to prevent underreporting of events and to improve data comparability through clear definitions and grading systems. This review provides a historical overview of hemovigilance and its achievements, current challenges, and future plans.
Collapse
Affiliation(s)
- Tomislav Vuk
- Croatian Institute of Transfusion Medicine, Zagreb, Croatia.
| | - Constantina Politis
- Coordinating Centre for Haemovigilance and Surveillance of Transfusion, National Public Health Organization, Athens, Greece
| | | | - Miquel Lozano
- Department of Hemotherapy and Hemostasis, ICMHO, University Clinic Hospital, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Antoine Haddad
- Department of Clinical Pathology and Blood Bank, Sacré-Coeur Hospital, Lebanese University, Beirut, Lebanon; Lebanese American University, Beirut, Lebanon
| | | | - Olivier Garraud
- SAINBIOSE-INSERM_U1059, Faculty of Medicine, University of Saint-Etienne, Saint-Etienne, France
| | -
- SAINBIOSE-INSERM_U1059, Faculty of Medicine, University of Saint-Etienne, Saint-Etienne, France
| |
Collapse
|
11
|
L Poisson J, O'Leary MF. Improving our reaction time - Using technology to identify transfusion reactions sooner. Transfusion 2022; 62:923-927. [PMID: 35485170 DOI: 10.1111/trf.16881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 04/06/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Jessica L Poisson
- Department of Pathology, Duke University, Durham, North Carolina, USA
| | - Mandy Flannery O'Leary
- Department of Pathology, Moffitt Medical Group, H. Lee Moffitt Cancer Center, Tampa, Florida, USA.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida, USA
| |
Collapse
|
12
|
Politis C, Wiersum-Osselton J, Richardson C, Grouzi E, Sandid I, Marano G, Goto N, Contego J, Boudjedir K, Asariotou M, Politi L, Land K. Adverse reactions following transfusion of blood components, with a focus on some rare reactions: reports to the International Haemovigilance Network Database (ISTARE) in 2012-2016. Transfus Clin Biol 2022; 29:243-249. [PMID: 35476961 DOI: 10.1016/j.tracli.2022.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The International Haemovigilance Network's (IHN) ISTARE database collects surveillance data on all adverse reactions (AR) associated with transfusion of blood and blood components, facilitating the sharing of best practice and benchmarking for improving blood safety and quality. Up to 2012 no publications discussed certain rare AR. The aim of this study is to examine ISTARE data on AR from 2012 to 2016, focusing on hypotensive reactions, post-transfusion purpura (PTP), transfusion-associated graft versus host disease (TA-GvHD), hyperkalemia and hypocalcemia. MATERIALS AND METHODS National Haemovigilance Systems (HVS), provided aggregate annual data on AR by type of reaction, severity, imputability to transfusion, and blood component implicated. Twenty-nine HVS provided 104 annual reports covering 107,778,290 blood units issued. RESULTS Among AR reported, 25% were serious, including 368 deaths. The 284 transfusion-transmitted infections included 187 bacterial infections, 84 viral and 13 parasitic or fungal; nine deaths resulted. AR related to the respiratory system transfusion-associated circulatory overload, transfusion-related acute lung injury and transfusion-associated dyspnoea accounted for 8.3% of all AR, 20.1% of serious, and 52.2% of deaths. Of 1634 rare AR, 1565 were hypotensive, 38 PTP, 17 GvHD, 9 hyperkalemia and 5 hypercalcemia. Half were serious and 16 fatalities were recorded (13 hypotensive, 2 GvHD, one PTP). Among 14 countries that reported any hypotensive AR, incidences diverged widely. CONCLUSIONS ARs in this group are frequently severe or life-threatening. Hypotensive AR are the most common, but may have been overlooked and counted under allergic and other AR presenting with hypotension. Compliance with the ISBT definition may be suboptimal, thus its real incidence may be higher. Data on GvHD may contribute to clarifying the role of leukodepletion with or without irradiation. ISTARE continues to be a useful surveillance tool for all transfusion AR and provides relevant insights into overlooked and rare AR, thus offering important contributions towards maximising transfusion safety.
