Impact of buffy coat reduction on the severity of febrile nonhemolytic transfusion reactions with red cell components

BACKGROUND: Febrile nonhemolytic transfusion reactions (FNHTRs) are the most common adverse reaction reported under the Haemovigilance Programme of India, and the use of leukodepleted blood products is recommended. The severity of the reaction may affect the morbidity associated with the reaction. T...

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Main Authors: Lakhvinder Singh, Nippun Prinja, Ashish Jain, Ratti Ram Sharma, Neelam Marwaha
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Asian Journal of Transfusion Science
Subjects:
Online Access:http://www.ajts.org/article.asp?issn=0973-6247;year=2023;volume=17;issue=1;spage=69;epage=73;aulast=Singh
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author Lakhvinder Singh
Nippun Prinja
Ashish Jain
Ratti Ram Sharma
Neelam Marwaha
author_facet Lakhvinder Singh
Nippun Prinja
Ashish Jain
Ratti Ram Sharma
Neelam Marwaha
author_sort Lakhvinder Singh
collection DOAJ
description BACKGROUND: Febrile nonhemolytic transfusion reactions (FNHTRs) are the most common adverse reaction reported under the Haemovigilance Programme of India, and the use of leukodepleted blood products is recommended. The severity of the reaction may affect the morbidity associated with the reaction. This study aims to calculate the incidence of various transfusion reactions in our blood center and to evaluate the impact of buffy coat reduction on the severity of febrile reaction and other hospital resource-consuming activities. MATERIALS AND METHODS: It was an observational retrospective study in which all reported FNHTRs were evaluated during the period July 1, 2018–July 31, 2019. Patient demographic details, component transfused, and clinical presentation were analyzed to identify factors affecting the severity of FNHTRs. RESULTS: The incidence of transfusion reaction in our study period was 0.11%. Out of total 76 reactions reported, 34 (44.7%) were febrile reactions. Other reactions included allergic reactions (36.8%), pulmonary reactions (9.2%), transfusion-associated hypotension (3.9%), and others (2.7%). The incidence of FNHTR in buffy coat-depleted packed red blood cells (PRBCs) and PRBCs is 0.03% and 0.05%, respectively. FNHTRs are seen more in females with prior history of transfusion (87.5%) as compared to males (66.67%) (P = 0.046). We also found that FNHTRs are less severe with buffy coat-depleted PRBC transfusion than PRBC transfusion as mean ± standard deviation temperature rise was less in buffy coat-depleted PRBC (1.3 ± 0.8) than PRBC (1.74 ± 1.129). The febrile response to buffy coat-depleted PRBC transfusion occurred at higher volume (145 ml) transfusion than PRBC transfusion (87.2 ml), and it was statistically significant (P = 0.047). CONCLUSION AND SUMMARY: Leukoreduction remains the main modality to prevent FNHTR, but in developing countries like India, the use of buffy coat-depleted PRBC over PRBC can reduce the incidence and severity of FNHTR.
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spelling doaj.art-cf118ff43a374478aac04fe2d272f1622023-03-21T07:27:37ZengWolters Kluwer Medknow PublicationsAsian Journal of Transfusion Science0973-62471998-35652023-01-01171697310.4103/ajts.ajts_90_22Impact of buffy coat reduction on the severity of febrile nonhemolytic transfusion reactions with red cell componentsLakhvinder SinghNippun PrinjaAshish JainRatti Ram SharmaNeelam MarwahaBACKGROUND: Febrile nonhemolytic transfusion reactions (FNHTRs) are the most common adverse reaction reported under the Haemovigilance Programme of India, and the use of leukodepleted blood products is recommended. The severity of the reaction may affect the morbidity associated with the reaction. This study aims to calculate the incidence of various transfusion reactions in our blood center and to evaluate the impact of buffy coat reduction on the severity of febrile reaction and other hospital resource-consuming activities. MATERIALS AND METHODS: It was an observational retrospective study in which all reported FNHTRs were evaluated during the period July 1, 2018–July 31, 2019. Patient demographic details, component transfused, and clinical presentation were analyzed to identify factors affecting the severity of FNHTRs. RESULTS: The incidence of transfusion reaction in our study period was 0.11%. Out of total 76 reactions reported, 34 (44.7%) were febrile reactions. Other reactions included allergic reactions (36.8%), pulmonary reactions (9.2%), transfusion-associated hypotension (3.9%), and others (2.7%). The incidence of FNHTR in buffy coat-depleted packed red blood cells (PRBCs) and PRBCs is 0.03% and 0.05%, respectively. FNHTRs are seen more in females with prior history of transfusion (87.5%) as compared to males (66.67%) (P = 0.046). We also found that FNHTRs are less severe with buffy coat-depleted PRBC transfusion than PRBC transfusion as mean ± standard deviation temperature rise was less in buffy coat-depleted PRBC (1.3 ± 0.8) than PRBC (1.74 ± 1.129). The febrile response to buffy coat-depleted PRBC transfusion occurred at higher volume (145 ml) transfusion than PRBC transfusion (87.2 ml), and it was statistically significant (P = 0.047). CONCLUSION AND SUMMARY: Leukoreduction remains the main modality to prevent FNHTR, but in developing countries like India, the use of buffy coat-depleted PRBC over PRBC can reduce the incidence and severity of FNHTR.http://www.ajts.org/article.asp?issn=0973-6247;year=2023;volume=17;issue=1;spage=69;epage=73;aulast=Singhdirect antiglobulin testfebrile nonhemolytic transfusion reactionhaemovigilance programme of indiainternational society of blood transfusionpacked red blood cellssagm packed red blood cellstumor necrosis factor
spellingShingle Lakhvinder Singh
Nippun Prinja
Ashish Jain
Ratti Ram Sharma
Neelam Marwaha
Impact of buffy coat reduction on the severity of febrile nonhemolytic transfusion reactions with red cell components
Asian Journal of Transfusion Science
direct antiglobulin test
febrile nonhemolytic transfusion reaction
haemovigilance programme of india
international society of blood transfusion
packed red blood cells
sagm packed red blood cells
tumor necrosis factor
title Impact of buffy coat reduction on the severity of febrile nonhemolytic transfusion reactions with red cell components
title_full Impact of buffy coat reduction on the severity of febrile nonhemolytic transfusion reactions with red cell components
title_fullStr Impact of buffy coat reduction on the severity of febrile nonhemolytic transfusion reactions with red cell components
title_full_unstemmed Impact of buffy coat reduction on the severity of febrile nonhemolytic transfusion reactions with red cell components
title_short Impact of buffy coat reduction on the severity of febrile nonhemolytic transfusion reactions with red cell components
title_sort impact of buffy coat reduction on the severity of febrile nonhemolytic transfusion reactions with red cell components
topic direct antiglobulin test
febrile nonhemolytic transfusion reaction
haemovigilance programme of india
international society of blood transfusion
packed red blood cells
sagm packed red blood cells
tumor necrosis factor
url http://www.ajts.org/article.asp?issn=0973-6247;year=2023;volume=17;issue=1;spage=69;epage=73;aulast=Singh
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