2.Serious Adverse Transfusion Reactions Reported in the National Recipient-Triggered Trace Back System in Korea (2006-2014).
Jeong Ran KWON ; Eun Jeong WON ; Hyun Jung JO ; Sae Rom CHOI ; Kyoungyul LEE ; Sinyoung KIM ; Hyeong Sik AHN ; Young Sill CHOI ; Duck CHO ; Dong Han LEE
Annals of Laboratory Medicine 2016;36(4):335-341
BACKGROUND: Adverse transfusion reactions (ATRs) are clinically relevant to patients with significant morbidity and mortality. This study aimed to review the cases of ATR reported in the recipient-triggered trace back system for a recent nine-year period in Korea. METHODS: Nine-year data obtained from 2006 to 2014 by the trace back system at the Division of Human Blood Safety Surveillance of the Korean Centers for Disease Control (KCDC) were reviewed. The suspected cases were assessed according to six categories: (i) related to, (ii) probably related to, (iii) probably not related to, (iv) not related to transfusion, (v) unable to investigate, and (vi) under investigation. RESULTS: Since 2006, 199 suspected serious ATRs were reported in hospitals and medical institutions in Korea, and these ATRs were reassessed by the division of Human Blood Safety Surveillance of the KCDC. Among the reported 193 cases as transfusion related infections, hepatitis C virus (HCV) infection (135, 67.8%) was reported most frequently, followed by hepatitis B virus (HBV) infection (27, 13.6%), HIV infection (13, 6.5%), syphilis (9, 4.5%), malarial infection (4, 2.0%), other bacterial infections (3, 1.5%), HTLV infection (1, 0.5%), and scrub typhus infection (1, 0.5%), respectively. Of the 199 cases, 13 (6.5%) cases were confirmed as transfusion-related (3 HCV infections, 3 malarial infections, 1 HBV infection, 2 Staphylococcus aureus sepsis, 3 transfusion-related acute lung injuries, and 1 hemolytic transfusion reaction). CONCLUSIONS: This is the first nationwide data regarding serious ATRs in Korea and could contribute to the implementation of an effective hemovigilance system.
Acute Lung Injury/epidemiology/etiology
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Blood Transfusion/*adverse effects
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HIV Infections/epidemiology/etiology
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Hepatitis C/epidemiology/etiology
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Humans
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Malaria/epidemiology/etiology
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Republic of Korea
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Retrospective Studies
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Transfusion Reaction/*etiology
3.Application of Damage Control Resuscitation Strategies to Patients with Severe Traumatic Hemorrhage: Review of Plasma to Packed Red Blood Cell Ratios at a Single Institution.
Younghwan KIM ; Kiyoung LEE ; Jihyun KIM ; Jiyoung KIM ; Yunjung HEO ; Heejung WANG ; Kugjong LEE ; Kyoungwon JUNG
Journal of Korean Medical Science 2014;29(7):1007-1011
When treating trauma patients with severe hemorrhage, massive transfusions are often needed. Damage control resuscitation strategies can be used for such patients, but an adequate fresh frozen plasma: packed red blood cell (FFP:PRBC) administration ratio must be established. We retrospectively reviewed the medical records of 100 trauma patients treated with massive transfusions from March 2010 to October 2012. We divided the patients into 2 groups according to the FFP:PRBC ratio: a high-ratio (> or =0.5) and a low-ratio group (<0.5). The patient demographics, fluid and transfusion quantities, laboratory values, complications, and outcomes were analyzed and compared. There were 68 patients in the high-ratio and 32 in the low-ratio group. There were statistically significant differences between groups in the quantities of FFP, FFP:PRBC, platelets, and crystalloids administered, as well as the initial diastolic blood pressure. Bloodstream infections were noted only in the high-ratio group, and the difference was statistically significant (P=0.028). Kaplan-Meier plots revealed that the 24-hr survival rate was significantly higher in the high-ratio group (71.9% vs. 97.1%, P<0.001). In severe hemorrhagic trauma, raising the FFP:PRBC ratio to 0.5 or higher may increase the chances of survival. Efforts to minimize bloodstream infections during the resuscitation must be increased.
Acute Lung Injury/epidemiology/etiology
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Adolescent
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Adult
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Aged
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Aged, 80 and over
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Bacterial Infections/epidemiology
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*Blood Transfusion/adverse effects
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*Erythrocyte Transfusion/adverse effects
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Female
;
Hemorrhage/etiology/*prevention & control
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Hospital Mortality
;
Humans
;
Kaplan-Meier Estimate
;
Male
;
Middle Aged
;
Patients
;
Respiratory Distress Syndrome, Adult/epidemiology/etiology
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Resuscitation
;
Retrospective Studies
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Wounds and Injuries/complications/mortality/*therapy
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Young Adult