A SHOT in the arm for safer blood transfusion

Williamson, Lorna M.; Heptonstall, J; Soldan, Kate

doi:10.1136/bmj.313.7067.1221

Cited by 42 publications

(25 citation statements)

References 14 publications

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“…The SHOT launch was publicised at professional conferences and by an editorial in the BMJ 3. Suspected cases of post-transfusion infection were reported to local blood centres, and cases confirmed after donor investigation as related to transfusion were collated by the National Blood Authority/Public Health Laboratory Service Communicable Disease Surveillance Centre.…”

Section: Methods For Case Ascertainmentmentioning

confidence: 99%

Serious hazards of transfusion (SHOT) initiative: analysis of the first two annual reports

Williamson

Lowe

Love

et al. 1999

BMJ

318

215

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reprovision programmes in Britain, provided that these are well planned and well resourced. ConclusionOur findings dispel some of the common concerns and myths associated with "care in the community" patients and provide robust evidence that community care has worked well for the former patients of psychiatric hospitals, most of whom are currently living in the community and posing minimal risk to themselves and the public. In light of this, a change towards institutional care is not a rational policy.We thank the research workers who have contributed to the collection of the data, the patients, and the hospital and community staff. This paper is designated the TAPS project 45.Contributors: NT participated in data collection, analysis, interpretation, and drafting the paper. JL conceived and designed the Team for the Assessment of Psychiatric Services (TAPS) project and has been the director of the research team for the past 13 years. He helped to draft and edit this paper. GG participated in the analysis and interpretation of the mortality data. He also computerised the assessment tools used by TAPS. NT and JL will act as guarantors for the paper.Funding: The Team for the Assessment of Psychiatric Services (TAPS) is funded by the Department of Health, North Thames Regional Health Authority, and the Gatsby Foundation. It is administered through the Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, London.Competing interests: The TAPS project was largely funded by the Department of Health. This, and previous TAPS papers, were sent for comments to the Department of Health before submission. However, all papers, including this one, were drafted without administrative intervention or scrutiny of any kind. The opinions expressed do not necessarily reflect the policy of the Department of Health. AbstractObjective To receive and collate reports of death or major complications of transfusion of blood or components.

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Section: Methods For Case Ascertainmentmentioning

confidence: 99%

Serious hazards of transfusion (SHOT) initiative: analysis of the first two annual reports

Williamson

Lowe

Love

et al. 1999

BMJ

318

215

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“…Policies to vaccinate people who receive multiple transfusions3 remain justified. The serious hazards of transfusion scheme4and collaborative work between the national blood services and Public Health Laboratory Service will continue to monitor post-transfusion infections.…”

Section: Commentmentioning

confidence: 99%

Acute hepatitis B infection associated with blood transfusion in England and Wales, 1991-7: review of database

Soldan¹,

Ramsay²,

Collins³

1999

BMJ

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Blood donations in England and Wales are collected from healthy donors who do not acknowledge factors associated with an increased risk of bloodborne infections. All donations issued for transfusion since the early 1970s have been tested for hepatitis B surface antigen as a marker of transmissible hepatitis B virus. These measures have resulted in low rates of transmission by transfusion but have not eliminated all infectious donations from the blood supply.Hepatitis B infections in transfusion recipients are investigated by the national blood services to identify if they were transmitted by transfusion. A donation is concluded as having been probably infectious if the donor was surface antigen negative but had evidence of acute infection or of carrying the virus (antibody to hepatitis B core antigen with no or low titres of antibody to surface antigen 1 ) or if the donor was surface antigen positive (on review of test results or retesting archived serum) and blood was erroneously released. Mutant strains of hepatitis B virus not detected by routine surface antigen tests also pose a risk of infectious donations being transfused. 2Acute hepatitis B infections, and the probable route of infection, are reported voluntarily by laboratories in England and Wales to the Communicable Disease Surveillance Centre. We examined these reports to describe the frequency and nature of acute hepatitis B infection transmitted by transfusion. Methods and resultsWe reviewed cases of acute hepatitis B infection reported to the surveillance centre during 1991-7 and sought information from the national blood services for cases associated with transfusion (table). Twenty four of 4185 (0.6%) cases were associated with transfusion in England and Wales. For 10 reports investigation by the national blood services was not possible (for example, donation identifiers not available) or inconclusive (for example, one or more donor not traced for retesting), or information was not available retrospectively. Of the 14 probably infectious donations that were identified, three were from surface antigen negative donors during acute hepatitis B infection and 11 were collected from negative donors during late carriage of the virus. No reports of erroneous release of surface antigen positive blood were identified. CommentOver 2.5 million donations are issued annually in England and Wales. The cases presented here underestimate the number of hepatitis B infections transmitted by transfusion as infection is often asymptomatic and not all acute infections are diagnosed and reported. Nevertheless, these data show that transmission of hepatitis B by transfusion does occur but is rare in England and Wales. Transfusion accounts for only a small part of the total burden of acute symptomatic hepatitis B infection and most cases are due to carriage of infection rather than acute infections in donors. A similar observation was made by the North London Blood Centre during 1985-93 (John Barbara, personal communication).Donor selection criteria aim to exclude people...

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“…The Serious Hazards of Transfusion (SHOT) committee has established an anonymous system for reporting transfusion incidents aimed at improving transfusion safety and standards of hospital transfusion practice 2 – 4. Although few, errors do occur: of 169 reports received in the first year of reporting 81 (47%) were episodes where a patient received blood intended for someone else (resulting in one death and nine cases of morbidity).…”

mentioning

confidence: 99%

Better blood transfusion

Provan

1999

BMJ

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A SHOT in the arm for safer blood transfusion

Cited by 42 publications

References 14 publications

Serious hazards of transfusion (SHOT) initiative: analysis of the first two annual reports

Serious hazards of transfusion (SHOT) initiative: analysis of the first two annual reports

Acute hepatitis B infection associated with blood transfusion in England and Wales, 1991-7: review of database

Better blood transfusion

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