Collapse
Affiliation(s)
- C Politis
- Coordinating Centre for Haemovigilance and Surveillance of Transfusion, Hellenic National Public Health Organization, Attika, Greece.
| | | | - C Richardson
- Panteion University of Social and Political Sciences, Athens, Greece
| | - E Grouzi
- Transfusion Service and Clinical Hemostasis, Saint Savvas Oncology Hospital of Athens, Greece
| | - I Sandid
- French National Agency for Medicines and Health Products Safety (ANSM), France
| | - G Marano
- National Blood Centre, Instituto Superiore di Sanita, Rome, Italy
| | - N Goto
- Safety Vigilance Division, Technical Department, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - J Contego
- Transplantacao, Instituto Portugues do Sangue e da Transplantacao, Port, Portugal
| | - K Boudjedir
- French National Agency for Medicines and Health Products Safety (ANSM), France
| | - M Asariotou
- Coordinating Centre for Haemovigilance and Surveillance of Transfusion, Hellenic National Public Health Organization, Attika, Greece
| | - L Politi
- Directorate of Surveillance and Prevention of Infectious Diseases, Hellenic National Public Health Organization, Greece
| | - K Land
- Clinical Services at Vitalant San Antonio, Texas, United States
| |
Collapse
|
13
|
Samukange WT, Kluempers V, Porwal M, Mudyiwenyama L, Mutoti K, Aineplan N, Gardarsdottir H, Mantel-Teeuwisse AK, Nuebling CM. Implementation and performance of haemovigilance systems in 10 sub-saharan African countries is sub-optimal. BMC Health Serv Res 2021; 21:1258. [PMID: 34801022 PMCID: PMC8605544 DOI: 10.1186/s12913-021-07235-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background Haemovigilance is an important element of blood regulation. It includes collecting and evaluating the information on adverse events resulting from the use of blood and blood components with the aim to improve donor and patient safety. We describe the results of the pilot of the integrated GBT+ Blood for the haemovigilance function in 10 sub-Saharan African countries. Methods We piloted the integrated WHO Global Benchmarking Tool plus Blood (GBT+ Blood) to assess the haemovigilance function of national regulatory authorities (NRAs) in Ethiopia, Kenya, Malawi, Nigeria, Liberia, Rwanda, South Africa, Tanzania, Uganda, and Zimbabwe. Data obtained from documents and face to face interviews were used to determine the status of implementation and performance of the following six indicators; legal provisions regulations and guidelines, organisation and governance, human resources, regulatory processes, transparency and accountability and finally, monitoring progress and assessing impact, by estimating median scores across 20 sub-indicators. In addition, a cluster analysis was performed. Results The countries showed inter-organisation variability in implementation and performance of the haemovigilance function. The overall median score (all sub-indicators) was 44 % (range: 7.5 % - 70 %). The lowest average performance scores were for the arrangement for effective organisation and coordination (35 %) and human resources (35 %) indicators. The highest average scores were observed for the mechanism to promote transparency and mechanism to monitor regulatory performance indicators (50 % and 60 %, respectively). We identified clusters of best-implemented sub-indicators from the procedures for haemovigilance and poorly implemented sub-indicators from the legal provisions, regulations and guidelines for haemovigilance and human resources. Conclusions Implementation of sub-indicators and performance of haemovigilance systems varied greatly for all countries with a few countries performing reasonably well in the implementation of some sub-indicators under procedures for haemovigilance. Most countries were poorly implementing sub-indicators in the legal provisions, arrangement for effective organisation and human resources indicators. The legislative provisions in most countries were at a nascent stage. There is a need to set up targeted and customised technical support coupled with prioritised interventions to strengthen the capacities of NRAs. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07235-0.
