PubMed · 12953390
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Rhonda Siddall. 2003-08-21. Under pressure.. https://pubmed.ncbi.nlm.nih.gov/12953390/
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During the 2002 epidemic of West Nile virus (WNV) in the United States, a total of 23 persons were reported to have acquired WNV infection after receipt of blood components from 16 WNV-viremic blood donors, and an estimated 500 viremic donations might have been collected (B. Biggerstaff, M.D., CDC, personal communication, 2003). Because of the possibility of recurrent WNV epidemics in the United States, blood collection agencies (BCAs) recently implemented WNV nucleic acid--amplification tests (NATs) to screen all donations and quarantine and retrieve potentially infectious blood components. In addition to NAT screening, the Food and Drug Administration (FDA) recommended that BCAs enhance donor deferral questions by specifically asking about fever with headache occurring in the week before donation and defer persons reporting such symptoms. This report describes the NAT screening process for two WNV-viremic donors and presents data summarizing the testing results for approximately 95% of the civilian blood donations collected during late June to early August. These preliminary data suggest that investigational screening tests are effective in identifying viremic donations and preventing the implicated blood components from entering the blood supply.
The objective of haemovigilance, a set of surveillance procedures covering the complete transfusion chain, is to collect and assess information concerning unexpected and undesirable effects arising from the therapeutic use of labile blood products, and to prevent the recurrence of such incidents. A number of guidelines and directives from national and European health authorities require hospitals to institute a haemovigilance system. Preliminary data from one blood bank region in the Netherlands reveals the various types of transfusion reactions reported. The current haemovigilance systems still have some limitations. A considerable amount of time and effort will be needed for the benefits of haemovigilance to become apparent.
OBJECTIVE: Itemize blood transfusion incidents in the South-West Netherlands region (about 3.5 million inhabitants), where a regional reporting system for transfusion incidents was introduced in January 2001. DESIGN: Prospective, descriptive. METHOD: In the period 1 January 2001-31 December 2001, 22 hospitals voluntarily reported transfusion incidents in patients to the blood bank. All incidents were anonymously recorded in a standardised report and registered in 14 categories. RESULTS: A total of 119 transfusion incidents were reported and categorised as: incorrect blood component transfused (n = 8), mild fever 1-2 degrees C (n = 14), non-haemolytic fever > 2 degrees C (n = 36), acute haemolytic transfusion reactions (n = 3). delayed haemolytic transfusion reactions (n = 18), allergic reactions (n = 11), bacterial contamination (n = 3), transfusion-related acute lung injury (n = 1), near accidents (n = 6) and product recalls (n = 19). There were no reports in the categories anaphylactic shock, post-transfusion purpura, transfusion-acquired viral infection, and transfusion-related graft versus host disease. In the same year of haemovigilance, the blood bank issued a total of 158,000 blood products. A complication rate of 1:700 blood products was calculated. It is estimated that 53% of all incidents were reported. CONCLUSION: Despite all of the safety measures taken, severe adverse events still occurred. A well-run system for haemovigilance can contribute to the knowledge of transfusion incidents. The safety and quality of blood transfusions can be improved if this knowledge is incorporated into ongoing education about blood transfusions and in the prevention and treatment of transfusion reactions.