Fatal Blood Donation
A safe blood supply depends on a well-organized supply system that ensures regular donation by healthy individuals who have no excess risk of infections transmissible by blood. Every blood donation must be reliably tested to detect and exclude those containing transmissible agents. In the developed world, this includes hepatitis B, hepatitis C, HIV and human T lymphotropic virus (HTLV) which is detected with tests for antibody to the virus, viral antigen or nucleic acid.
The UK haemovigilance study, SHOT, has collated reports of Serious Hazards of Transfusion for the years 1996-2003, during which about 23 million units of blood components were supplied.
Fever and allergic symptoms or signs, such as itching all over the body, occur during about 1% of transfusions, usually in patients who have had repeated transfusions. Usually these reactions are not serious but any new symptoms or signs that arise during a transfusion must be taken seriously as they may be the first warnings of a serious reaction.
Over the past 30 years, the viruses that cause hepatitis B, AIDS and hepatitis C have been identified and effective tests introduced to detect and exclude infected blood units. Where blood is from ‘safe’ donors and correctly tested, the current risk of a donation being infectious is very small. In 2002-3 in the UK, the estimated chances that a unit of blood might transmit one of the viruses for which blood is tested, was 0.02 per 100 000 units for HIV, 0.005 for HCV and 0.24 for HBV. More patients are put at risk by receiving an unintended blood component (6 per 100 000), including ABO-incompatible blood (1 per 100 000).
Bacterial contamination of a blood component may rarely occur, causing very severe and often lethal transfusion reactions. In the UK, 16 incidents with 9 fatalities were identified during the 5 years to 1999;
Transfusion-transmitted malaria is extremely rare in the UK and US but may be more important where malaria is prevalent.
Most mismatched transfusions result from mistakes in taking or labeling the blood sample for pre-transfusion testing, or from failure to carry out standard checks before infusion to make certain the correct pack has been selected for the patient.Such an accident is likely to kill or harm the patient and is avoidable. Errors leading to patients receiving the wrong blood are one of the main causes of mortality and morbidity due to transfusion. The patient’s safety depends not only on correct pre-transfusion testing in the laboratory but also on the use of standard procedures for taking correctly labeled blood samples from the patient and for making sure that blood is infused into the correct patient. The proposed transfusion and any alternatives should be discussed with the patient, or if that is not possible with a relative and this should be documented. Every hospital where blood is transfused should have a written transfusion policy that is used by all staff ordering and administering blood products.
Tags: Blood Donation