Blood transfusion dynamics in Colombia: Unveiling patterns, reactions and survival rates in multitransfused patients.

IF 1.8 4区医学 Q3 HEMATOLOGY Vox Sanguinis Pub Date : 2024-09-01 Epub Date: 2024-06-24 DOI:10.1111/vox.13700

María-Isabel Bermúdez-Forero, Michel-Andrés García-Otálora

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Abstract

Background and objectives: There is no consensus on a universally accepted threshold to categorize a patient as multitransfused. In 2019, Colombia established the definition of a multitransfused patient as someone who has received six or more blood components, irrespective of the time frame. This study aims to delineate the characteristics, adverse transfusion reactions (ATRs, definitions according to the International Society of Blood Transfusion [ISBT]) and survival rates in this population.

Materials and methods: We performed an analysis from the data of all institutions engaged in blood component transfusions at the national level who notified events to the National Information System of Haemovigilance (SIHEVI-INS), from January 2018 to December 2022. The selection criteria focused on individuals who not only exhibited ATRs but also received six or more blood components.

Results: Among the 1,784,428 patients who received 6,637,271 blood components, an average of 3.7 components per patient was noted. Concurrently, 8378 ATRs were reported (12.6 ATRs/10,000 transfused components). Within this cohort, 691 patients met the criteria for multitransfusion. Predominantly women (51.8%), these individuals received between 6 and 14 blood components. Out of the 691 multitransfused individuals who experienced ATR, 541 had an allergic reaction. Conversely, out of the 6479 non-multitransfused individuals who experienced ATR, 3835 had an allergic reaction (odds ratio: 2.49, 95% confidence interval: 2.06-3.0). Notably, 271 multitransfused individuals (39.2%) were documented as deceased, with 76% succumbing within 12 months of encountering their most recent ATR.

Conclusion: Multitransfused individuals in Colombia, being a high-risk group, exhibit a heightened susceptibility to allergic reactions, surpassing the frequency observed in other transfusion populations. This underscores the necessity for tailored medical care specific to this group.

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哥伦比亚的输血动态：揭示多次输血患者的输血模式、反应和存活率。

背景和目的：对于将患者归类为多重输血者的普遍接受的阈值，目前尚无共识。2019 年，哥伦比亚确定了多重输血患者的定义，即接受过六次或六次以上血液成分输注的患者，无论时间长短。本研究旨在了解这一人群的特征、输血不良反应（ATRs，根据国际输血协会[ISBT]的定义）和存活率：我们对2018年1月至2022年12月期间向国家血液警戒信息系统（SIHEVI-INS）通报事件的所有国家级血液成分输血机构的数据进行了分析。选择标准侧重于不仅表现出ATR，而且接受了六次或六次以上血液成分输注的个体：在接受了 6637271 份血液成分的 1784428 名患者中，平均每名患者接受了 3.7 份血液成分。同时，还报告了 8378 例 ATR（12.6 例 ATR/10,000 例输血成分）。在这批患者中，有 691 名患者符合多次输血的标准。这些患者主要为女性（51.8%），接受了 6 至 14 份血液成分。在发生 ATR 的 691 名多方输血者中，有 541 人出现了过敏反应。相反，在经历过 ATR 的 6479 名非多方输血者中，有 3835 人出现过敏反应（几率比：2.49，95% 置信区间：2.06-3.0）。值得注意的是，有 271 名多输血者（39.2%）被记录为死亡，其中 76% 在最近一次发生 ATR 后的 12 个月内死亡：结论：哥伦比亚的多重输血者属于高危人群，对过敏反应的易感性高于其他输血人群。因此，有必要为这一群体提供量身定制的医疗服务。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vox Sanguinis 医学-血液学

CiteScore

4.40

自引率

11.10%

发文量

156

审稿时长

6-12 weeks

期刊介绍： Vox Sanguinis reports on important, novel developments in transfusion medicine. Original papers, reviews and international fora are published on all aspects of blood transfusion and tissue transplantation, comprising five main sections: 1) Transfusion - Transmitted Disease and its Prevention: Identification and epidemiology of infectious agents transmissible by blood; Bacterial contamination of blood components; Donor recruitment and selection methods; Pathogen inactivation. 2) Blood Component Collection and Production: Blood collection methods and devices (including apheresis); Plasma fractionation techniques and plasma derivatives; Preparation of labile blood components; Inventory management; Hematopoietic progenitor cell collection and storage; Collection and storage of tissues; Quality management and good manufacturing practice; Automation and information technology. 3) Transfusion Medicine and New Therapies: Transfusion thresholds and audits; Haemovigilance; Clinical trials regarding appropriate haemotherapy; Non-infectious adverse affects of transfusion; Therapeutic apheresis; Support of transplant patients; Gene therapy and immunotherapy. 4) Immunohaematology and Immunogenetics: Autoimmunity in haematology; Alloimmunity of blood; Pre-transfusion testing; Immunodiagnostics; Immunobiology; Complement in immunohaematology; Blood typing reagents; Genetic markers of blood cells and serum proteins: polymorphisms and function; Genetic markers and disease; Parentage testing and forensic immunohaematology. 5) Cellular Therapy: Cell-based therapies; Stem cell sources; Stem cell processing and storage; Stem cell products; Stem cell plasticity; Regenerative medicine with cells; Cellular immunotherapy; Molecular therapy; Gene therapy.