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 ; Blood Transfusion/*adverse effects ; HIV Infections/epidemiology/etiology ; Hepatitis C/epidemiology/etiology ; Humans ; Malaria/epidemiology/etiology ; Republic of Korea ; Retrospective Studies ; Transfusion Reaction/*etiology

BACKGROUND: Although transfusion is a paramount life-saving therapy, there are multiple potential significant risks. Therefore, all adverse transfusion reaction (ATR) episodes require close monitoring. Using the computerized reporting system, we assessed the frequency and pattern of non-infectious ATRs. METHODS: We analyzed two-year transfusion data from electronic medical records retrospectively. From March 2013 to February 2015, 364,569 units of blood were transfused. Of them, 334,582 (91.8%) records were identified from electronic nursing records. For the confirmation of ATRs by blood bank physicians, patients' electronic medical records were further evaluated. RESULTS: According to the nursing records, the frequency of all possible transfusion-related events was 3.1%. After the blood bank physicians' review, the frequency was found to be 1.2%. The overall frequency of febrile non-hemolytic transfusion reactions (FNHTRs) to red blood cells (RBCs), platelet (PLT) components, and fresh frozen plasmas (FFPs) were 0.9%, 0.3%, and 0.2%, respectively, and allergic reactions represented 0.3% (RBCs), 0.9% (PLTs), and 0.9% (FFPs), respectively. The pre-storage leukocyte reduction significantly decreased the frequency of FNHTRs during the transfusion of RBCs (P<0.01) or PLTs (Pfalling dots0.01). CONCLUSIONS: The frequency of FNHTRs, allergic reactions, and "no reactions" were 22.0%, 17.0%, and 60.7%, respectively. Leukocyte-reduction was associated with a lower rate of FNHTRs, but not with that of allergic reactions. The development of an effective electronic reporting system of ATRs is important in quantifying transfusion-related adverse events. This type of reporting system can also accurately identify the underlying problems and risk factors to further the quality of transfusion care for patients.
Blood Transfusion/*adverse effects/statistics & numerical data ; Humans ; Republic of Korea/epidemiology ; Retrospective Studies ; Tertiary Care Centers ; Transfusion Reaction/*epidemiology/etiology

BACKGROUNDUnhygienic blood collection in the early 1990s led to blood-borne infections in Central China. This study aimed to estimate human immunodeficiency virus (HIV) co-infection with hepatitis C and B viruses (HCV and HBV) and their risk factors in a rural area of Shanxi Province with a history of commercial blood donation.

METHODSA cross-sectional study was conducted in 2004. All adult residents in the target area were invited to participate in the study. Face-to-face interviews were completed and blood specimens were tested for HIV, HCV, and HBV surface antigen (HBsAg).

RESULTSPrevalence rates of HIV, HCV, and HBsAg were 1.3% (40/3 062), 12.7% (389/3 062), and 3.5% (103/2982), respectively. Of the 40 HIV-positive specimens, 85% were HCV positive and 2.5% were HBsAg positive. The history of commercial blood donation was positively associated with HIV, HCV, and HIV/HCV co-infections, but was negatively associated with HBsAg seropositivity. Migration for employment in the last 5 years was positively related to HIV, HBsAg, and HIV/HCV co-infections. Univariate logistic analysis showed that illegal drug use, number of sex partners, extramarital sex behavior, commercial sex behavior, and condom use rate were not related to anti-HIV, anti-HCV, HBsAg seropositivity or their co-infections.

CONCLUSIONThe history of commercial blood donation was the main risk factor for HIV, HCV, and HIV/HCV co-infections in this former commercial blood donation area. HIV and HCV prevention and treatment interventions are important in this area.

Adolescent ; Adult ; Blood Donors ; China ; epidemiology ; Cross-Sectional Studies ; Female ; HIV Infections ; epidemiology ; etiology ; Hepatitis B ; epidemiology ; etiology ; Hepatitis C ; epidemiology ; etiology ; Humans ; Male ; Middle Aged ; Transfusion Reaction ; Young Adult

Carbamoyl-Phosphate Synthase (Ammonia) ; genetics ; Enteral Nutrition ; adverse effects ; Enterocolitis, Necrotizing ; epidemiology ; etiology ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; epidemiology ; etiology ; Multivariate Analysis ; Polymorphism, Single Nucleotide ; Premature Birth ; Risk Factors ; Transfusion Reaction

OBJECTIVETo quantitatively assess the association between transfusions and the risk of necrotizing enterocolitis (NEC) in neonates.

METHODBoth Chinese and English literature published from Jan. 1985 to Nov. 2011 about the case-control study of the association between transfusions and neonatal NEC were retrieved by searching the electronic resource databases. A meta-analysis was then performed on the comparison and synthesis of findings from included studies. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using RevMan 5.0 software. Sensitivity analysis was conducted and possible publication bias was tested as well.

RESULTA total of 7 case-control studies (480 blood transfusion cases, 2845 control cases) were included. The meta-analysis with a random-effects model found a pooled OR of 3.35 (95% CI: 1.54-7.27). Sensitivity analysis showed that OR for post-transfusion NEC within 48 h was 4.21 (95% CI: 2.17-8.16). The OR was 4.29 (95% CI: 1.39-13.24) after factors such as gestational age and birth weight were de-confounded. The fail-safe number was 263.

