Rates of delayed hemolytic transfusion reactions observed in a trauma center

Background Delayed hemolytic transfusion reactions (DHTRs) are reported to be rare occurrences but may be more frequently observed in the trauma setting where patients are heavily transfused, followed over long inpatient admissions, and have frequent subsequent blood counts as they undergo multiple...

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Bibliographic Details
Published in:Transfusion (Philadelphia, Pa.) Pa.), 2021-07, Vol.61 (7), p.2035-2040
Main Authors: Hasan, Rida Abid, Asif, Maryam, Tuott, Erin E., Stansbury, Lynn G., Hess, John R.
Format: Article
Language:English
Subjects:
Alloantibodies
Antibodies
Erythrocytes
hazards of transfusion
immunohematology
immunology
Patients
RBC alloimmunization
Resuscitation
Transfusion
Trauma
Trauma centers
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Summary:Background Delayed hemolytic transfusion reactions (DHTRs) are reported to be rare occurrences but may be more frequently observed in the trauma setting where patients are heavily transfused, followed over long inpatient admissions, and have frequent subsequent blood counts as they undergo multiple surgical interventions. Study design and methods We examined the rates of DHTRs on a per transfusion and per patient basis in an academic county hospital with a level 1 trauma center serving a four‐state region and over a 3‐year period. DHTRs were entered sequentially into a registry as they were observed, and a retrospective review of all new alloantibodies detected was performed to identify any additional DHTRs. The number of units of red blood cells (RBCs), the number of unique patients, types of alloantibodies, and number of transfusions were extracted from blood bank records. Results Twenty‐nine DHTRs were observed from January 1, 2017, through December 31, 2019, from newly observed alloantibodies after a median of 12 red blood cells (RBCs) transfusions per patient. These reactions occurred in response to 24,633 unique transfusions in 6905 unique patients, so the observed rates were about 1:849 RBC transfusions and 1:238 transfused patients. Evidence of delayed hemolysis was seen in five additional patients who were transfused during emergency resuscitation and later found to have had known RBC antibodies. Discussion We report a higher rate of DHTRs than previously described to demonstrate that DHTRs are not rare in trauma centers.
ISSN:0041-1132
1537-2995
DOI:10.1111/trf.16433