Adverse Reactions and Events in Transfusion
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What is Haemovigilance?
The systemic surveillance of adverse transfusion reactions and events. And collecting data on these to improve safety throughout the transfusion chain from donor to patient.
What types of incidents are reported to SHOT?
All incidents, near misses, reactions and events.
What does ‘SHOT’ stand for?
Serious Hazards Of Transfusion
What is the purpose of the SHOT group?
To make recommendations to improve patient safety.
What does MHRA stand for?
Medicines and Healthcare products Regulatory Agency
What is the purpose of MHRA?
They have the power to impose the ‘case and desist’ order.
What does SABRE stand for?
Serious Adverse Blood Reactions and Events
What is SABRE?
A merged database of MHRA and SHOT
What data is reported t MHRA?
SARs (Serious adverse reactions) SAEs (Serious adverse events).
Define a serious adverse reaction.
An unintended response to a donor in a patient that is associated with the collection, or transfusion of blood or blood components that is fatal, life-threatening, disabling or incapacitating, or which results in or prolongs hospitalisation or morbidity.
Where are notifications of SAR submitted?
On SABRE
What are the clinical symptoms of an allergic anaphylactic shock?
Severe hypotension associated with wheezing. Stridor from laryngeal oedema. Swelling of the face, limbs or mucous membranes. Flushing and urticaria.
What is Stridor?
Loud breathing sounds
What is Angiodema?
Swelling of the deeper layers of the skin caused by build up of fluid.
How are less severe allergic reactions treated?
With anti-histamines
In what patients is anaphylaxis common?
In patients with a known allergy where the donor has consumed the allergen.
What type of transfusions commonly cause anaphylaxis?
Plasma rich components such as platelets of fresh frozen plasma.
What investigation usually occurs after a anaphylactic reaction due to transfusion?
Investigated by clinical immunologists for IgA deficiency.
What are the clinical symptoms of febrile reaction?
Fever (often with shivering), muscle pain and nausea
What is the main cause of febrile reaction?
Antibodies directed against donor Leukocytes and human leukocyte antigens.
What mediates febrile reaction?
Pre-formed cytokines in the donor plasma as a consequence of leukocyte breakdown.
How quickly do febrile reactions occur after transfusion?
Up to 2 hours after completion of the transfusion
In what type of patients is febrile reaction most common?
In multi-transfused patients receiving red cells.
What is the treatment for febrile reaction?
Paracetamol and slow rate of transfusion.