Systematic evaluation and classification of adverse reactions to incompatible blood component transfusion in patients undergoing ABO-incompatible allogeneic hematopoietic stem cell transplantation
10.13303/j.cjbt.issn.1004-549x.2022.11.009
- VernacularTitle:ABO血型不合的异基因造血干细胞移植后患者输注异型成分血不良反应系统评估分级
- Author:
Yuan TIAN
1
;
Wenmin LU
1
;
Jiaojiao WENG
1
;
Shujuan ZHOU
1
Author Information
1. Department of Hematology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- Publication Type:Journal Article
- Keywords:
blood group incompatibility;
hematopoietic stem cell transplantation;
transfusion of incompatible blood components;
adverse reactions;
Assessment Grading
- From:
Chinese Journal of Blood Transfusion
2022;35(11):1127-1131
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To analyze and evaluate the occurrence of adverse reactions to incompatible blood component transfusion in patients undergoing ABO-incompatible allogeneic hematopoietic stem cell transplantation (ABO-incompatible allo-HSCT) in our hospital, and provide a basis for clinical safety management of incompatible blood component transfusion. 【Methods】 The case data of 467 ABO-incompatible allo-HSCT patients with incompatible blood components transfused in our hospital from June 2021 to December 2021 were retrospectively analyzed, and the adverse reactions to blood transfusion that occurred were diagnosed according to the clinical manifestations and changes before and after blood transfusion as well as the results of related laboratory tests. The evaluation was based on three aspects as the degree of certainty of the type of reaction, the severity of it, and its probablity associated with blood transfusion. 【Results】 The overall incidence of adverse reactions to transfusion of incompatible blood components was 30.19% (141/467). The incidence occurred in suspended red blood cells were 42.86%(15/35), apheresis platelets 39.25%(73/186), frozen plasma 28.26%(26/92), cryoprecipitated coagulation factors 19.05%(8/42) and washed red blood cells 16.96%(19/112). The incidence of adverse reactions of washed red blood cells and suspended red blood cells was statistically different(P<0.05). The types of adverse reactions were mainly allergic reactions (67.37%, 95/141), followed by non-hemolytic febrile reactions (22.69%, 32/141), transfusion-related graft-versus-host disease(2.84%, 4/141), acute hemolytic transfusion reactions(2.84%, 4/141), transfusion-related hypotension(2.84%, 4/141) and 2 cases (1.42%, 2/141) of other adverse reactions. A total of 141 adverse reactions were graded: 113 cases (80.14%, 113/141) were " sure" , 20 cases (14.19%, 20/141) were " basically sure" , 8 cases were " suspected" (5.67%, 8/141); 130 cases (92.20%, 130/141) were " mild" , and 10 cases (7.09%, 10/141) were" moderate" , 1 case was " severe" (0.71%, 1/141). As to the occurrence associated with blood transfusion: 117 cases (82.98%, 117/141) were " highly correlated" , 17 cases (12.06%, 17/141) were " likely correlated" , and 7 cases (4.96%, 7/141) were " less correlated" . 【Conclusion】 Evaluating and grading the adverse reactions to transfusion of incompatible blood components can deepen the cognition of clinical medical staff, increase the accuracy and rigor of their judgment of adverse reactions, and avoid the missed and false reports of adverse reactions to a certain extent, which laid the foundation for the establishment of a unified standard for adverse reactions to incompatible blood transfusion.
