Transfusion rate and prevalence of unexpected red blood cell alloantibodies in women undergoing hysterectomy for benign disease.

OBJECTIVE

To determine transfusion rates, risk factors for transfusion and the prevalence of unexpected red blood cell alloantibodies in women undergoing hysterectomy for benign disease. In addition, we aimed to evaluate the necessity of the pretransfusion testing for red blood cell alloantibodies.

DESIGN

Retrospective cohort study.

SETTING

The Danish Hysterectomy Database and a regional computerized blood bank register.

POPULATION

The 4 181 hysterectomies in 2004 reported to the Hysterectomy Database. The blood bank registers 2 603 hysterectomies performed between 1997 and 2005.

METHODS

From the hysterectomy database, information about indications for the hysterectomy, surgical procedures, re-operations, number of blood transfusions, and demographic, descriptive and clinical characteristics were extracted. Urgency of the transfusion episodes was evaluated by a retrospective review of the patients' medical records. From the regional blood bank register, results of the screening for red blood cell alloantibodies were extracted.

MAIN OUTCOME MEASURES

Transfusion rates, prevalence of unexpected red blood cell alloantibodies.

RESULTS

In all, 242 women (5.8%) received blood transfusions, but only 32 of the 4 181 women (0.77%) were urgently transfused. Re-operations were frequently associated with urgent blood transfusions. Nine of the 2 603 women from the regional register (0.35%) had newly detected, clinically significant red blood cell alloantibodies.

CONCLUSIONS

The risk of a hemolytic transfusion reaction was estimated to be less than 1 in 17 000 hysterectomies (upper confidence limit) if the routine pretransfusion test were to be omitted. We suggest that reconsideration of the necessity for routine preoperative pretransfusion testing for women undergoing hysterectomy for benign disease is indicated.