A Comparative Study of Transfusion Reactions in the Thalassemia Patients before and after Implementation of the Hemovigilance System in Yazd Province, Iran

Background: Patients with thalassemia major require frequent blood transfusions. Blood transfusion can lead to the adverse reactions. Reporting and evaluating the transfusion reactions are among the goals of implementing the hemovigilance system to improve blood recipients’ safety. This study aimed to compare the transfusion reactions in the thalassemia patients before and after implementation of the hemovigilance system in the Shahid Sadoughi Hospital in Yazd (Iran). Materials and Methods:  In this historical cohort study conducted in 2018, the data of 87 patients with thalassemia major including age, sex, the total number of blood transfusions before and after the implementation of hemovigilance system, information about the occurrence of blood transfusion reactions, type, and severity of each reaction were recorded in the questionnaire. Paired-Samples T-test and Chi-Square test were used for data analysis. Results: The mean age of the participants was equal to 19.69±8.41 years old and 52% of them were male. The age of onset of transfusion was 14.3±16.62 months with a range of 2 - 96 months. The relative frequency of transfusion reactions in the thalassemia patients was 0.74% and 0.81%, respectively before and after implementation of the hemovigilance system. Allergic (54%) and non-hemolytic febrile reactions (23%) were the most frequent transfusion reactions. Severe and life-threatening reactions were reported more frequently after implementation of the hemovigilance system compared to pre-implementation (p=0.007). Totally, 8% of the reactions were hemolytic reactions and 7.5% of the patients had unexpected alloantibodies identified after implementation of the hemovigilance system. Conclusion: Documentation and reporting of the transfusion reactions after implementation of the hemovigilance system have resulted in reporting of more severe reactions and determination of the clinically significant alloantibodies. Therefore, prevention of the subsequent reactions and increasing the safety of the blood transfusion for the thalassemia patients could be provided, emphasizing the continuation of the system.