Déterminants sociocognitifs de l’intention d’appliquer les procédures de transfusion sanguine : enquête dans des hôpitaux publics français

Objectives

Studies on blood transfusion reveal that specific rules are not always respected by healthcare professionals. This study aims to better understand the intention to apply the blood transfusion rules, and to examine, within the framework of the theory of planned behavior, the barriers and facilitators.

Haemovigilance: recent achievements and developments in the near future

Since the introduction of haemovigilance in the 1990s, the majority of the European countries has established a national haemovigilance system and communication between these systems was organized through the European Haemovigilance Network (EHN). The concept of haemovigilance has steadily expanded and the number of haemovigilance systems outside Europe is increasing. Several of these systems have also joined the EHN. Furthermore, initiated by the World Health Organization, a Global Steering Committee for Haemovigilance has been installed to promote haemovigilance particularly in developing countries. Both these haemovigilance systems and the network have documented the safety of blood transfusion and indicated where the main problems and opportunities for improvement are. Furthermore, they have suggested measures for improvement of the safety and, last but not least, documented the effect of these measures. Therefore, they have contributed considerably to the improvement of the quality and safety of the blood transfusion chain. In the near future, the EHN will become an official International Haemovigilance Network. Ongoing developments concerning the scope of vigilance include the vigilance of optimal use of blood products and safety of cells and tissues of human origin (biovigilance).     

Adverse events and safety issues in blood donation--a comprehensive review

Although blood donation is generally safe, a variety of risks and complications exist, the most common being iron deficiency, vasovagal reactions and citrate-related events. In the last decades, extensive efforts have significantly improved recipient and product safety, but there is still great potential to optimise donor care. Many therapies in modern medicine depend on the prompt availability of blood products, therefore it is crucial to maintain a motivated and healthy donor pool in view of a limited number of healthy volunteers willing and able to give blood or blood components. We present a comprehensive review on adverse events addressing all types of blood donation including whole blood, plasma, platelet, peripheral blood stem cell, leucocyte and bone marrow donation. In addition, we outline strategies for the prevention and treatment of these events and give a blueprint for future research in this field.     

Neonatal transfusion

Neonates and particularly preterm neonates are frequent recipients of large volumes of blood products relative to their size. Good quality evidence for transfusion practice in this patient group has been lacking but is now increasing. Triggers for red cell transfusion are now better defined, with on-going trials of platelet transfusions likely to yield similar evidence. Transfusion is now extremely safe, but complications such as transfusion associated acute lung injury (TRALI) and transfusion associated circulatory overload (TACO) are likely to be under recognised, particularly in the sick extremely preterm neonate with respiratory symptoms. This review summarises the rationale and current practice with regard to blood component therapy. Background data on component specifications and hazards of transfusion are provided. Indications for transfusion of specific products including red cells, platelets, and plasma are discussed, and their use is illustrated by case examples.     

Transfusion reactions: A retrospective analysis of the Iranian national haemovigilance system (INHS) data

BackgroundThe use of blood and blood components is an essential and effective treatment for many patients, but the transmission of infectious agents via transfusion and the occurrence of non-infectious transfusion reactions (TRs) are unavoidable. The objective of our study was to determine the frequency and type of transfusion-related reactions reported in Iran between 2014 and 2018.MethodsThis retrospective study was carried out in the Iranian blood transfusion organization (IBTO) during a period of five years (2014–2018). All TRs reported to the Iranian national haemovigilance system (INHS) were analyzed using SPSS software.ResultsA total of 20,062 TRs were reported to the INHS from 2014 to 2018. The overall frequency of TRs was 0.14 %. The most common TRs were allergic (42.51 %) and febrile non-hemolytic reactions (37.17 %), respectively. The frequency of TRs to red blood cell (RBC) components was significantly higher than those to the components of platelet (PLT) and plasma (P < 0.05).ConclusionsIn the present study, the frequency of TRs was relatively low (0.14 %) and the majority of them were allergic and febrile non-hemolytic reactions. The recording and reporting of all occurred TRs, the implementation of INHS in all hospitals and the continuity of specific educational courses to physicians, nurses and blood banking staff, as well as the use of an online reporting system will help to improve the haemovigilance in Iran.