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Introdução: A hemoterapia é uma prática terapêutica pelo meio de transfusão sanguínea. Devido ao baixo estoque de bolsas de sangue e o aumento de pacientes crônicos e emergenciais, se faz necessária a realização de testes imuno-hematológicos para minimizar os riscos de reações transfusionais e aloimunizações em doadores e receptores de sangue. Deste modo, no estudo foi avaliada a prevalência dos antígenos dos sistemas Rh e Kell em doadores de sangue de Porto Alegre RS.Métodos: Estudo quantitativo, transversal e retrospectivo que foi realizado através da análise das informações dos doadores de sangue contidas no banco de dados do Hemocentro do Estado do Rio Grande do Sul, nos anos de 2018 e 2019.Resultados: Das 6.479 amostras fenotipadas, quanto ao sistema Rh, 44,6% são Rh positivo e 55,4% são Rh negativo. As frequências dos antígenos encontradas foram de, CC 10,1%, Cc 27%, cc 62,9%, EE 1,2%, Ee 13,9%, ee 84,9%. E, para o sistema Kell, K1 positivo 7,1% e K1 negativo 92,9%.Conclusões: Antígenos do sistema Rh e Kell exibem um grande nível de imunogenicidade e uma forte ligação com a Doença Hemolítica do Recém-nascido, podendo ocorrer a sensibilização em pacientes caso não haja a compatibilidade sanguínea. Este estudo ressalta a importância da implementação da fenotipagem eritrocitária em doadores de sangue, sugere-se mais estudos com períodos distintos para a pesquisa de resultados satisfatórios.
Introduction: Hemotherapy is a therapeutic practice consisting of blood transfusion. Low blood supply and an increase in chronic and emergency patients have made it necessary to conduct immunohematology tests to minimize the risks of adverse reactions and alloimmunization in donors and recipients. Therefore, this study aimed to assess the prevalence of Rh and Kell blood group antigens among blood donors in Porto Alegre, Rio Grande do Sul, Brazil.Methods: We conducted a quantitative, cross-sectional, retrospective study. Information from blood donors included in the Rio Grande do Sul's Blood Center database from 2018 to 2019 were analyzed.Results: A total of 6,479 samples were phenotyped, of which 44.6% were Rh-positive and 55.4% were Rh-negative. Antigen prevalence was CC (10.1%), Cc (27%), cc (62.9%), EE (1.2%), Ee (13.9%), and ee (84.9%). As for the Kell group, 7.1% were K1-positive and 92.9% were K1-negative.Conclusions: The Rh and Kell antigens are highly immunogenic and have a strong link with the hemolytic disease of the newborn. Sensitization may occur in patients if there is no blood compatibility. This study highlights the importance of implementing erythrocyte phenotyping in blood donors. Further studies should be conducted in different time frames to achieve satisfactory results.
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Humanos , Sistema do Grupo Sanguíneo Rh-Hr/sangue , Doadores de Sangue/estatística & dados numéricos , Reação Transfusional/sangue , Sistema do Grupo Sanguíneo de Kell/sangue , Transfusão de Sangue , Estudos Retrospectivos , Serviço de HemoterapiaRESUMO
Objetivo: identificar e discutir a ocorrência de reações transfusionais imediatas, considerando o tipo de hemocomponente transfundido, demanda e capacidade de atendimento em um Hospital Universitário do estado da Bahia, Brasil. Método: estudo de caso, retrospectivo, quantitativo, realizado por meio de levantamento de registros e documentos. Análise descritiva das frequências e percentuais das ocorrências e tipologias das Reações Transfusionais, bem como da demanda e capacidade de atendimento da unidade de hemoterapia deste hospital. Resultados: frequência de 6,43% de Reações Transfusionais imediatas/1.000 hemocomponentes transfundidos. A Reação Febril Não Hemolítica e a Reação Alérgica foram as que mais ocorreram. Maior número de Reações Transfusionais foram do grau I (97,5%); os concentrados de hemácias (44,1%) e de plaquetas (41,9%) foram os hemocomponentes envolvidos na maioria das Reações Transfusionais. Conclusão: a unidade estudada mostrou capacidade de atendimento à demanda, com notificação das reações transfusionais e destaque de tais ações para contínuo aperfeiçoamento da qualidade.