Collapse
Affiliation(s)
- Washington T Samukange
- Division of Pharmacoepidemiology & Clinical Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands.,Paul Ehrlich Institut, Langen, Germany
| | | | | | | | - Khamusi Mutoti
- South African Health Products Regulatory Authority (SAHPRA), Pretoria, South Africa
| | | | - Helga Gardarsdottir
- Division of Pharmacoepidemiology & Clinical Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands
| | - Aukje K Mantel-Teeuwisse
- Division of Pharmacoepidemiology & Clinical Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands
| | - C Micha Nuebling
- Paul Ehrlich Institut, Langen, Germany. .,Major Policy and International Relations, Paul Ehrlich Institut, Langen, Germany.
| |
Collapse
|
14
|
Abstract
Blood transfusions are generally safe but can carry considerable risks. This review summarizes the different types of transfusion reactions and ways to diagnose and manage them. Symptoms are often overlapping and nonspecific. When a reaction is suspected, it is critical to stop the transfusion immediately and report the reaction to the blood bank, as this can affect the patient's outcome. New evidence-based algorithms of transfusion, newer blood screening methods and donor policies and deferrals, new laboratory testing, electronic verification systems, and improved hemovigilance lead to the avoidance of unnecessary transfusions and decrease the incidence of serious transfusion reactions.
Collapse
Affiliation(s)
- Rim Abdallah
- Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Herleen Rai
- Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Sandhya R Panch
- Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, MD, USA.
| |
Collapse
|
15
|
Mikkelsen C, Paarup HM, Bruun MT, Pedersen LØ, Hasslund S, Larsen R, Aagaard B, Sørensen BS. The new donor vigilance system in Denmark reveals regional differences in adverse reactions supposedly caused by variation in the registration. Vox Sang 2021; 117:321-327. [PMID: 34523137 DOI: 10.1111/vox.13202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/24/2021] [Accepted: 08/24/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES In recent years, there has been an increased focus among blood bank professionals on the health and safety of blood donors. In 2019, the Danish Haemovigilance Committee designed a national donor vigilance system to improve the registration of adverse reactions (AR) in blood donors. The new donor vigilance system was implemented on 1 January 2020 and we here present the results from the first year of registration. MATERIALS AND METHODS AR categories, severity level and imputability score were defined based on the definitions from the International Society of Blood Transfusion, AABB and the European Commission directive 2005/61/EC, respectively. RESULTS Across all severity levels, AR in Danish blood donors were found to be rare (1498 per 100,000 donations). Only 0.2% of the registered reactions were classified as serious (2.7 per 100,000 donations). Large regional differences were seen in the registration of citrate reactions and haematomas. CONCLUSION Significant differences across regions in what to categorize as an AR were persistent even when including a severity score in the reporting. The Danish Haemovigilance Committee will commence a national work to align the definitions but suggests that this matter is raised to an international level as part of the current work to agree upon definitions for assessment of donor AR.
Collapse
Affiliation(s)
- Christina Mikkelsen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark.,Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health Science, Copenhagen University, Copenhagen, Denmark
| | | | - Mie Topholm Bruun
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | | | - Sys Hasslund
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Rune Larsen
- Department of Clinical Immunology, Naestved Hospital, Naestved, Denmark
| | - Bitten Aagaard
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | | |
Collapse
|
16
|
Seifner A, Fox AW. Why Does the Precautionary Principle Suffice for Blood Regulation? Pharmaceut Med 2021; 35:281-286. [PMID: 34491565 PMCID: PMC8421462 DOI: 10.1007/s40290-021-00400-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 10/26/2022]
Abstract
Traditional approaches to blood regulation emphasise the precautionary principle and pursue zero-risk for viral transmission; these traditional approaches have usually followed tragedy, such as the HIV and hepatitis C infections that followed the use of factor VIII concentrates. However, a much more haphazard haemovigilance system operates for general adverse events. Such imprecise assessment of hazards prevents sound benefit-risk assessment, and for blood products this is further confounded by the fact that their efficacy has attracted little systematic study. The ongoing COVID-19 pandemic has now prompted the proposal of a convalescent plasma (CP) blood product. Clearly, mere freedom from infectious agents will not suffice in assessing CP, and an objective measure of efficacy, so as to permit formal benefit-risk analysis, is essential. This is both a scientific and an ethical demand, as has been the case for other experimental COVID-19 treatments. With special reference to COVID-19 CP, the well-recognized adverse events of transfusion-associated lung injury (TRALI) and transfusion-associated circulatory overload (TACO) will be important. Furthermore, not only efficacy but also product quality attributes (e.g., antibody titre) will have to be defined. Both of these are outside the traditional regulatory philosophy for blood products and are needed to truly assess the benefit-risk of this putative therapeutic product.
