Haemovigilance

Blood transfusions pose numerous risks to the patient, one of which is the possibility of an adverse transfusion reaction (please refer to the Blood Safety Information section for more information about these risks).

Clinicians should report all suspected adverse transfusion reactions to their designated Blood Bank as soon as possible, after the patient has been stabilised. The Blood Bank will require the following:

• Return of all used and unused blood products, and all giving sets.
• Three post-transfusion EDTA samples from the patient.
• A completed ‘Report of a suspected adverse transfusion reaction’ form (this can be downloaded below) that details the reaction.

The Blood Bank initiates serological investigations, then sends the samples to the WCBS Immunohaematology Laboratory for further testing. Additional blood products are not issued until provisional testing is completed, although incompletely cross-matched blood can be released if the clinician accepts full responsibility for the clinical consequences. Serological investigations of adverse transfusion reactions include ABO, Rh, and antibody screen retesting of the patient’s pre- and post-transfusion samples, as well as the units transfused. Careful attention is paid to the detection of haemolysis in the patient’s blood that may be indicative of a haemolytic transfusion reaction. Bacterial culture testing of the implicated unit is also performed by an external laboratory if there is suspicion of bacterial contamination of the blood product. Clinicians should always perform blood culture testing on their patients if this complication is suspected, to determine whether the same organism is isolated from both the blood product and the patient.

The WCBS Lead Medical Consultant reviews all information related to the incident and escalates it to the National Haemovigilance Committee based on the severity of the patient’s symptoms. The final classification of the incident is emailed to the clinician who submitted the report, provided their contact information is available. The outcomes of transfusion reactions are also recorded in the Blood Bank database, allowing this information to be requested from Blood Bank staff. Reports are no longer posted to hospitals due to POPIA risks.

Report of a suspected adverse transfusion reaction

For medical support and advice, please contact Dr Caroline Hilton, WCBS Lead Medical Consultant.

Dr Caroline Hilton: Telephone +27 (0)21 507 6441 | Cell 083 282 1612 | Email Caroline@wcbs.org.za