Hemovigilance network in France: organization and analysis of immediate transfusion incident reports from 1994 to 1998

Andreu, G.; Morel, Pascal; Forestier, F.; Debeir, J; Rebibo, Danielle; Janvier, G.; Hervé, P.

doi:10.1046/j.1537-2995.2002.00202.x

Cited by 241 publications

(244 citation statements)

References 18 publications

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“…In the study, patients who donated autologous blood had a higher overall rate of blood transfusion, with 71% receiving blood peripartum compared with 12% of patients who received homologous blood. While autologous blood has a slightly smaller incidence of bacterial contamination, the risk of ABO mismatching is similar for both autologous and homologous blood [20,21]. Thus, administration of autologous blood should not be viewed as innocuous and should be administered for the same indications as banked blood.…”

Section: Autologous Blood Donationmentioning

confidence: 99%

“…While patients are often highly concerned about the infectious risks associated with blood transfusion, patients are actually at more risk for complications resulting from ABO incompatibility errors and similar mixups unrelated to infections [20,21,37]. A survey of transfusion errors in New York state over a 10-year period found the incidence of erroneous administration to be one for every 19,000 red blood cell units administered with blood being administered to the wrong recipient representing 38% of the errors [20].…”

Section: Errors and Transfusionmentioning

confidence: 99%

“…A survey of transfusion errors in New York state over a 10-year period found the incidence of erroneous administration to be one for every 19,000 red blood cell units administered with blood being administered to the wrong recipient representing 38% of the errors [20]. The incidence of ABO incompatibility errors ranges from one for every 38,000 units administered to one in every 138,000 units administered [20,21,37]. Overall, the incidence of a fatal reaction due to erroneous administration is approximately one in every 1,500,000 units of blood administered [37].…”

Section: Errors and Transfusionmentioning

confidence: 99%

See 2 more Smart Citations

Blood Component Therapy in Obstetrics

Fuller¹,

Bucklin²

2007

Obstetrics and Gynecology Clinics of North America

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Section: Autologous Blood Donationmentioning

confidence: 99%

Section: Errors and Transfusionmentioning

confidence: 99%

Section: Errors and Transfusionmentioning

confidence: 99%

See 1 more Smart Citation

Blood Component Therapy in Obstetrics

Fuller¹,

Bucklin²

2007

Obstetrics and Gynecology Clinics of North America

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“…6 Andreu reports similar findings from the hemovigilance program in France. 7 Yet, the true incidence of mis-transfusion is undoubtedly even higher due to failure to recognize many errors. In a very provocative study conducted in three university hospitals in Belgium, mis-transfusion was estimated to occur at the astonishing rate of 1 in 400 units.…”

Section: Mis-transfusion: More Common Than We Realizementioning

confidence: 99%

Technology for Enhanced Transfusion Safety

Dzik

2005

Hematology

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Data from reporting systems around the world document that non-infectious hazards are the leading cause of serious morbidity or mortality resulting from blood transfusion. Among these non-infectious hazards, mis-transfusion represents the most frequently observed serious hazard and occurs at an estimated rate of 1 in 14,000 transfusions. Mistransfusion events result from "lapse errors" (slip ups) rather than cognitive mistakes. Case Summary-Ms JohnstonOn a Thursday evening, you are paged to consult on the management of a patient (Mary Johnston) who has received incompatible blood. The patient is a 48-year-old woman who underwent surgery that morning for removal of a 2 cm, right para-renal mass. The surgery was uncomplicated and a frozen-section pathology specimen was read as a benign adenoma. She received 2.8 L of crystalloid solution during surgery. Post-operatively, her hematocrit was found to be 24% and she was given one unit of group A packed RBCs over 2 hours. Towards the end of the transfusion, she developed a shaking chill and her temperature rose from 99°F to 101°F. Her urine was red as a result of the renal surgery. A blood culture and complete blood count (CBC) were sent and the CBC specimen was reported as hemolyzed with a Hct = 24%. A transfusion reaction evaluation was sent to the blood bank accompanied by the empty blood bag and a freshly drawn post-transfusion specimen. The blood bank called back to report that a "wrong blood transfusion" had likely occurred. The name and medical record number attached to the empty blood bag tag (Mary Johnson, MRN 2395783) did not match that on the post-transfusion specimen (Mary Johnston, MRN 2395837). There was no pre-op sample on file for

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“…The risk of bacterial contamination remains, however, and is now the most common transfusion-related infectious adverse event (1). Preparations of platelet concentrates (PCs) are particularly at risk, as they must be stored at 20 to 24°C to maintain optimal viability and functional properties.…”

mentioning

confidence: 99%

Rapid Screening Method for Detection of Bacteria in Platelet Concentrates

Ribault¹,

Harper²,

Grave³

et al. 2004

J Clin Microbiol

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Public awareness has long focused on the risks of the transmission of viral agents through blood product transfusion. This risk, however, pales in comparison to the less publicized danger associated with the transfusion of blood products contaminated with bacteria, in particular, platelet concentrates. Up to 1,000 cases of clinical sepsis after the transfusion of platelet concentrates are reported annually in the United States. The condition is characterized by acute reaction symptoms and the rapid onset of septicemia and carries a 20 to 40% mortality rate. The urgent need for a method for the routine screening of platelet concentrates to improve patient safety has long been recognized. We describe the development of a rapid and highly sensitive method for screening for bacteria in platelet concentrates for transfusion. No culture period is required; and the entire procedure, from the time of sampling to the time that the final result is obtained, takes less than 90 min. The method involves three basic stages: the selective removal of platelets by filtration following activation with a monoclonal antibody, DNA-specific fluorescent labeling of bacteria, and concentration of the bacteria on a membrane surface for enumeration by solid-phase cytometry. The method offers a universal means of detection of live, nondividing, or dead gram-negative and gram-positive bacteria in complex cellular blood products. The sensitivity is higher than those of the culture-based methods available at present, with a detection limit of 10 to 10 2 CFU/ml, depending upon the bacterial strain.

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Hemovigilance network in France: organization and analysis of immediate transfusion incident reports from 1994 to 1998

Abstract: Hemovigilance is an important tool not only to analyze blood transfusion incidents, but also to measure the effects of new processes or corrective actions at a national level.

Cited by 241 publications

References 18 publications

Blood Component Therapy in Obstetrics

Blood Component Therapy in Obstetrics

Technology for Enhanced Transfusion Safety

Rapid Screening Method for Detection of Bacteria in Platelet Concentrates

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