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非溶血性急性输血反应:患者和血液制品特征的影响。

Non-hemolytic acute transfusion reactions: the impact of patient and blood product characteristics.

机构信息

Department of Hematology, Erol Olçok Training and Research Hospital, Hitit University, Çorum, Türkiye.

Department of Internal Medicine, Erol Olçok Training and Research Hospital, Hitit University, Çorum, Türkiye.

出版信息

Postgrad Med. 2024 Sep;136(7):726-730. doi: 10.1080/00325481.2024.2396797. Epub 2024 Aug 30.

DOI:10.1080/00325481.2024.2396797
PMID:39192816
Abstract

BACKGROUND

Non-hemolytic acute transfusion reactions (ATRs) are generally not fatal, but they can cause serious increases in workload and costs as a result of blood product wastage.

METHODS

A retrospective analysis was made of the data of the 7-year period between January 2016 and December 2022 to identify the possible associations between patient and product characteristics and the development of ATRs.

RESULTS

A total of 113,666 blood products were transfused during the study period. There were 146 ATRs with an estimated rate of 1.28 per 1000 blood products administered. The most common ATR was mild allergic reactions ( = 84, 57.6%). No statistically significant relationship was found in blood group distribution between patients who had and did not develop ATR ( = 0.797). Febrile Non-hemolytic Transfusion Reaction (FNHTR) was more common in patients receiving erythrocyte suspension (ES) transfusion, and Fresh Frozen Plasma (FFP) was mostly used in those with mild allergic reactions ( < 0.001). Patient age was determined as > 60 years in those who developed FNHTR or 'others,' and < 60 years in patients with mild allergic reactions ( = 0.046).

CONCLUSION

The results of the current study demonstrated that regardless of blood group, the probability of developing FNHTR is high when ES is transfused in elderly patients, and the probability of developing mild allergic reaction is high when FFP is used. While recognizing that ATRs are difficult to prevent, it can be emphasized that prediction and management may become easier if clinicians keep these possibilities in mind when making transfusion decisions.

摘要

背景

非溶血性急性输血反应(ATRs)一般不会致命,但由于血液制品浪费,会导致工作量和成本的严重增加。

方法

回顾性分析了 2016 年 1 月至 2022 年 12 月 7 年间的数据,以确定患者和产品特征与 ATR 发展之间的可能关联。

结果

研究期间共输注了 113666 个血制品。发生了 146 例 ATR,估计每输注 1000 个血制品中就有 1.28 例。最常见的 ATR 是轻度过敏反应( = 84,57.6%)。在发生和未发生 ATR 的患者中,血型分布无统计学差异( = 0.797)。发热性非溶血性输血反应(FNHTR)在接受红细胞悬液(ES)输血的患者中更为常见,而新鲜冷冻血浆(FFP)在发生轻度过敏反应的患者中更为常见( < 0.001)。发生 FNHTR 或“其他”的患者年龄确定为 > 60 岁,发生轻度过敏反应的患者年龄为 < 60 岁( = 0.046)。

结论

本研究结果表明,无论血型如何,老年患者输注 ES 时发生 FNHTR 的概率较高,而使用 FFP 时发生轻度过敏反应的概率较高。虽然认识到 ATR 很难预防,但如果临床医生在做出输血决策时考虑到这些可能性,预测和管理可能会变得更容易。

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