Serologic assessments in acute transfusion reactions: practices and yields

Vox Sanguinis
Robert CohenChristine Cserti-Gazdewich

Abstract

Serologic testing after transfusion reactions (TRs) aims to find accountable immune haemolytic incompatibility. Our hospital policies recommend serologic testing in all TR, except for low-risk fevers (subclinical temperature <39°C) or uncomplicated allergic reactions. Assessing compliance with these guidelines and serologic testing yields may provide insights on quality of practice and value. Interrogation of two haemovigilance databases identified all possible-to-definite TR over a 4-year period (2013-2016) at four academic hospitals. We reviewed the performance and outcome of serologic testing by site, year, reaction type, implicated product and service. Serologic testing occurred in 769 (55%) of 1408 referrals, with 1153 (82%) compliant with guidelines. Similar proportions deviated to overtesting (85/550 [15%]) and undertesting (174/858 [20%]), with undertesting seen most often in atypical TR. Overall, 30 (4.4%) of 769 cases had a new finding, but only 2 (0.3%) reflected host-derived antibodies. Overall, the number needed to test to discover an unexpected allospecificity was 385, or 253 if limited to high-risk fevers. Reaction- and product-specific yields ranged from 0% to 48%. The yield in complicated allergic reactions was...Continue Reading

Associated Clinical Trials

References

Nov 12, 2009·Transfusion·Mark H Yazer, Darrell J Triulzi
Jul 30, 2014·Transfusion·Richard M KaufmanSherrill J Slichter
Jul 28, 2016·Transfusion·Jeanne E HendricksonUNKNOWN National Heart, Lung, and Blood Institute (NHLBI) Recipient Epidemiology and Donor Evaluation Study (REDS-III)
Apr 4, 2017·Transfusion·Robert CohenChristine Cserti-Gazdewich
Nov 11, 2017·Vox Sanguinis·M P JanssenJ C Wiersum-Osselton

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