Uyoga, S;
Mpoya, A;
Olupot-Olupot, P;
Kiguli, S;
Opoka, RO;
Engoru, C;
Mallewa, M;
... Maitland, K; + view all
(2019)
Haematological quality and age of donor blood issued for paediatric transfusion to four hospitals in sub-Saharan Africa.
Vox Sanguinis
, 114
(4)
pp. 340-348.
10.1111/vox.12764.
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Abstract
BACKGROUND AND OBJECTIVES: Paediatric blood transfusion for severe anaemia in hospitals in sub-Saharan Africa remains common. Yet, reports describing the haematological quality of donor blood or storage duration in routine practice are very limited. Both factors are likely to affect transfusion outcomes. MATERIALS AND METHODS: We undertook 3 audits examining the distribution of pack types, haematological quality and storage duration of donor blood used in a paediatric clinical trial of blood at four hospitals in Africa (Uganda and Malawi). RESULTS: The overall distribution of whole blood, packed cells (plasma-reduced by centrifugation) and red cell concentrates (RCC) (plasma-reduced by gravity-dependent sedimentation) used in a randomised trial was 40.7% (N=1215), 22.4% (N=669) and 36.8% (N=1099) respectively. The first audit found similar median haematocrits of 57.0% (50.0,74.0), 64.0% (52.0,72.5; p=0.238 vs whole blood) and 56.0% (48.0,67.0; p=0.462) in whole blood, RCC and packed cells respectively, which resulted from unclear pack labelling by blood transfusion services (BTS). Retraining of the BTS, hospital blood banks and clinical teams led to, in subsequent audits, significant differences in median haematocrit and haemoglobins across the 3 pack types and values within expected ranges. Median storage duration time was 12 days (IQR 6,19) with 18.2% (537/2964) over 21 days in storage. Initially, 9 (2.8%) packs were issued past the recommended duration of storage, dropping to 0.3% (N=7) in the third audit post training. CONCLUSION: The study highlights the importance of close interactions and education between BTS and clinical services and the importance of haemovigilence to ensure safe transfusion practice.
| Type: | Article |
|---|---|
| Title: | Haematological quality and age of donor blood issued for paediatric transfusion to four hospitals in sub-Saharan Africa |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/vox.12764 |
| Publisher version: | https://doi.org/10.1111/vox.12764 |
| Language: | English |
| Additional information: | Copyright © 2019 The Authors. Vox Sanguinis published by John Wiley & Sons Ltd on behalf of International Society of Blood Transfusion This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Anaemia, blood transfusion services, haemoglobin, haematocrit, donor blood pack |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10066845 |
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