Impact of Transfusion Practice on the Occurrence of Acute Transfusion Reactions in a Malaysian Hospital: A Single-centre Retrospective Study

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Published: Oct 31, 2021
Keywords:
Acute transfusion reaction, Allergic reaction, Febrile non-haemolytic transfusion reaction, Stored red blood cell

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Firdaus Che Ros
Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, Pulau Pinang, Malaysia
Noorsuzana Mohd Shariff
Lifestyle Science Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, Pulau Pinang, Malaysia
Siti Nadiah Abdul Kadir
Department of Transfusion Medicine, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Bandar Alor Setar, 05460 Alor Setar, Kedah, Malaysia
Sharifah Azdiana Tuan Din
Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, Pulau Pinang, Malaysia

Abstract

Introduction: Acute transfusion reactions (ATR) are commonly reported in clinical transfusion practice, which may result in significant morbidity and mortality. This study aims to explore the impact of transfusion practice on the prevalence, characteristics, and associated factors of ATR at Hospital Sultanah Bahiyah, Kedah, Malaysia. Methods: This was a retrospective study using records from haemovigilance forms of reported transfusion reactions, E-Delphyn (blood bank system), and E-His (hospital information system). A total of 118 cases of ATR from January 1, 2015 until December 31, 2017 were selected and analysed. For each case, a control was selected from a patient who did not develop ATR. Results: A total of 122,215 units of whole blood and blood component transfusions have been performed and 415 ATR were reported. The prevalence of ATR was 0.34% or one in 294 units transfused. There was a significant association between ATR and red cell concentrate (RCC) stored for more than 14 days (adj OR = 65.29, 95% CI 9.29-458.85). The most common ATR were allergic reactions with 63 cases (53.4%), followed by febrile non-haemolytic transfusion reactions (FNHTR) with 45 cases (38.1%). Allergic reactions were significantly associated with female patients (p = 0.038) and the paediatrics age group (p = 0.038). Multivariate analysis revealed a significant association between FNHTR and RCC stored more than 14 days (p = 0.002). Conclusion: The prevalence of ATR in this hospital was low and associated with RCC stored for more than 14 days. Implementation of pre-storage leucoreduction is recommended.

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How to Cite
Che Ros, F., Mohd Shariff, N., Abdul Kadir, S. N., & Tuan Din, S. A. (2021). Impact of Transfusion Practice on the Occurrence of Acute Transfusion Reactions in a Malaysian Hospital: A Single-centre Retrospective Study. Malaysian Journal of Medicine and Health Sciences, 17(4), 87–94. Retrieved from http://mjmhsojs.upm.edu.my/index.php/mjmhs/article/view/466
Issue
Vol. 17 No. 4 (2021)
Section
Original Articles

References

Rogers MAM, Rohde JM, Blumberg N. Haemovigilance of reactions associated with red blood cell transfusion: Comparison across 17 Countries. Vox Sang. 2016;110(3):266–77.

Organization WH. A guide to establishing a national haemovigilance system. 016;44- Available from: https://apps.who.int/iris/bitstream/handle/10665/250233/9789241549844-ng.pdf?sequence=1 [Accessed 1st July 2019].

De Vries RRP, Faber JC, Strengers PFW. Haemovigilance: An effective tool for improving transfusion practice. Vox Sang. 2011;100(1):60–7.

Harmening DM. Adverse Effects of Blood Transfusion. In: Modern Blood Banking & Transfusion Practices 6th Edition. F.A. Davis Company; 2012; 370-378.

Noor Haslina M, Mohd Fakhri M, Saw T, Salamah A. An audit on acute transfusion reaction in North Eastern Malaysia. Sch J Med. 2012;2(5):60–2.

Rabeya Y, Abdul-Kahar AH, Leong CF. An audit of reported acute transfusion reactions in Universiti Kebangsaan Malaysia Medical Centre. Malays J Pathol. 2011 Jun;33(1):25-9.

Sharma DK, Datta S, Gupta A. Study of acute transfusion reactions in a teaching hospital of Sikkim: A hemovigilance initiative. Indian J Pharmacol. 2015;47(4):370-374.