Collapse
Affiliation(s)
- Alexandra Seifner
- Pharmaceutical Medicine Group, Faculty of Life Sciences and Medicine, King's College London, 150 Stamford Street, London, SE1 9NH, England.
| | - Anthony W Fox
- EBD London Ltd., 147 Sulgrave Road, London, W6 7PX, England
| |
Collapse
|
17
|
Iannotta D, Yang M, Celia C, Di Marzio L, Wolfram J. Extracellular vesicle therapeutics from plasma and adipose tissue. NANO TODAY 2021; 39:101159. [PMID: 33968157 PMCID: PMC8104307 DOI: 10.1016/j.nantod.2021.101159] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Extracellular vesicles (EVs) are cell-released lipid-bilayer nanoparticles that contain biologically active cargo involved in physiological and pathological intercellular communication. In recent years, the therapeutic potential of EVs has been explored in various disease models. In particular, mesenchymal stromal cell-derived EVs have been shown to exert anti-inflammatory, anti-oxidant, anti-apoptotic, and pro-angiogenic properties in cardiovascular, metabolic and orthopedic conditions. However, a major drawback of EV-based therapeutics is scale-up issues due to extensive cell culture requirements and inefficient isolation protocols. An emerging alternative approach to time-consuming and costly cell culture expansion is to obtain therapeutic EVs directly from the body, for example, from plasma and adipose tissue. This review discusses isolation methods and therapeutic applications of plasma and adipose tissue-derived EVs, highlighting advantages and disadvantages compared to cell culture-derived ones.
Collapse
Affiliation(s)
- Dalila Iannotta
- Department of Biochemistry and Molecular Biology, Mayo Clinic, Jacksonville, FL, USA
- Department of Pharmacy, University of Chieti – Pescara “G d’Annunzio”, Chieti, Italy
| | - Man Yang
- Department of Biochemistry and Molecular Biology, Mayo Clinic, Jacksonville, FL, USA
| | - Christian Celia
- Department of Pharmacy, University of Chieti – Pescara “G d’Annunzio”, Chieti, Italy
| | - Luisa Di Marzio
- Department of Pharmacy, University of Chieti – Pescara “G d’Annunzio”, Chieti, Italy
| | - Joy Wolfram
- Department of Biochemistry and Molecular Biology, Mayo Clinic, Jacksonville, FL, USA
- Department of Nanomedicine, Houston Methodist Research Institute, Houston TX, USA
| |
Collapse
|
18
|
Musumari PM, Mbikayi SM, Srithanaviboonchai K, Techasrivichien T, Tangmunkongvorakul A, Tshilolo L. Symptoms of acute transfusion reactions at a general referral hospital in Kinshasa, Democratic Republic of Congo: a cross-sectional study. BMJ Open 2021; 11:e045081. [PMID: 34290061 PMCID: PMC8296776 DOI: 10.1136/bmjopen-2020-045081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Blood transfusion is a life-saving procedure and is also associated with a range of risks including the occurrence of symptoms of acute transfusion reactions (ATRs). Very few studies in sub-Saharan Africa have reported on ATRs. The present study addresses this gap in the literature by documenting the prevalence of and factors associated with ATRs in the Democratic Republic of Congo (DRC). DESIGN This is a cross-sectional descriptive and analytical study using blood bank data from a general referral hospital. SETTING Centre Hospitalier Mère-Enfant (CHME) Monkole, a general referral hospital in Kinshasa, DRC. PARTICIPANTS General population who have received blood transfusion in CHME Monkole between 2014 and 2019. RESULTS The data set included a total of 7166 patients; 3153 (44%) men and 4013 (56%) women. The overall prevalence of symptoms of ATRs was 2.6%; the lowest prevalence was in 2017 (2.34%) and highest in 2018 (2.95%) and 2019 (2.94%). The documented symptoms included 74 (39.6%) cases of dyspnoea/respiratory distress, 60 (32.1%) cases of fever, 36 (19.2%) cases of pruritus/urticaria and 17 (9.1%) cases of vomiting. None of the studied factors was associated with symptoms of ATRs. CONCLUSION Symptoms of ATRs were not uncommon in the studied population. Dyspnoea and respiratory distress, fever and pruritus/urticaria were the most common symptoms of ATRs. This study highlights the need for a clinical and biological surveillance to detect, prevent and manage ATRs in the context of the DRC.
