جستجوی مقالات مرتبط با کلیدواژه « Transfusion Reaction » در نشریات گروه « پزشکی »

Planning for blood request and balancing supply and demand are still contentious issues in hospitals and blood transfusion centers. This study aimed to compare the safety and cost-effectiveness of two pre-transfusion tests for red blood cells in patients undergoing orthopedic surgery.

In this descriptive-analytical cross-sectional study, patients undergoing surgery who required blood transfusion during the operation were included via convenience sampling method. The necessary information for this study was collected using a researcher-made checklist consisting of two parts: background information, blood bag information, and information related to potential complications. The cost estimation of the tests was also extracted using the records. The findings were analyzed using descriptive and inferential statistics with SPSS software (version 18), and the significance level was set at 0.05.

A total of 212 patients with a mean age of 44.98 years were included in the study. Cross-match was performed for 108 patients (50.9%), and antibody screening test was used for 104 patients (49.1%). Regarding complications after blood transfusion, at least one sign was observed in 12 patients (5.7%). Jaundice, fever, and itching were the most common symptoms. The cross-match to transfusion (C/T) ratio was higher than international standard criteria (5.25 vs. 2.5).

The results of this study demonstrated that the safety and accuracy of both pre-transfusion methods were similar, and no significant difference was observed. However, the cross-match test was more cost-effective compared to the match antibody screening test.

Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare and fatal complication caused by blood transfusion. In this condition, donated lymphocyte cells attack host tissues. In this review article, the history, prevalence, pathogenesis, clinical symptoms, risk factors, diagnostic methods, strategies to reduce its occurrence, prognosis, disease management, and laboratory characteristics of this condition are discussed.

For this purpose, a search was made using published reliable research in Google Scholar, PubMed, and MEDLINE databases and the findings of more than 70 articles were cited.

The following study showed that live T lymphocytes from donated blood products and the resulting cytokine storm play a role in the occurrence of this complication. The symptoms of this disease appear in the form of skin rash, pancytopenia, and fever, and its diagnosis is based on clinical symptoms and laboratory findings of skin biopsy, increased liver enzymes, confirmation of lymphocyte chimerism using STR-PCR, and determination of the HLA phenotype of lymphocytes and FISH method. This complication has a higher prevalence in populations with high genetic similarity or people with immune deficiencies, however, it also occurs in other people who do not have these conditions or who have partial donor-recipient HLA matching (one-way HLA matching).

Conclusions  :

This complication is one of the fatal complications caused by blood transfusion that occurs within 2 to 30 days after blood products transfusion; the typical cases are associated with more than 90% mortality and mild or atypical cases have longer survival and are associated with a better prognosis that may go undetected or be treated spontaneously.

Transfusion of blood components is one of the therapeutic measures that today has a special place in the treatment and saving of the lives of patients. However, the adverse effects caused by blood components transfusion may harm patients and impose high costs on patients and the health care system.

In this cross-sectional descriptive-analytical study, the data related to adverse reactions following blood transfusion such as: time of onset of symptoms, type of symptoms, severity of symptoms, hemolytic reaction or type of complication were collected among 55839 patients who were admitted to Al-Zahra Hospital in Isfahan city, and had been received blood products during the years 2020-2021. The results were compared with the American Association Blood Bank (AABB) standards.

The total number of patients who suffered complications after receiving blood components is 48 patients, 32 patients (62.7%) are women and 16 patients (33.3%) are men. The average age of the patients is 59.70 ± 18.68. Allergic reactions with 26 cases (54.16%) and Febrile Non-Hemolytic Transfusion Reactions (FNHTR) with 17 cases (35.4%) are the most common reactions found.

Allergic reaction and FNHTR are the most common complications after receiving blood components. The incidence of these complications in this study is lower than the statistics announced by AABB. The most common clinical symptoms manifested in patients are chills, hives, itching, restlessness, and fever.

 Due to blood supply problems, the cost of blood processing, and the complications of blood transfusion, it is very important to observe the indications for blood transfusion. In addition, necessary precautions should be taken for blood transfusion. Therefore, this study was performed to evaluate the criteria for receiving blood products as well as transfusion complications in patients referring to the emergency department. 

 This study was a descriptive-analytical and cross-sectional study. All patients who referred to Imam Hossein and Shohadaye Tajrish Hospitals and needed to receive blood products during 36 months from April 2016 to March 2018 were evaluated. The data collection tool was a researcher-made checklist that included demographic characteristics, injection indication, and transfusion complications. After collection, the data were entered into SPSS statistical software version 18 and analyzed using Chi-square and Fisher's exact tests. 

 The mean age of patients was 43.51 ± 20.05 years. Sex distribution showed that 61.5% were male. The results showed that the amount of blood products consumed was 2041.28±161.309 units for all patients and 410.89±52.056 units in the emergency department. O and AB blood groups had the highest and lowest frequencies, respectively. In terms of injection indication, trauma was the most common. A difference was observed between the amounts of reserved and consumed products in the emergency department: 357.25±62.105 units for packed cells, 123.33±28.238 units for fresh frozen plasma, 71.533±21.313 units for blood platelets, and 53.78±12.069 units for cryoprecipitate. In terms of complications, shivering (22 cases) was the most common. The results showed that the difference between the mean reserve of compressed blood cells in 2016 and 2017 was significant (P = 0.029). There was also a significant difference between reserved platelete units in 2016 and 2018 (P=0.031). 

 Blood reservation should be done according to specific instructions, and quantitative and qualitative control in the field of blood reservation and consumption in medical centers is necessary. Also, reducing the number of unnecessary injections of blood product units to patients can be one of the effective factors in reducing the complications of blood transfusion.

