[Prevention of ABO-incompatible transfusion].

Area of Science:

• Transfusion Medicine
• Patient Safety
• Hematology

Background:

• ABO-incompatible blood transfusions pose significant risks, primarily due to patient-blood product identification errors.
• Phlebotomy errors also contribute to serious adverse transfusion events.
• Effective management systems are crucial for preventing transfusion errors.

Purpose of the Study:

• To highlight the causes and consequences of ABO-incompatible blood transfusions.
• To emphasize the importance of hospital transfusion management systems and specialized personnel.
• To discuss strategies for mitigating transfusion risks, particularly in emergency situations.

Main Methods:

• Review of transfusion error causes and clinical outcomes.
• Analysis of transfusion reaction severity based on ABO mismatch and blood product type.
• Evaluation of transfusion safety protocols in emergency settings.

Main Results:

• Major ABO mismatch transfusions (>50 ml) cause severe acute hemolytic reactions.
• Minor ABO mismatch with leukocyte-reduced red cell concentrate (RCC-LR) may not show detectable acute hemolysis.
• Type-O RCC-LR is safer than ABO-identical RCC-LR in emergent transfusions with single patient blood tests.

Conclusions:

• Implementing hospital transfusion committees, responsible physicians, and blood banking specialists is vital for preventing ABO-incompatible transfusions.
• Type-O RCC-LR is a safer alternative in emergencies when ABO-identical blood is unavailable or patient typing is pending.
• Failure to perform red cell antibody screening increases the risk of hemolysis, including delayed reactions, regardless of ABO compatibility.