Collapse
Affiliation(s)
- Patou Masika Musumari
- Global Health Interdisciplinary Unit, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
- Chiang Mai University Research Institute for Health Sciences, Chiang Mai, Thailand
| | - Samclide Mutindu Mbikayi
- Department of Hematology, Centre Hospitalier Mère-Enfant Monkole, Kinshasa, Democratic Republic of Congo
| | - Kriengkrai Srithanaviboonchai
- Chiang Mai University Research Institute for Health Sciences, Chiang Mai, Thailand
- Department of Community Medicine, Chiang Mai University Faculty of Medicine, Chiang Mai, Thailand
| | - Teeranee Techasrivichien
- Global Health Interdisciplinary Unit, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
- International Institute of Socio-Epidemiology, Kyoto, Japan
| | | | - Léon Tshilolo
- Department of Hematology, Centre Hospitalier Mère-Enfant Monkole, Kinshasa, Democratic Republic of Congo
- Centre de Formation et Appui Sanitaire (CEFA), Kinshasa, Democratic Republic of Congo
| |
Collapse
|
19
|
Murphy MF. Hemovigilance drives improved transfusion safety. Transfusion 2021; 61:1333-1335. [PMID: 33831223 DOI: 10.1111/trf.16322] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Michael F Murphy
- NHS Blood & Transplant, Oxford, UK.,National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals and the University of Oxford, Oxford, UK
| |
Collapse
|
20
|
Masror Roudsari D, Feizi S, Maghsudlu M. Nurses' hemovigilance knowledge and performance after teach-back, concept map, and lecture: A quasi-experimental study. Heliyon 2021; 7:e05982. [PMID: 33506134 PMCID: PMC7814151 DOI: 10.1016/j.heliyon.2021.e05982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/02/2020] [Accepted: 01/11/2021] [Indexed: 11/09/2022] Open
Abstract
Objectives This study aimed to compare the effects of teaching by three methods of teach-back, concept map, and lecture on knowledge and performance of nurses in hemovigilance process. Methods This quasi-experimental study was performed on 108 Iranian nurses. In the lecture group, the educational intervention was conducted during a 4-hour session; and in the concept map and teach-back groups, it was performed in two 2-hour sessions. The nurses’ knowledge and performance were measured by “routine blood transfusion knowledge questionnaire (RBTKQ)” and “self-reporting performance-evaluator questionnaire”. Results After the interventions, knowledge was significantly higher in the teach-back and the concept map groups compared to the lecture group (p = 0.001), but the performance in the lecture group was higher than the other two groups (p = 0.01). No statistically significant differences were found between teach-back and concept map groups. Conclusion Teach-back and concept map methods were effective in improving the nurses’ hemovigilance knowledge, while the lecture was associated with a significant increase in their performance. Therefore, integrating the hemovigilance teaching methods is suggested.
Collapse
Affiliation(s)
- Daryadokht Masror Roudsari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Shahoo Feizi
- Student Research Committee, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mahtab Maghsudlu
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| |
Collapse
|
21
|
Pediatric Hemovigilance and Adverse Transfusion Reactions. Clin Lab Med 2020; 41:51-67. [PMID: 33494885 DOI: 10.1016/j.cll.2020.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Some types of transfusion reactions occur more frequently in the pediatric than the adult population. Allergic reactions are the most common, followed by nonhemolytic transfusion reactions; male children seem most susceptible to such reactions. Platelets are often implicated and pulmonary reactions are understudied in children. Clinical sequelae in neonates, such as bronchopulmonary dysplasia/chronic lung disease and intraventricular hemorrhage, have received increasing attention in relation to transfusion. There is a need to better understand the pathophysiology of transfusion reactions in neonatal and pediatric populations so preventive strategies can be undertaken. There is also a need for robust hemovigilance systems.
