CC BY-NC-ND 4.0 · J Lab Physicians 2020; 12(02): 133-140
DOI: 10.1055/s-0040-1716592
Original Article

Analysis of Patterns of Adverse Transfusion Reactions and Management: A Novel Initiative toward Hemovigilance in a Teaching Hospital of South India

Anandraj Vaithy Krishnamurthy
1   Department of Pathology, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth University (Deemed), Puducherry, India
Janani Mathialagan
1   Department of Pathology, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth University (Deemed), Puducherry, India
A.T.M. Venkat Raghavan
1   Department of Pathology, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth University (Deemed), Puducherry, India
Sowmya Srinivasan
1   Department of Pathology, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth University (Deemed), Puducherry, India
› Author Affiliations


Objective Blood transfusion being a major lifesaving frontline procedure in majority of clinical wards, has a high potential with risk for adverse events ranging in severity, thus warranting optimal usage of blood. Continuous monitoring of adverse transfusion reaction (ATR) and analysis of the reactions can promote better comprehension of various contributing risk factors. Hemovigilance being a quality indicator with data system assists in ensuring quality and safe blood transfusion. The present study was designed to analyze the incidence and nature of adverse transfusion-associated events reported to the blood bank from our teaching hospital located in the remote part of South-East Coastal region with emphasis on corrective and preventive actions.

Materials and Methods The prospective study included all the ATR reported to our hospital blood bank over a period of 42 months. The transfusion reactions report forms filled by the clinicians were analyzed and the reactions were categorized into patterns. The associated risk factors for the reaction are evaluated with substantial laboratory and clinical parameters in reference to hemovigilance.

Results Among 19,800 transfusions, 189 transfusion reactions were encountered with a ratio of 10:0.9 with age ranging from 12 to 80, with female preponderance. Reactions associated with whole blood (WB) transfusion were common (50%, p = 0.002) followed by packed red blood cells transfusion (PRBC) (1.4%, p = 0.006) and platelets (0.8%, p = 0.1). Febrile nonhemolytic transfusion reactions were predominant patterns noted in 122 cases followed by allergic reactions in 43 cases with more commonly associated PRBC transfusion whereas hemolytic reactions showed association with WB transfusion. No delayed reactions or mortalities were encountered.

Conclusion The present study concludes with novelty showing the overall incidence of transfusion-associated reactions in the study domain is slightly higher than more advanced centers in India owing to lack of leukodepletion units which could enable to substantially retard the incidence of adverse events of transfusion as a general measure and febrile reactions in particular. Hemovigilance and pattern analysis of ATR provide scope for corrective and preventive action and give referral guidelines to prevent future recurrence.

Publication History

Article published online:
02 September 2020

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  • References

  • 1 IPC-NIB Guidance Document for Reporting Serious Adverse Reactions in Blood Transfusion Service. National Institute of Biological, Ministry of Health and Family Welfare, Government of India; 2012. Paper T1–31
  • 2 Faber JC. Worldwide overview of existing haemovigilance systems. Transfus Apheresis Sci 2004; 31 (02) 99-110
  • 3 Faber JC. Haemovigilance around the world. Vox Sang 2002; 83 (Suppl. 01) 71-76
  • 4 Sahu S, Hemlata. Verma A. Adverse events related to blood transfusion. Indian J Anaesth 2014; 58 (05) 543-551
  • 5 Callum JL, Pinkerton PH. Transfusion reactions. In: Callum JL, Pinkerton PH. eds. Bloody Easy: Blood Transfusions, Blood Alternatives and Transfusion Reactions, A Guide to Transfusion Medicine. Toronto, Ontario: Sunny brook and Women’s College Health Sciences Centre; 2005: 34-65
  • 6 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 (04) 370-374
  • 7 Kumar P, Thapliyal R, Coshic P, Chatterjee K. Retrospective evaluation of adverse transfusion reactions following blood product transfusion from a tertiary care hospital: a preliminary step towards hemovigilance. Asian J Transfus Sci 2013; 7 (02) 109-115
  • 8 Payandeh M, Zare ME, Kansestani AN. et al. Descriptions of acute transfusion reactions in the teaching hospitals of Kermanshah University of Medical Sciences, Iran. Int J Hematol Oncol Stem Cell Res 2013; 7 (02) 11-16
  • 9 Venkatachalapathy TS. A prospective audit of blood transfusion reactions in tertiary care hospital for the use of blood and blood components. J Blood Disord Transfus 2012; 3: 118
  • 10 Haslina MNN, Fakhri MA, Saw TH, Salamah AS. An audit on acute transfusion reaction in North Eastern Malaysia. Sch J Med 2012; 2 (05) 60-62
  • 11 Bhattacharya P, Marwaha N, Dhawan HK, Roy P, Sharma RR. Transfusion-related adverse events at the tertiary care center in North India: an institutional hemovigilance effort. Asian J Transfus Sci 2011; 5 (02) 164-170
  • 12 Kumar R, Gupta M, Gupta V, Kaur A, Gupta S. Acute transfusion reactions (ATRs) in intensive care unit (ICU): a retrospective study. J Clin Diagn Res 2014; 8 (02) 127-129
  • 13 Khalid S, Usman M, Khurshid M. Acute transfusion reactions encountered in patients at a tertiary care center. J Pak Med Assoc 2010; 60 (10) 832-836
  • 14 Mafirakureva N, Khoza S, Mvere DA, Chitiyo ME, Postma MJ, Van Hulst M. Incidence and pattern of 12 years of reported transfusion adverse events in Zimbabwe: a retrospective analysis. Blood Transfus 2014; 12 (03) 362-367
  • 15 Lingegowda JB, Jeyakumar JD, Muddegowda PH, Pitchai R, Gopal N, Sinha P. An audit of requests for fresh frozen plasma in a Tertiary Care Center in South India. J Lab Physicians 2016; 8 (01) 41-44
  • 16 Peña JR, Dzik WS. Utilization management in the blood transfusion service. Clin Chim Acta 2014; 427: 178-182
  • 17 Agarwal N, Subramanian A, Pandey RM, Albert V, Karjee S, Arya V. An audit of fresh frozen plasma usage in a Tertiary Trauma Care Centre in North India. Indian J Hematol Blood Transfus 2014; 30: 328-332
  • 18 Hendrickson JE, Hillyer CD. Noninfectious serious hazards of transfusion. Anesth Analg 2009; 108 (03) 759-769
  • 19 Adams RL, Bird R. Quality use of blood products. Aust Prescr 2014; 37: 132-136