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Pediatric blood transfusions in Colombia: Dissecting adverse reaction trends and age dynamics
María-Isabel Bermúdez-Forero1, Diego-Alexander Anzola-Samudio1, Michel-Andrés García-Otálora2
1Coordinación Red Nacional Bancos de Sangre y Servicios de Transfusión. Instituto Nacional de Salud (INS), Bogotá, Colombia.
Insights
Adverse transfusion reactions (ATRs) are significantly more common in Colombian children than adults, occurring three times more frequently. This study highlights increased risks for pediatric patients, particularly concerning allergic reactions associated with platelet transfusions.
Area of Science:
- Transfusion Medicine
- Pediatric Hematology
- Patient Safety
Background:
- Adverse transfusion reactions (ATRs) are patient responses to blood transfusions.
- Pediatric populations typically experience higher ATR rates than adults.
- Existing data suggests pediatric ATR rates are 1.3-2.6 times higher than adult rates.
Purpose of the Study:
- To investigate ATR trends in the Colombian pediatric population.
- To compare pediatric ATR rates with adult rates within Colombia.
- To identify specific reaction types and risk factors in pediatric transfusions.
Main Methods:
- Retrospective analysis of transfusion data from January 1, 2018, to December 31, 2022.
- Utilized data from the National Hemovigilance Information System.
- ATRs were reported using International Society of Blood Transfusion guidelines.
Main Results:
- Over 6.6 million transfusions were analyzed, with 6830 ATRs reported.
- Pediatric transfusions showed a higher ATR rate (79.4 per 10,000) compared to adults (27.7 per 10,000).
- Pediatric patients had more allergic reactions and fewer febrile nonhemolytic transfusion reactions (FNHTRs); apheresis platelets showed higher ATR rates in both populations.
Conclusions:
- Adverse transfusion reactions are three times higher in Colombian children compared to adults.
- The findings underscore a significant safety concern for pediatric transfusions in Colombia.
- Platelet transfusion reactions, particularly allergic types, warrant further investigation in pediatric care.
Background:
Adverse transfusion reactions (ATRs) represent undesired responses in patients. Different reports indicate that rates of ATRs are 1.3-2.6 times higher in pediatric populations compared with adults. The aim of this study was to investigate whether similar trends are observed within the pediatric population in Colombia.
Study Design And Methods:
This retrospective study, conducted from January 1, 2018, to December 31, 2022, investigated transfusion occurrences and ATRs. Data were collected from the National Hemovigilance Information System. ATRs were reported by medical personnel using standardized forms following guidelines set by the International Society of Blood Transfusion.
Results:
The study included 2,097,179 patients receiving 6,637,363 transfusions, with 6830 ATRs. In comparison with adult transfusions, pediatric transfusions exhibit a male bias, a higher rate of ATRs per 10,000 transfused patients (79.4 vs. 27.7), a greater prevalence of allergic reactions and a lower incidence of febrile nonhemolytic transfusion reactions (FNHTRs). The rate of ATRs varied across age groups: 17.1 for those aged 0-1 year, 120.5 for individuals aged 2-14 years, 42.5 for people aged 15-65 years, and 24.4 for those over 65 years. Among pediatric patients, 688 of 1126 allergic reactions were linked to platelet transfusions. Platelets obtained via apheresis had a higher ATR rate compared with those from the buffy coat method (OR: 1.44), while in adults, 960 of 3002 allergic reactions were attributed to platelet transfusions, with higher ATR rates for apheresis platelets compared with buffy coat platelets (OR: 1.41).
Conclusion:
ATRs in the Colombian pediatric population were three times higher than adults.
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