Faculty of Medicine of Tunis - University Tunis El Manar, Djebal Lakhdar Street, 1006 Tunis, Tunisia; Hematology Laboratory, La Rabta University Hospital, La Rabta, 1007 Tunis, Tunisia.
Faculty of Medicine of Tunis - University Tunis El Manar, Djebal Lakhdar Street, 1006 Tunis, Tunisia; Hematology Laboratory, La Rabta University Hospital, La Rabta, 1007 Tunis, Tunisia.
Transfus Apher Sci. 2024 Jun;63(3):103916. doi: 10.1016/j.transci.2024.103916. Epub 2024 Mar 19.
Transfusion safety may be becoming dependent on the financial resources made available for transfusion structures and may vary between high-income countries (HIC) and low-to-middle-income countries (LMIC). To assess whether there is a difference in the reported TR between these two groups of countries, we examined TR reported in Tunis the capital of Tunisia, a LMIC, and compared their frequency with reported TR in HIC.
Data of TR were collected from transfusion incident report (TIR) forms declared by healthcare facilities in Tunis between 2015 and 2019. They were analysed and compared to reported TR in France (ANSM) and UK (SHOT).
The incidence of TR was 70.6/100 000 blood components (BP) issued. A third of TR (36.8%) occurred at night. Febrile non-hemolytic transfusion reactions (43.7%) and allergic reactions (35%) were the most reported TR respectively 22.4/100 000 BP and 17.9/100 000 BP. The rate of ABO incompatibilities was 1.96/100 000 red blood cell units (RBC): they were all caused by human error. The rates of TRALI, TACO and bacterial contaminations were respectively 1.26/100 000 BP, 1.4/100 000 RBC and 0.7/100 000 BP.
While advanced technologies applied to transfusion have improved transfusion safety, this study shows that their impact has been relatively minor, as reported TR in LMIC are still comparable to those in HIC. ABO-incompatibilities are still higher in LMIC: this should be addressed by reinforcing the training of all healthcare personnel involved in transfusion medicine.
输血安全可能越来越依赖于用于输血结构的财政资源，并且在高收入国家（HIC）和中低收入国家（LMIC）之间可能有所不同。为了评估这两组国家报告的 TR 是否存在差异，我们检查了报告来自突尼斯首都突尼斯的 LMIC 的 TR，并将其频率与 HIC 报告的 TR 进行了比较。
从 2015 年至 2019 年，在突尼斯的医疗机构报告的输血事件报告（TIR）表中收集了 TR 数据。对其进行了分析，并与法国（ANSM）和英国（SHOT）报告的 TR 进行了比较。
TR 的发生率为每 100000 个发出的血液成分（BP）发生 70.6 次。三分之一的 TR（36.8%）发生在夜间。发热非溶血性输血反应（43.7%）和过敏反应（35%）是分别报告的最常见的 TR，分别为每 100000 BP 22.4 次和每 100000 BP 17.9 次。ABO 不相容性的发生率为每 100000 个 RBC 单位 1.96 次：它们都是由人为错误引起的。TRALI、TACO 和细菌污染的发生率分别为每 100000 BP 1.26 次、每 100000 RBC 1.4 次和每 100000 BP 0.7 次。
尽管应用于输血的先进技术提高了输血安全性，但本研究表明，其影响相对较小，因为 LMIC 报告的 TR 仍与 HIC 报告的 TR 相当。ABO 不相容性在 LMIC 中仍然更高：这应该通过加强所有参与输血医学的医疗保健人员的培训来解决。