Collapse
|
22
|
Goldman M, Townsend M, Magnussen K, Lozano M, Nissen-Meyer LS, Lee CK, Leung JNS, Takanashi M, McKay J, Kvist M, Robitaille N, Deschênes J, Di Angelantonio E, McMahon A, Roberts D, Maghsudlu M, Castrén J, Tiberghien P, Woimant G, Morel P, Kamel H, Bravo M, Shinhar E, Gendelman V, Raz H, Wendel S, Fachini R, Quee F, van den Hurk K, Wiersum J, Grima K, Speedy J, Bruun M, Dunbar N. Vox Sanguinis International Forum on Mitigation Strategies to Prevent Faint and Pre-faint Adverse Reactions in Whole Blood Donors: Summary. Vox Sang 2020; 116:351-359. [PMID: 33245787 DOI: 10.1111/vox.13037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 11/01/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Mindy Goldman
- Donor and Clinical Services, Canadian Blood Services, Ottawa, ON, Canada
| | | | - Karin Magnussen
- Immunology & Transfusion Medicine, Innlandet Hospital Trust, Lillehammer, Norway
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Nancy Dunbar
- Blood Bank, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| |
Collapse
|
23
|
Garraud O, Vuk T, Lozano M, Tissot JD. Transfusion medicine: Overtime paradigm changes and emerging paradoxes. Transfus Clin Biol 2020; 27:262-267. [PMID: 33035654 PMCID: PMC7537623 DOI: 10.1016/j.tracli.2020.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This essay aims to discuss some aspects of blood transfusion in the perspective of the changes that occurred over time as well as modifications of the paradigms that transformed the activities and the organization of blood transfusion services. Without specific knowledge, pioneers envisioned precision and personalized medicine, rendering transfusion medicine operational. Transfusion medicine is like The Picture of Dorian Grey: always young despite being old and sometimes appearing old-fashioned. Over the years, the transfusion medicine discipline has evolved, and major progress has been achieved, despite some troublesome periods (for example, the tainted blood scandal, and—at the time being—the offending plasma market and the selling of human parts). Transfusion medicine has at all times implemented the rapidly developing biomedical technologies to secure blood components. The safety of blood components has now reached an exceptional level in economically wealthy countries, especially compared to other health care disciplines. Strengthening of the safety has mandated that blood donors and recipients are unrelated, an issue which has eased preservation and fractionation practices; blood is no longer arm-to-arm transfused and neither is whole blood, the commonest component. However, it is interesting to note that a revival is occurring as whole blood is back on stage for certain specific indications, which is one among the many paradoxes encountered while studying this discipline.
Collapse
Affiliation(s)
- O Garraud
- Université de Lyon Saint-Étienne, 10, rue Tréfilerie, 42023 Saint-Etienne Cedex 2, France; Institut National de la Transfusion Sanguine, 6, rue Alexandre Cabanel, 75015 Paris, France.
| | - T Vuk
- Croatian institute of transfusion medicine, Petrova ul. 3, 10000 Zagreb, Croatia
| | - M Lozano
- Clinic university hospital Barcelona, university of Barcelona, 170C. de Villarroel, 08036 Barcelona, Spain
| | - J-D Tissot
- Faculté de biologie et de médecine, université de Lausanne, 21, rue du Bugnon, 1011 Lausanne, Switzerland
| |
Collapse
|
24
|
Grey S, Bolton-Maggs P. Pulmonary complications of transfusion: Changes, challenges, and future directions. Transfus Med 2020; 30:442-449. [PMID: 32924216 DOI: 10.1111/tme.12709] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 07/26/2020] [Accepted: 07/27/2020] [Indexed: 11/27/2022]
Abstract
The pulmonary complications of transfusion (TACO, TRALI and TAD) are the leading cause of transfusion-related mortality and major morbidity. Advance in this area is essential in improving transfusion safety. This review describes the drivers for change in haemovigilance practice, the influence of recent key publications and future directions.