Amphotericin B is one of the most useful therapeutic modalities for the treatment of patients with invasive fungal infections, in spite of serious side effects, namely kidney injury, electrolyte imbalances, and infusion-related reactions. The goal of this study was to assess the different aspects of premedication practice and the incidence and types of infusion-related reactions in patients receiving amphotericin B.

This observational study was performed on 70 hospitalized patients who received amphotericin B in different departments of two university hospitals, affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, from January 2017 to February 2018. Information on physicians’ performance regarding premedication administration for amphotericin B, including the types and doses of medications administered prior to amphotericin B infusion, as well as patients’ clinical data including infusion-related side effects were collected and then analyzed in comparison with the standard practice guidelines.

The study population consisted of 70 patients with the mean age of 51.6±18.3 years, who received amphotericin B for 8.2±3.5 days. From 70 evaluated patients, 21 patients (30%) had encountered the infusion-related reactions, including chills, fever, urticaria, headache, and hypotension. These side effects were evident in 19 patients (27%) who received no premedication and 2 patients (3%) who received only one drug as premedication, before amphotericin B administration. Twenty patients (28%) experienced chills, fever and headache, while 7 patients (10%) had nausea and vomiting during amphotericin B infusion. Hydrocortisone 50-200 mg, was the most prescribed agent for premedication (in 67% of patients), while chlorpheniramine 10 mg (in 50% of patients) and promethazine 10 mg (in 35% of patients) were the second and third prescribed ones, respectively.

In this study, the patients who received no or only one drug as premedication experienced infusion-related side effects. This emphasizes the necessity for standard premedication practices to prevent this type of adverse reactions. Considering the higher price of liposomal form of Amphotericin-B, if prescribed correctly, even the conventional form would be an effective and tolerable treatment for invasive fungal infections.

Blood transfusion in critical  patients is a lifesaver and at the same time can be fatal due to possible complications. The purpose of this study was to investigate the barriers to reporting the complications of blood transfusion nad the awareness of these complications in nursing staff.

A descriptive cross-sectional study was performed on the Mashhad nursing staff in the selected hospital. A population of 120 nursing staff was included in the study.  Data collection was done by a researcher-made questionnaire including demographic, knowledge and barrier factors after  the confirmation of its validity and reliability. The data were analyzed by SPSS 16.

The mean age was 36 ± 70 years, 56.67% (68) were women, 75.87% (91) had a bachelor's degree and 71.15% (86) were nurses. The legal issues (3.43%), injection of  corticosteroids before blood transfusion (3.36%), high inquiries and time consuming forms (3.34%) were major barriers in reporting adverse reactions. The mean knowledge score regarding the recognition of reactions was 85.04% (good) and regarding the care after reactions was 72.79% (moderate). There was no significant relationship between the barriers of reporting adverse reactions and demographic characteristics.

It is necessary to provide training on the detection of the transfusion reactions and its importance. There is also a need to take steps to encourage staff to report, ensure non-punishment approach to reporting reactions and errors, facilitate reporting, and simplify design of the reporting form to pave the way for reporting reactions of blood transfusions.

There are many antibodies and antigens that cause blood group related transfusion reactions. In this study we aim to find the prevalence of blood group antibodies in patients at different ages and with different gender. In this descriptive study, we screened 30659 patients (59% female and 41% male, age range 1-85) referring to different wards of Imam Khomeini complex hospital during 2017-2018 for presence of any antibodies against blood group antigens. Then, for those patients with screened positive antibody we identified the antibody in each patient. Finally we categorized the antibody positive patients based on their main ABO and Rh blood group of all wards such as cancer, hematology, general and also separately for postpartum ward. Out of 30659 patients in all wards, 123 and  out of 4364 just in postpartum ward, 20 patients had positive antibody. The most prevalent alloantibodies were detected to be anti-E(31.7%), anti-K(30.8%), and anti-D(14.6%) in order.
Anti-E and anti-K are the most likely antibodies presenting in patients with positive antibody screening results awareness of which can be helpful in storing blood components with rare blood groups. Moreover,  the evaluation of common alloantibodies in the postpartum ward shows that the administration of RhoGAM might not be adequate in HDFN prevention and other antibodies should be considered in this regard.

Pre-transfusion inactivation of donor T-cells by irradiation is the method of choice for prevention of TA-GVHD. This study reviewed the usage of irradiated products in one year period in Tehran Blood Transfusion Center. There were 1333 requests for irradiated blood products to be evaluated. The data including the quantity and type of irradiated products، patients’ age and indications were gathered. Descriptive statistical analysis was performed by SPSS 18 software. The requested irradiated products in the one-year period of time include platelets (71. 3%)، packed RBCs (28. 1%)، FFP (0. 4%)، paediatric bags (0. 2%)، and whole blood (0. 1%). The age groups of patients having received irradiated products were adults (59. 6%)، children (25. 9%)، infants (6. 5%)، and neonates (3. 3%). Indications of prescription consist of leukaemia/lymphoma and Hodgkin (49. 6%)، allogeneic and autologous bone marrow transplantation (17. 7%)، immunosuppressive therapy (9. 6%)، congenital immunodeficiency (8. 6%)، premature birth (7. 6%)، aplastic anaemia (6. 5%)، relatives designated donation (0. 3%)، and HLA matched plateletphaeresis (0. 1%). The increasing trend in the quantity of requests of irradiated products and requesting hospitals was observed. It is recommended that a higher number of hospitals and their staff be informed about irradiated products and their indications and the roles they have on the prevention of TA-GVHD.