Transfusion risks and hemovigilance policy

Hemovigilance is defined as a system of surveillance and alarm in the transfusion field. A database of transfusion adverse events in Switzerland has been created. The goal of such a system is to prevent the recurrence of incidents by identifying their cause(s).

As with any medical procedure, the benefits for the recipient must outweigh the risks of blood transfusions.

About 0.5% to 3% of all transfusions result in some adverse events, but the majority of these are minor reactions with no significant consequences. A significant proportion of adverse events occurs as a result of errors in ordering or administration of blood products.

Infectious risks of transfusion

Currently, the risk of transmission of infectious diseases through transfusion in Switzerland is extremely small. Nevertheless, many infectious agents, including viruses, bacteria, and parasites (malaria, trypanosomes) can be transmitted through blood transfusion, prions apparently too.

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Noninfectious risks of transfusion

Noninfectious adverse events remain the most common complications associated with transfusion. The majority of these are immune mediated. Acute immune mediated reactions include acute hemolytic transfusion reaction, febrile non hemolytic transfusion reaction, urticarial reaction, transfusion-related acute lung injury (TRALI) and anaphylaxis. TRALI is supposed to be essentially caused by blood products containing antibodies reacting with patient's leucocytes. Delayed immune mediated reactions consist of delayed hemolytic transfusion reaction, transfusion associated graft-versus-host disease, and posttransfusion purpura (thrombocytopenia).

Nonimmune transfusion reactions include hyperkalemia, hypocalcemia, hypothermia, iron overload, circulatory overload and air embolus. Many of these reactions (and almost all severe acute hemolytic transfusion reactions) are error-related.

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