Abstract
Background: For the investigation of transfusion-transmitted bacterial infection and transfusion-related acute lung injury (TRALI), examination of residual transfused blood is essential. However, methods for the collection of residual transfused blood have not been fully implemented at respective hospital level. Therefore, the causes of these reactions are not being fully investigated.
Methods: We developed a procedure for investigating the cause of acute transfusion reactions, including a method for collecting residual blood. Using this method, we investigated serious acute transfusion reactions at 50 large hospitals between 2005 and 2006.
Results: Transfusion was performed using 283,636 bags of red cell concentrate, 183,591 bags of fresh frozen plasma and 141,538 bags of platelets concentrate at these facilities during the investigation period. Transfusion-transmitted bacterial infection was diagnosed in two cases and suspected in 12 cases. Three cases met the diagnostic criteria for TRALI and one case was identified as possible TRALI. Transfusion-associated circulatory overload was diagnosed in one case. Five patients demonstrated deterioration of clinical condition after transfusion during treatment of acute lung injury. Four patients demonstrate dyspnea without pulmonary edema. Severe allergic reactions were detected in 15 cases and febrile non hemolytic transfusion reaction in one case. The cause was not precisely known in two cases.
Conclusion: This type of investigation is useful for detecting the cause of acute transfusion reactions, such as allergic reactions, TRALI and transfusion-transmitted bacterial infection. The frequency of acute transfusion reactions will be clarified by increasing the number of participating facilities, thereby contributing to hemovigilance.