Objetivo: identificar y discutir la aparición de reacciones transfusionales inmediatas, considerando el tipo de componente sanguíneo transfundido, la demanda y la capacidad de atención en un Hospital Universitario en el estado de Bahía, Brasil. Método: estudio de caso práctico, retrospectivo, cuantitativo, realizado a través de la recopilación de registros y documentos. Análisis descriptivo de las frecuencias y porcentajes de ocurrencias y tipologías de reacciones transfusiones, así como la demanda y capacidad de la unidad de hemoterapia de este hospital. Resultados: frecuencia del 6,43% de las reacciones transfusiones inmediatas/1.000 componentes sanguíneos transfundidos. La Reacción Febril No-hemolítica y la Reacción Alérgica fueron las que más ocurrieron. El mayor número de reacciones transfusionales fue el grado I (97,5%); los concentrados de glóbulos rojos (44,1%) y plaquetas (41,9%) fueron los componentes sanguíneos involucrados en la mayoría de las reacciones transfusiones. Conclusión: los resultados demostraron la importancia de comprender las potencialidades y desafíos de las familias para cuidar a los ancianos en el hogar.
Objective: to identify and discuss the occurrence of immediate transfusion reactions, considering the type of transfused blood component, demand and care capacity in a University Hospital in the state of Bahia, Brazil. Method: case, retrospective, quantitative study, performed through the collection of records and documents. Descriptive analysis of the frequencies and percentages of occurrences and typologies of Transfusion Reactions, as well as the demand and capacity of the hemotherapy unit of this hospital. Results: frequency of 6.43% of immediate Transfusion Reactions/1,000 transfused blood components. The Nonhemolytic Febrile Reaction and Allergic Reaction were the ones that most occurred. The highest number of Transfusion Reactions were grade I (97.5%); red blood cell concentrates (44.1%) and platelets (41.9%) were the blood components involved in most Transfusion Reactions. Conclusion: the unit studied showed capacity to meet the demand, with notification of transfusion reactions and highlighting such actions for continuous quality improvement.
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Humanos , Masculino , Feminino , Serviço de Hemoterapia , Segurança do Sangue , Reação Transfusional/sangue , Estudos Retrospectivos , Vigilância em Desastres , Sistemas de Informação em Saúde/estatística & dados numéricosRESUMO
CASE REPORT: A 26-year-old woman with sickle cell disease (SCD) on chronic transfusion therapy complained of severe arthralgia, myalgia, abdominal pain, headache, and fever 24 hours after transfusion of a red blood cells (RBCs). Dengue virus (DENV) infection was suspected and the patient was hospitalized for clinical support and RBC transfusion, to lower the hemoglobin S to less than 30%. The patient's clinical condition improved approximately 8 days after the onset of symptoms. RESULTS: DENV type 2 (DENV-2) TaqMan real-time polymerase chain reaction was negative in the patient's pretransfusion sample while the posttransfusion sample was positive (Ct, 27.8), suggesting a high viral load and an acute infection. To investigate DENV transfusion transmission (TT-DENV) the stored donor serum was tested and was also positive (Ct, 25.8). Molecular typing confirmed the presence of DENV-2. The phylogenetic analysis of the DENV-2 strains obtained from both donor and patient samples were classified as the Southeast Asia-American genotype (Genotype III) and demonstrated 100% genomic identity, indicating TT-DENV. CONCLUSION: This is the first description of TT-DENV in a SCD patient. A presumed high viral load in the transfused RBC unit probably determined the early clinical manifestation. In endemic regions dengue fever should be considered as differential diagnosis in SCD patients with fever and acute pain crisis, mainly during DENV outbreaks.
