Modern blood transfusion is extremely safe practice when compared with other medical and surgical procedures. However deaths and major morbidity still do occur with blood transfusion.
- majority are caused by identification errors (of patients, blood samples and blood components) resulting in ‘wrong blood into patient’ incidents, including ABO-incompatible transfusions
- around 1 in 13 000 blood component units is transfused to the wrong patient (not always with adverse consequences)
- up to 1 in 1 300 pre-transfusion blood samples are taken from the wrong patient.
In 2012, UK Serious Hazards of Transfusion haemovigilance scheme (SHOT) reported:
- 252 incidents of ‘incorrect blood component transfused’
- 10 ABO-incompatible transfusions (all due to clinical errors)
- 145 incidents of ‘avoidable, delayed or under-transfusion’
- 9 transfusion-related deaths (six associated with transfusion-associated circulatory overload)
- 134 cases of major morbidity (most often following acute transfusion reactions) (1).
Adverse effects of transfusion may be classified into:
- acute - occur within minutes to 24 hours of the transfusion
- chronic - may develop days, months, or even years later
This can be divided further into the categories of noninfectious and infectious.
- infectious complications are less common due to advances in the blood screening process
- risk of contracting an infection from transfusion has decreased 10,000-fold since the 1980s
- current risk of an infectious donation entering the UK blood supply is now
- <1 in 1.2 million donations for hepatitis B,
- <1 in 7 million for HIV
- <1 in 28 million for hepatitis C
- noninfectious serious hazards of transfusion are up to 1,000 times more likely than an infectious complication (1,2)
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