Oakley FD, Woods M, Arnold S, Young PP. Transfusion reactions in pediatric compared with adult patients: A look at rate, reaction type, and associated products. Transfusion. 2015;55(3):563– 70.

Vasudev R, Sawhney V, Dogra M, Raina T. Transfusion-related adverse reactions: From institutional hemovigilance effort to National Hemovigilance program. Asian J Transfus Sci. 2016;10(1):31.

Kato H, Nakayama T, Uruma M, Okuyama Y, Handa M, Tomiyama Y, et al. A retrospective observational study to assess adverse transfusion reactions of patients with and without prior transfusion history. Vox Sang. 2015;108(3):243– 50.

Yanagisawa R, Tatsuzawa Y, Ono T, Kobayashi J, Tokutake Y, Hidaka E, et al. Analysis of clinical presentations of allergic transfusion reactions and febrile nonatric patients. Vox Sanguinis. 2019;114(8):826-34.

Vlaar APJ, Toy P, Fung M, Looney MR, Juffermans NP, Bux J, et al. A consensus redefinition of transfusion-related acute lung injury. Transfusion. 2019;59(7):2465-76.

Bux J, Sachs UJ. Pulmonary transfusion reactions. Transfus Med Hemother. 2008;35(5):337-345.

Tinegate H, Birchall J, Gray A, Haggas R, Massey E, Norfolk D, et al. Guideline on the investigation and management of acute transfusion reactions Prepared by the BCSH Blood Transfusion Task Force. 2012;1:1–11.

Hussain S, Moiz B, Ausat FA, Khurshid M. Monitoring and reporting transfusion reactions as a quality indicator - a clinical audit. Transfus Apher Sci. 2015 Feb;52(1):122-7.

Kumar H, Gupta PK, Mishra DK, Sarkar RS, Jaiprakash M. Leucodepletion and Blood Products. Med J Armed Forces India. 2006;62(2):174-7.

Gelaw Y, Woldu B, Melku M. Proportion of Acute Transfusion Reaction and Associated Factors Among Adult Transfused Patients at Felege Hiwot Compressive Referral Hospital, Bahir Dar, Northwest Ethiopia: A Cross-Sectional Study. J Blood Med. 2020;11:227-236.

Tobian AA, Savage WJ, Tisch DJ, Thoman S, King KE, Ness PM. Prevention of allergic transfusion reactions to platelets and red blood cells through plasma reduction. Transfusion. 2011 Aug;51(8):1676-83.

Heddle NM, Griffith L, Roberts R, Shukla G. A prospective study to identify the risk factors associated with acute reactions to platelet and red cell transfusions. Transfusion. 1993:33(10):794- 797.

King KE, Shirey RS, Thoman SK, Bensen- kennedy D, Tanz WS, Al KET. nonhemolytic transfusion reactions to RBCs. Transfusion. 2004;44(January):25–9.

Balzer D, Thomas D. Universal leukodepletion of blood components results in a significant reduction of febrile non-hemolytic but not allergic transfusion reactions. Transfusion and Apheresis Science. 2004;30:41–6.

Rajesh K, Harsh S, Amarjit K. Effects of Prestorage Leukoreduction on the Rate of Febrile Nonhemolytic Transfusion Reactions to Red Blood Cells in a Tertiary Care Hospital. Ann Med Health Sci Res. 2015;5(3):185-188.

Paglino JC, Pomper GJ, Fisch GS, Champion MH, Snyder EL. Reduction of febrile not allergic reactions to RBCs and platelets after conversion to universal prestorage leukoreduction. Transfusion. 2004;44(January):16–24.

Savage WJ, Tobian AAR, Savage JH, Hamilton RG, Borge PD, Kaufman RM, et al. Transfusion and component characteristics are not associated with allergic transfusion reactions to apheresis platelets. Transfusion. 2015;55(2):296–300.

Cardigan R, New HV, Tinegate H, Thomas S. Washed red cells: theory and practice. Vox Sanguinis. 2020;115(8):606-16.

Ezidiegwu CN, Lauenstein KJ, Sbb MTA, Rosales LG, Kelly KC, Henry JB. Febrile Nonhemolytic Transfusion Reactions Management by Premedication and Cost Implications in Adult Patients. Arch Pathol Lab Med. 2002;991–5.