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Anemia Falciforme , Vírus da Dengue , Dengue , Transfusão de Eritrócitos/efeitos adversos , Vasoconstrição , Adulto , Anemia Falciforme/sangue , Anemia Falciforme/fisiopatologia , Anemia Falciforme/terapia , Dengue/sangue , Dengue/etiologia , Dengue/fisiopatologia , Feminino , Humanos , Reação Transfusional/sangue , Reação Transfusional/fisiopatologiaRESUMO
BACKGROUND: Red blood cell (RBC) transfusions are used in sickle cell disease (SCD) to treat acute complications or as chronic transfusion therapy (CTT) to prevent severe manifestations. The objectives of this study were to describe blood utilization and adverse events (AEs) associated with RBCs in the Brazilian SCD population and compare characteristics of patients treated or not with CTT. STUDY DESIGN AND METHODS: A SCD cohort was established at six Brazilian centers. Medical and blood bank records were abstracted for clinical and transfusion history. Two controls not treated with CTT matched on center, SCD genotype, sex, and age were selected for each CTT case within the cohort to compare characteristics between the two groups. RESULTS: Most of the 2794-member cohort had received a transfusion (75.0% of children and 89.2% of adults) with 29.2% of patients receiving transfusion in the prior year. There were 170 (10.6%) children and 115 (9.2%) adults treated with CTT. Children not treated with CTT were more likely to have pain and acute chest hospitalizations in the prior year (25.3% vs. 11.9%, p = 0.0003; and 22.0% vs. 10.7%, p = 0.002, respectively). Both iron overload and alloimmunization were more common in CTT cases compared to controls (65.6% vs. 17.0% and 36.2% vs. 15.9%, respectively). A higher proportion of adults treated with CTT demonstrated oxygen saturation of greater than 95% compared to controls not treated (51.1% vs. 39.2%), while there was no difference in oxygenation between children treated or not. Of 4501 transfusion episodes, 28 (0.62%) AEs were reported. There was no difference in AEs associated with transfusions for acute indications versus CTT. CONCLUSION: Red blood cell transfusion was common in Brazilian SCD patients, with utilization driven by CTT. Transfusion reactions were not common; however, alloimmunization and iron overload were frequent among those on CTT, highlighting the need for novel clinical strategies to mitigate these risks.
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Síndrome Torácica Aguda , Transfusão de Eritrócitos/efeitos adversos , Sobrecarga de Ferro , Oxigênio/sangue , Reação Transfusional , Síndrome Torácica Aguda/sangue , Síndrome Torácica Aguda/epidemiologia , Síndrome Torácica Aguda/terapia , Adolescente , Adulto , Fatores Etários , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Sobrecarga de Ferro/sangue , Sobrecarga de Ferro/epidemiologia , Sobrecarga de Ferro/etiologia , Masculino , Fatores Sexuais , Reação Transfusional/sangue , Reação Transfusional/epidemiologiaRESUMO
BACKGROUND: One of the strategies used to reduce the risk of haemolysis due to ABO-minor incompatible platelet transfusions is to perform a screening test to identify group O donors with high titres of anti-A and anti-B. However, critical immunoglobulin M/ immunoglobulin G (IgM/IgG) titres remain unclear. OBJECTIVE: This study aimed to determine IgM titres of anti-A and anti-B in individual donor serum vs platelet products plasma and identify a possible association between IgM/IgG titres, haemolysin test and IgG subclasses in Brazilian blood donors from group O. METHODS: IgM anti-A and Anti-B titration tests were performed on single-donor serum and platelet product plasma by gel agglutination (GA) at room temperature. For IgG anti-A and anti-B titration, serum was first treated with 0.01 M dithiothreitol (DTT), and the test was performed by GA with incubation at 37°C. Dilution of 1:64 as the cut-off was considered for both IgM/IgG. The qualitative haemolysin test was performed in tube, adding AB fresh serum, with incubation at 37°C. IgG subclasses were determined by GA using specific monoclonal antibodies. RESULTS: An association between anti-A and anti-B IgM titres and haemolysin were demonstrated (P < .001). IgM titres in plasma samples from platelet components correlated to those in single-serum samples. IgG1/IgG3 subclasses were associated with total haemolysis and titres above 64, whereas IgG2/IgG4 subclasses were associated with the absence of haemolysis and titres below 64 (P < .001). CONCLUSION: Our data suggest that a value of 64 as a critical titre can be used as a screening test of anti-A and anti-B IgM to prevent transfusion reactions. This can be a safe and cost-effective approach for managing ABO-incompatible platelet transfusions.