Collapse
Affiliation(s)
- Sharran Grey
- Lancashire Haematology Centre, Blackpool Teaching Hospitals NHS Foundation Trust, North Lancashire, UK.,Serious Hazards of Transfusion, Manchester Blood Centre, Manchester, UK
| | - Paula Bolton-Maggs
- Serious Hazards of Transfusion, Manchester Blood Centre, Manchester, UK.,Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| |
Collapse
|
25
|
Storch EK. Donor hemovigilance: a call to arms. Transfusion 2020; 60:1115-1117. [DOI: 10.1111/trf.15854] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 04/29/2020] [Indexed: 01/26/2023]
Affiliation(s)
- Emily K. Storch
- Division of Blood Components and DevicesOffice of Blood Research and Review, Center for Biologics Evaluation and Research, Food and Drug Administration Silver Spring Maryland
| |
Collapse
|
26
|
Roberts DJ. January 2020: What lies ahead? Transfus Med 2020; 30:3-4. [DOI: 10.1111/tme.12673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 02/17/2020] [Indexed: 12/01/2022]
Affiliation(s)
- David J. Roberts
- Radcliffe Department of MedicineUniversity of Oxford, John Radcliffe Hospital Oxford UK
- National Health Service Blood and TransplantJohn Radcliffe Hospital Oxford UK
| |
Collapse
|
27
|
Bolton‐Maggs PHB, Watt A. Transfusion errors — can they be eliminated? Br J Haematol 2019; 189:9-20. [DOI: 10.1111/bjh.16256] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/03/2019] [Accepted: 09/04/2019] [Indexed: 12/14/2022]
Affiliation(s)
| | - Alison Watt
- Serious Hazards of Transfusion Manchester Blood Centre Manchester UK
| |
Collapse
|
28
|
Storch EK, Custer BS, Jacobs MR, Menitove JE, Mintz PD. Review of current transfusion therapy and blood banking practices. Blood Rev 2019; 38:100593. [PMID: 31405535 DOI: 10.1016/j.blre.2019.100593] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/08/2019] [Accepted: 07/23/2019] [Indexed: 01/28/2023]
Abstract
Transfusion Medicine is a dynamically evolving field. Recent high-quality research has reshaped the paradigms guiding blood transfusion. As increasing evidence supports the benefit of limiting transfusion, guidelines have been developed and disseminated into clinical practice governing optimal transfusion of red cells, platelets, plasma and cryoprecipitate. Concepts ranging from transfusion thresholds to prophylactic use to maximal storage time are addressed in guidelines. Patient blood management programs have developed to implement principles of patient safety through limiting transfusion in clinical practice. Data from National Hemovigilance Surveys showing dramatic declines in blood utilization over the past decade demonstrate the practical uptake of current principles guiding patient safety. In parallel with decreasing use of traditional blood products, the development of new technologies for blood transfusion such as freeze drying and cold storage has accelerated. Approaches to policy decision making to augment blood safety have also changed. Drivers of these changes include a deeper understanding of emerging threats and adverse events based on hemovigilance, and an increasing healthcare system expectation to align blood safety decision making with approaches used in other healthcare disciplines.
Collapse
Affiliation(s)
| | - Brian S Custer
- UCSF Department of Laboratory Medicine, Blood Systems Research Institute, USA.
| | - Michael R Jacobs
- Department of Pathology, Case Western Reserve University, USA; Department of Clinical Microbiology, University Hospitals Cleveland Medical Center, USA.
| | - Jay E Menitove
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, USA
| | | |
Collapse
|
29
|
The best blood product and its best use for each patient: An evolving role for hemovigilance? Transfus Clin Biol 2019; 26:188-191. [DOI: 10.1016/j.tracli.2019.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 04/30/2019] [Indexed: 11/20/2022]
|