CONCLUSIONBlood transfusion can increase the risk of NEC in neonates. The clinical application of this conclusion should be cautious due to limited reports. High-quality randomized control trials are still needed for the further proof of the association between blood transfusion and neonatal NEC.

Bias ; Case-Control Studies ; Enterocolitis, Necrotizing ; epidemiology ; etiology ; Female ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; epidemiology ; etiology ; therapy ; Infant, Premature ; Literature Based Discovery ; Male ; Odds Ratio ; Risk Factors ; Transfusion Reaction

OBJECTIVETo determine the incidence, course, potential risk factors, and outcomes of noninfectious fever developed in patients after aortic surgery.

METHODSpatients who received operation for aortic aneurysm or dissection in our center from January 2006 to January 2008 were reviewed. Patients who met one of the following criteria were excluded: having a known source of infection during hospitalization; having a preoperative oral temperature greater than or equal to 38.0 degrees C; undertaking emergency surgery; having incomplete data. Univariate analysis was performed in patients with noninfectious postoperative fever and those without, with respect to demographics, intraoperative data, etc. Risk factors for postoperative fever were considered for the multivariate logistic regression model if they had a P value less than 0.10 in the univariate analysis.

RESULTSTotally 463 patients undergoing aortic surgery were enrolled for full review. Among them, 345 (74.5%) patients had noninfectious postoperative fever, the other 118 (25.5%) patients didn't develop postoperative fever. Univariate analysis demonstrated that several risk factors were associated with the development of noninfectious postoperative fever, including weight, surgical procedure, minimum intraoperative bladder temperature, temperature upon intensive care unit (ICU) admission, discharge, and during ICU stay, as well as blood transfusion. In a further multivariate analysis, surgical site of thoracic and thoracoabdominal aorta (odds ratio: 4.861; 95% confidence interval: 3.029-5.801; P=0.004), lower minimum intraoperative bladder temperature (odds ratio: 1.117; 95% confidence interval: 1.01-1.24; P=0.04), and higher temperature on admission to the ICU (odds ratio: 2.57; 95% confidence interval: 1.28-5.18; P=0.008) were found to be significant predictors for noninfectious postoperative fever. No difference was found between the febrile and afebrile patients with regard to postoperative hospitalization duration (P=0.558) or total medical costs (P=0.896).

CONCLUSIONNoninfectious postoperative fever following aortic surgery is very common and closely related with perioperative interventions.

Adult ; Aged ; Aneurysm, Dissecting ; surgery ; Aortic Aneurysm ; surgery ; Female ; Fever ; diagnosis ; epidemiology ; etiology ; Humans ; Incidence ; Interleukin-6 ; blood ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; etiology ; Risk Factors ; Transfusion Reaction

OBJECTIVETo observe the status of iron deposition in patient with β thalassemia major, and to formulate appropriate treatment strategies.

METHODThe data of status of transfusion and chelation in 135 patients aged from 6 years and 4 months to 17 years and 11 months with β thalassemia major were collected and analyzed. Serum ferritin levels were determined and cardiac and hepatic iron deposition was determined using MRI T2(*) technology.

RESULTOf the 135 cases studied, 66 were male, and 69 were female, their average age was 12.1 years. Serum ferritin (SF) was determined for 111 cases, it varied from 1 086.8 µg/L to 15 011.5 µg/L. Among them, 16 cases had SF level <2 000 µg/L (14.5%) , in 41 cases SF were between 2 000 and 4 000 µg/L (36.0%) ;in 54 cases SF >4 000 µg/L (48.7%) . Liver MRI T2(*) results showed that in only 8 cases (5.9%) iron content in the liver was in normal range, 19 cases (14.9%) showed mild liver iron deposition;34 (25.2%) moderate and 74 (54.8%, the youngest one was only 6 years and 4 months of age) had severe iron deposition respectively. Cardiac MRI T2(*) showed that in 89 cases (65.9%) iron content in the heart was in normal range;19 cases (14.1%) had mild cardiac iron deposition and 27 (20.0%) presented severe iron deposition (the youngest one was only 9 years and 3 months of age) . SF level was obviously related to liver and cardiac iron deposition (MRI T2(*)) r and P value were -0.284, 0.003 and -0.374, 0.000 respectively. In 108 cases regular transfusion and chelation were delayed due to financial problem. The late and insufficient dosage administered and irregular chelation caused the higher SF level and the severe iron deposition.

CONCLUSIONThe survival status of β thalassemia major in China is worrisome. Majority of them had not received regular transfusion and chelation. Liver and cardiac iron deposition occur early and had a high incidence.

Adolescent ; Child ; Female ; Ferritins ; blood ; Humans ; Iron ; metabolism ; Iron Chelating Agents ; adverse effects ; therapeutic use ; Iron Overload ; epidemiology ; etiology ; Liver ; metabolism ; Magnetic Resonance Imaging ; Male ; Myocardium ; metabolism ; Radiography ; Retrospective Studies ; Transfusion Reaction ; beta-Thalassemia ; diagnostic imaging ; metabolism ; therapy