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Sistema ABO de Grupos Sanguíneos/sangue , Proteínas Hemolisinas/sangue , Hemólise , Imunoglobulina G/sangue , Isoanticorpos/sangue , Reação Transfusional , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transfusão de Plaquetas , Reação Transfusional/sangue , Reação Transfusional/prevenção & controleRESUMO
Hemovigilância pode ser definida como um conjunto de procedimentos de inspeção da cadeia transfusional. Esta obtém e processa informações de efeitos colaterais ou inesperados, resultantes do uso terapêutico de componentes lábeis do sangue e hemoderivados. O objetivo do estudo foi identificar e mapear a incidência de reações transfusionais que ocorram nos setores de um hospital de urgências de grande porte do estado de Goiás por meio das notificações realizadas no Notivisa, no período da sua inauguração em 2015 a julho de 2019. Trata-se de um estudo quantitativo, descritivo e transversal. A coleta de dados foi realizada através das fichas de notificação de incidentes transfusionais no Sistema de Informação Notivisa. Como resultado foi observado que o concentrado de hemácias é o componente sanguíneo que ocasionou mais reações transfusionais, onde a maioria das reações foi classificada como imediatas, em pacientes do sexo masculino com idade acima de 60 anos
Hemovigilance can be defined as a set of procedures for inspecting the transfusion chain. It obtains and processes information on side or unexpected effects resulting from the therapeutic use of labile blood components and blood products. The objective of the study was to identify and map the incidence of transfusion reactions that occur in the sectors of a large emergency hospital in the state of Goiás through the notifications made at Notivisa, during the period of its inauguration in 2015 to July 2019. A quantitative, descriptive and cross-sectional study. Data collection was performed using the transfusion incident notification forms in the Notivisa Information System. As a result, it was observed that the red blood cell concentrate is the blood component that caused the most transfusion reactions, where most reactions were classified as immediate, in male patients over the age of 60 years
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Transfusão de Sangue , Segurança do Sangue , Reação Transfusional/sangue , Gestão de Riscos , Notificação de Doenças , Agência Nacional de Vigilância Sanitária , Sistemas de Informação em Saúde , Dano ao PacienteRESUMO
BACKGROUND: Confidential unit exclusion (CUE) was introduced in the 1980's as an additional layer to blood safety, before highly specific and sensitive nucleic acid tests (NAT) for HIV were implemented. The utility of CUE-use in settings that have implemented NAT should be evaluated over time. STUDY DESIGN, METHODS: Cross-sectional retrospective study carried out from June 2010-November 2015, at Manaus Hemocenter (HEMOAM), Amazonas, Brazil that implemented HIV-NAT in 2012. The HIV, HCV, HBV, HTLV, Chagas disease, and syphilis rates were compared among CUE and non-CUE blood donors, before and after HIV-NAT implementation. RESULTS: Among 287,588 donations, 2,154 (0.75%) were associated with CUE, mainly voluntary donations (64.2%), by repeat donors (58.4%) from young (median age = 31 years), males (84.4%), unmarried (63.1%). CUE-users compared to non-CUE donors (n = 285,434) had higher seropositivity rates to HIV (OR = 6.09, 95% CI: 3.68-10.07, p < 0.001), HBV (anti-HBc OR = 1.81 95% CI: 1.24-2.64, p = 0.004; HBsAg OR = 5.68, 95% CI: 1.78-18.07, p = 0.017), and syphilis (OR = 1.78, 95% CI: 1.05-3.04, p = 0.030). Most (97.2%) discarded blood units associated to CUE was seronegative for all pathogens. Most donations (73.4%) were tested by HIV-NAT and showed four window period donations, positive by HIV-NAT only among non-CUE donors. CONCLUSION: A high rate of transfusion transmissible infections/TTIs was observed at HEMOAM especially in CUE-users. CUE-use offered an additional layer of blood safety by its association with anti-HBc/HBsAg and syphilis that are not covered by NAT. For blood banks in highly endemic areas for HIV and TTI, as HEMOAM, the identification of at risk donors, and the orientation to be tested at proper sites remain a great challenge.
