Investigação das reações transfusionais imediatas em pacientes politransfundidos no Hemocentro do estado do Amazonas

Abstract

Transfusion reactions are adverse events that occur during or after blood transfusion, causing fever and allergies, among other more serious symptoms, and can be detected within a period of up to 24 hours after allogeneic exposure, directly interfering in the patient's clinical condition. Hematological patients who undergo a large number of blood transfusion procedures are more exposed to the occurrence of transfusion reactions and their associated risks. Objective: To characterize the immediate adverse events related to blood transfusion in hematological patients and polytransfused patients at the blood center of the state of Amazonas. Methodology: This is a prospective descriptive observational study of a longitudinal cohort, where adverse events that occur in polytransfused patients were investigated over a period of 2 years at the Blood Center of Amazonas. Patients were invited to participate in the study when they attended the blood center to receive a transfusion. After signing the informed consent form, a brief interview was conducted to verify whether they met the inclusion criteria for the study. Patients admitted to the blood center were approached in the Transfusion, Chemotherapy and Inpatient wards or in outpatient care in the Transfusion sector. Transfusions were monitored throughout their course. Through an active search by means of telephone calls 24 hours after the transfusion procedure, patients who were not hospitalized were then monitored to record their clinical condition and the occurrence of signs and symptoms of immediate transfusion reactions. Results: The study monitored 200 transfusions, in which 42 cases of Adverse Events to Transfusion were recorded, 7 of which were recorded as Immediate Transfusion Reactions. The study also demonstrated that male patients, children and elderly individuals over 60 years of age, diagnosed with AML and ALL are those who most often present with transfusion reactions, where the most common symptom was fever, followed by hypertension. Transfusions that frequently resulted in immediate adverse events were transfusions of filtered and irradiated red blood cell concentrate, generally with a transfusion indication due to anemia, and mostly from the ABO/Rh group “O+” or “A+”. There was no correlation between sex, age, diagnosis, indication, type of blood component transfused or ABO group of the blood component used and the occurrence of reactions. This study identified a total of 21% of RTs, with an 83% underreporting of cases. Conclusions: With the research data, it was possible to characterize the hematologic and polytransfused patients treated at the Amazonas blood center, also characterizing their transfusions and reactions presented, presenting a picture of symptoms characteristic of immediate RT at the moments during, after 30 minutes and within 24 hours of the transfusion and better understanding the associations between these variables and the presentation of these symptoms, thus contributing to the improvement of transfusion safety not only in the service of the Amazonas state but also in the hemotherapy service throughout Brazil.