How I reduce the risk of missed irradiation transfusion events in children

Delaney, Meghan

doi:10.1111/trf.14882

Cited by 10 publications

(6 citation statements)

References 14 publications

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“…Further, rapid visualization of the RBC units' irradiation status was especially important for our workflows because of our universal irradiation policy for RBC products. We select units with the shortest storage period following irradiation for young patients to reduce the risk of transfusion‐associated hyperkalemia 4 . The RFID system makes these complex selection strategies easy to do.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency identification tracking system (RFID) significantly improves blood bank inventory management and decreases staff work effort

da Souza,

Flores,

Millendez

et al. 2024

Transfusion

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BackgroundBefore implementation of the radio frequency identification (RFID) system, there was a high loss rate of 4.0%–4.3% of red blood cell (RBC) units every year expiring on the shelf in our transfusion service laboratory. We introduced RFID technology to improve inventory management and the burden of work on the staff. The goal of this study was to evaluate the impact of RFID technology on the inventory management of RBC units and the staff workload in a transfusion service laboratory.Study Design and MethodsUsing an RFID system involves encoding RBC units with an RFID tag capturing information such as donor identification number, product code, blood type, expiration date, product volume, and negative antigen(s). Tag information is collected through retrofitted storage shelves linked to the RFID server. The study analyzed RBC usage by unit and by volume (mL) and staff work effort to carry out inventory management tasks before and after the implementation of the RFID system.ResultsImplementation of the RFID technology reduced the loss, or discard, of RBC units to less than 1% annually (a statistically significant change, p < .001). The RFID computer dashboard provides a constant visual update of the inventory, allowing technologists to have accurate product counts and reducing their work burden.DiscussionImplementation of RFID technology substantially reduced RBC product loss, improved inventory management, and lessened staff work burden.

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Section: Discussionmentioning

confidence: 99%

Radiofrequency identification tracking system (RFID) significantly improves blood bank inventory management and decreases staff work effort

da Souza,

Flores,

Millendez

et al. 2024

Transfusion

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“…50 Management of various special transfusion requirements is challenging, and therefore some institutions may use universal irradiation as the policy to minimize the risk. 51 Fatal TA-GVHD occurred at the time we used the selective irradiation approach, and due to incorrect communication with transfusion service, a PC that was not irradiated was transfused to a patient at risk for TA-GVHD. After the occurrence of this reaction, universal irradiation was introduced for all hematological patients.…”

Section: Discussionmentioning

confidence: 99%

Changes in the incidence of transfusion reactions in hematological patients over the past 30 years

et al. 2022

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Background Patients with hematological diseases are polytransfused and often immunocompromised, therefore susceptible to transfusion reactions (TR). This study aims to document the incidence of TRs in adult hematological patients and assess the effect of changes in the production of blood components and transfusion practice on their occurrence. Study design and methods Retrospective observational analysis of TRs reported from 1993 to 2019 was performed. For the analysis of the effect of changes on the incidence of TRs, the evaluated time was divided into two periods: the 1st period before the introduction of changes in production, when leukoreduced blood components were used only selectively, and the 2nd period, when semi‐automated method of production and universal leukoreduction was introduced. Results The decrease in the incidence of TRs was observed for both red blood cell (RBC) and platelet concentrate (PC) transfusions in the 2nd period. Since platelet additive solution has been used, a further decrease in the incidence was reported. The decrease in incidence was also observed for delayed hemolytic/serological transfusion reactions and for transfusion‐transmitted bacterial infections. Four cases of incorrect blood transfusions were uniquely related to the hematological patients, caused by antigen loss and transfusion ordering after ABO‐incompatible hematopoietic stem cell transplantation. Discussion Our results provided evidence that the introduction of tools offered by modern transfusion medicine: universal leukodepletion, plasma replacement with additive solutions, sensitive laboratory techniques, prophylactic antigen matching policy, informatization, and automatization, decreased the incidence of TRs and improved transfusion safety.

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“…Despite protocols to identify patients at risk of TA‐GVHD who need irradiated blood products, missed irradiation events still occur 2 . Given this problem, some institutions have adopted a policy of universal irradiation of blood products for all patients to prioritize safety 3 …”

Section: Introductionmentioning

confidence: 99%

“…2 Given this problem, some institutions have adopted a policy of universal irradiation of blood products for all patients to prioritize safety. 3 While irradiation effectively prevents TA-GVHD, it may have other deleterious consequences on transfusion efficacy and outcomes. Irradiation disrupts the red blood cell (RBC) membrane integrity, increasing extracellular potassium and free hemoglobin and decreasing red cell adenosine triphosphate.…”

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confidence: 99%

Impact of universal irradiation on chronic transfusion for sickle cell disease

et al. 2021

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Background Irradiation of blood products prevents transfusion‐associated graft‐versus‐host disease, but most patients do not require this modification which could have an adverse impact on transfusion outcomes. We hypothesized that irradiation may increase transfusion requirements for patients with sickle cell disease (SCD) receiving chronic transfusion. Study Design and Methods Our pediatric hospital implemented a new policy of universal blood product irradiation in May 2018. We conducted a retrospective chart review of patients with SCD receiving chronic red blood cell (RBC) transfusion throughout the year before and after institution of this policy. The primary outcome was the change in RBC transfusion volume per patient weight transfused during the pre‐ vs. post‐ universal irradiation period. Secondary outcomes were the change in median pretransfusion laboratory values. Results Among 17 patients, 8 (47%) received more RBCs the year before irradiation and 9 (53%) received more the year after irradiation. Implementation of universal irradiation did not significantly increase transfusion volumes needed to clinically manage this population (median change +1.7 ml/kg/year, p = .54). Additionally, there were no significant changes in absolute reticulocyte count, hemoglobin, hemoglobin S%, white blood cell count, lactate dehydrogenase, total bilirubin, serum potassium, and ferritin during the two time periods. Conclusion In a cohort of patients with SCD receiving simple chronic transfusion, irradiation did not impact transfusion requirements or pertinent pretransfusion laboratory values. Irradiation does not appear to have clinically significant consequences for SCD chronic transfusion management.

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How I reduce the risk of missed irradiation transfusion events in children

Cited by 10 publications

References 14 publications

Radiofrequency identification tracking system (RFID) significantly improves blood bank inventory management and decreases staff work effort

Radiofrequency identification tracking system (RFID) significantly improves blood bank inventory management and decreases staff work effort

Changes in the incidence of transfusion reactions in hematological patients over the past 30 years

Impact of universal irradiation on chronic transfusion for sickle cell disease

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