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Segurança do Sangue , DNA Bacteriano/sangue , DNA Viral/sangue , Infecções por HIV , HIV-1 , Hepatite B , Técnicas de Amplificação de Ácido Nucleico , Sífilis , Reação Transfusional , Adolescente , Adulto , Biomarcadores/sangue , Brasil/epidemiologia , Criança , Feminino , Infecções por HIV/sangue , Infecções por HIV/epidemiologia , Anticorpos Anti-Hepatite B/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sífilis/sangue , Sífilis/epidemiologia , Reação Transfusional/sangue , Reação Transfusional/epidemiologiaRESUMO
INTRODUCCIÓN: la transmisión de enfermedades infecciosas a través de las transfusiones sanguíneas constituye un tema de gran importancia, por lo que es necesario aumentar la seguridad de la sangre y sus componentes en cada donación. OBJETIVO: caracterizar a los donantes de sangre positivos a enfermedades infecciosas. MÉTODOS: estudio observacional, transversal en el cual se analizó una muestra de 989 donantes que concurrieron al banco de sangre del Hospital Militar Central "Dr. Carlos J. Finlay" entre enero y marzo de 2014. Se utilizó para la determinación de los marcadores serológicos la tecnología del sistema ultramicroanalítico (SUMA) y el método de aglutinación en porta. RESULTADOS: se alcanzó una incidencia de AgsHB 1 %, VHC 2,3 %, VIH 3,4 % y VDRL 2,3 %; estas cifras se correspondieron con la mayor positividad obtenida en los meses de febrero y marzo. En los casos positivos predominó el sexo masculino. La mayoría de los seropositivos se encontraron en el grupo etario de 18-28 años. CONCLUSIONES: la incidencia de los marcadores serológicos mostró una tendencia al incremento durante el período analizado. Los donantes de sangre de menor edad y del sexo masculino fueron los de mayor seropositividad.
INTRODUCTION: the transmission of infectious diseases through blood transfusions has been a problem of great importance for many years. For this reason it is necessary to increase safety of blood and its components in every donation. OBJECTIVE: to characterize the blood donors, positive to infectious diseases. METHODS: observational cross-sectional study of 989 donors, who went to the blood bank of "Dr. Carlos J. Finlay" central military hospital from January to March, 2014. The ultramicroanalytical technology known as SUMA and the agglutination method were used to determine the serological markers. RESULTS: the incidence was as follows: HBAgs 1 %, HCV 2.3 %, HIV 3.4 % and VDRL 2.3 %. These figures accounted for the highest positivity index obtained in February and March. The positive cases were fundamentally men. Most of the seropositive cases were young people aged 18 to 28 years. CONCLUSIONS: the incidence of the serological markers showed an increasing tendency in the analyzed period. The younger blood donors of the male sex showed bigger seropositivity.