Scuracchio Patricia, Achkar Ruth, Dias Lara, Oliveira Melina, Casella Ivan, Presti Calogero, Fachini Roberta, Wendel Silvano
Hospital Sírio-Libanês Blood Bank, São Paulo, Brazil.
Universidade de São Paulo-Hospital das Clínicas, São Paulo, Brazil.
Transfusion. 2024 Mar;64(3):546-549. doi: 10.1111/trf.17725. Epub 2024 Jan 17.
Blood donation is a safe process though reactions may still occur. We describe a rare vascular complication in a frequent donor, with improvements in the collection process aimed at avoiding future events.
A 63-year-old woman presented with local pain and an apparent collection in the left arm 8 days after donation. Duplex ultrasound identified a superficial liquid collection and signs of arteriovenous fistula (AVF) between the cubital vein and an arterial branch. A computed tomography (CT)-angio performed 1 day after ultrasound did not identify signs of AVF, followed by a new duplex which confirmed CT-angio findings. It was assumed that a traumatic AVF evolved with spontaneous thrombosis. In the early follow-up (18 days), a progressive regression of hematoma was observed without any sequelae.
Investigation showed a faster whole blood bag collection time (3 min; normal: 5-9 min), and the processed packed red blood cell had a brighter red color than usual. The donor reported local bleeding after needle withdrawal, not observed in previous donations and a bruise forming on the same day. No arterial puncture (AP) was noticed by the collection staff during the procedure. The staff was retrained and actions were taken focusing on more active surveillance of late reactions, highlighting the importance of post-donation information by the donors, regardless of any adverse reaction observed, to detect late complications.
We described an uncommon AP in a donor that was not identified, leading to an AVF that spontaneously thrombosed.
尽管献血过程可能仍会出现反应，但它是一个安全的过程。我们描述了一位频繁献血者发生的罕见血管并发症，并对采血过程进行了改进，旨在避免未来发生此类事件。
一名63岁女性在献血8天后出现左臂局部疼痛并有明显肿物。双功超声检查发现一个浅表液体积聚以及肘静脉与一个动脉分支之间存在动静脉瘘（AVF）的迹象。超声检查1天后进行的计算机断层扫描（CT）血管造影未发现AVF迹象，随后再次进行双功超声检查，结果证实了CT血管造影的结果。推测是外伤性AVF伴发自发性血栓形成。在早期随访（18天）中，观察到血肿逐渐消退，未留下任何后遗症。
调查显示全血采集时间更快（3分钟；正常为5 - 9分钟），处理后的红细胞悬液颜色比平常更红。献血者报告拔针后局部出血，这在之前的献血中未观察到，且当天出现了瘀斑。采血过程中工作人员未注意到动脉穿刺（AP）。对工作人员进行了再培训，并采取行动加强对迟发反应的积极监测，强调无论是否观察到任何不良反应，献血者提供献血后信息对于发现迟发并发症的重要性。
我们描述了一例未被识别的献血者罕见动脉穿刺情况，该情况导致了AVF并自发形成血栓。
