Department of Pathology, Massachusetts General Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
Am J Clin Pathol. 2022 Aug 4;158(2):216-220. doi: 10.1093/ajcp/aqac032.
The 2019 SCARED study developed the Biomedical Excellence for Safer Transfusion (BEST) criteria in an effort to standardize the decision to culture residual units in the context of suspected septic transfusion reactions (STRs). The goal of this study was to apply the BEST criteria to determine the effect on the transfusion reaction decision to culture.
This retrospective, single-center, cross-sectional study assessed adult transfusion reactions identified in calendar years 2013 to 2020. Reactions following transfusion of RBCs, platelets, and plasma were included, and the decisions to culture following strict application of BEST criteria were compared with decisions to culture in actual practice.
In total, 1,068 transfusion reactions were reported and 200 (19%) suspected STRs were cultured, all with negative results; 303 (28%) reactions would have been cultured per strict application of the BEST criteria. Concordance between actual culture decision and BEST criteria recommendation was 62% for cultured components and 79% for components that were not cultured.
BEST criteria provide objective recommendations of when to culture residual units implicated in suspected STRs, but strict application of these criteria may result in increased culture rates. Clinical correlation to aid in the decision to culture is recommended.
2019 年 SCARED 研究制定了生物医学卓越安全输血（BEST）标准，旨在规范疑似脓毒性输血反应（STR）情况下培养剩余单位的决策。本研究的目的是应用 BEST 标准来确定其对培养的输血反应决策的影响。
这是一项回顾性、单中心、横断面研究，评估了 2013 年至 2020 年期间成年输血反应。纳入 RBC、血小板和血浆输注后的反应，并且严格应用 BEST 标准后的培养决策与实际实践中的培养决策进行了比较。
共报告了 1068 次输血反应，200 次（19%）疑似 STR 进行了培养，均为阴性结果；根据 BEST 标准的严格应用，将有 303 次（28%）反应进行培养。实际培养决策与 BEST 标准建议的一致性为培养成分的 62%和未培养成分的 79%。
BEST 标准为疑似 STR 中培养剩余单位提供了客观的建议，但严格应用这些标准可能会导致培养率增加。建议进行临床相关性研究以辅助培养决策。
