Transfusion safety: Is there a difference between reported reactions in low-to-middle income and high-income countries?

Mohamed Amine Hmida; Sonia Mahjoub; Leila Ben Hamed; Najet Mojaat; Abdessalem Bahloul; Slama Hmida

doi:10.1016/j.transci.2024.103916

Transfusion safety: Is there a difference between reported reactions in low-to-middle income and high-income countries?

Transfus Apher Sci. 2024 Mar 19:103916. doi: 10.1016/j.transci.2024.103916. Online ahead of print.

Authors

Mohamed Amine Hmida¹, Sonia Mahjoub², Leila Ben Hamed³, Najet Mojaat⁴, Abdessalem Bahloul⁵, Slama Hmida⁶

Affiliations

¹ Faculty of Medicine of Tunis - University Tunis El Manar, Djebal Lakhdar Street, 1006 Tunis, Tunisia; Hematology Laboratory, La Rabta University Hospital, La Rabta, 1007 Tunis, Tunisia. Electronic address: mohamedamine.hmida@etudiant-fmt.utm.tn.
² Faculty of Medicine of Tunis - University Tunis El Manar, Djebal Lakhdar Street, 1006 Tunis, Tunisia; Hematology Laboratory, La Rabta University Hospital, La Rabta, 1007 Tunis, Tunisia.
³ National Blood Transfusion Center, 13 Djebel Lakhdhar Street, Bab Sabdoun, 1006 Tunis, Tunisia.
⁴ Central Unit of Blood Transfusion and Blood Banks, Djebel Lakhdhar Street, Bab Sabdoun, 1006 Tunis, Tunisia.
⁵ Hematology Laboratory, Charles Nicolle University Hospital, 9 avril 1938 Street, Bab Saadoun, 1007 Tunis, Tunisia.
⁶ National Blood transfusion Center, 13 Djebel Lakhdhar Street, Bab Sabdoun, 1006 Tunis, Tunisia.

PMID: 38553365
DOI: 10.1016/j.transci.2024.103916

Abstract

Background and objectives: Transfusion safety may be becoming dependent on the financial resources made available for transfusion structures and may vary between high-income countries (HIC) and low-to-middle-income countries (LMIC). To assess whether there is a difference in the reported TR between these two groups of countries, we examined TR reported in Tunis the capital of Tunisia, a LMIC, and compared their frequency with reported TR in HIC.

Materials and methods: Data of TR were collected from transfusion incident report (TIR) forms declared by healthcare facilities in Tunis between 2015 and 2019. They were analysed and compared to reported TR in France (ANSM) and UK (SHOT).

Results: The incidence of TR was 70.6/100 000 blood components (BP) issued. A third of TR (36.8%) occurred at night. Febrile non-hemolytic transfusion reactions (43.7%) and allergic reactions (35%) were the most reported TR respectively 22.4/100 000 BP and 17.9/100 000 BP. The rate of ABO incompatibilities was 1.96/100 000 red blood cell units (RBC): they were all caused by human error. The rates of TRALI, TACO and bacterial contaminations were respectively 1.26/100 000 BP, 1.4/100 000 RBC and 0.7/100 000 BP.

Conclusion: While advanced technologies applied to transfusion have improved transfusion safety, this study shows that their impact has been relatively minor, as reported TR in LMIC are still comparable to those in HIC. ABO-incompatibilities are still higher in LMIC: this should be addressed by reinforcing the training of all healthcare personnel involved in transfusion medicine.

Keywords: Blood Transfusion; Developed Country; Developing Country; Hemovigilance; Transfusion reaction.