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Haematological quality and age of donor blood issued for paediatric transfusion to four hospitals in sub-Saharan Africa

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Title: Haematological quality and age of donor blood issued for paediatric transfusion to four hospitals in sub-Saharan Africa
Authors: Uyoga, S
Mpoya, A
Olupot-Olupot, P
Kiguli, S
Opoka, RO
Engoru, C
Mallewa, M
Kennedy, N
M'baya, B
Kyeyune, D
Wabwire, B
Bates, I
Gibb, DM
Walker, AS
George, EC
Williams, TN
Maitland, K
Item Type: Journal Article
Abstract: Background and ObjectivesPaediatric 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 MethodsWe undertook 3 audits examiningthe 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). ResultsThe 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=0.238vs whole blood) and 56.0% (48.0,67.0;p=0.462) in whole blood, RCCand 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 medianhaematocrit 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%)packswere issued past the recommended duration of storage, dropping to 0.3%(N=7) in the third audit post training. ConclusionThe study highlights the importance of close interactions and education between BTS and clinical services and the importance of haemovigilence to ensure safe transfusion practice.
Issue Date: 1-May-2019
Date of Acceptance: 28-Jan-2019
URI: http://hdl.handle.net/10044/1/67291
DOI: 10.1111/vox.12764
ISSN: 0042-9007
Publisher: Wiley
Start Page: 340
End Page: 348
Journal / Book Title: Vox Sanguinis
Volume: 114
Issue: 4
Copyright Statement: © 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.
Sponsor/Funder: Medical Research Council (MRC)
Medical Research Council
Wellcome Trust
MRC Australia
Engineering & Physical Science Research Council (EPSRC)
Medical Research Council (MRC)
Imperial College London
Wellcome Trust
Wellcome Trust
Funder's Grant Number: MR/J012483/1
MR/J012483/1
203077/Z/16/Z (C161)
EP/S515875/1
G0801439
100693/Z/12/Z
202800/Z/16/Z
Keywords: Science & Technology
Life Sciences & Biomedicine
Hematology
anaemia
blood transfusion services
donor blood pack
haematocrit
haemoglobin
CELLS
anaemia
blood transfusion services
donor blood pack
haematocrit
haemoglobin
Anemia
Blood Banks
Blood Donors
Blood Transfusion
Child
Hematocrit
Hematology
Hemoglobins
Hospitals
Humans
Malawi
Pediatrics
Quality Assurance, Health Care
Quality Control
Randomized Controlled Trials as Topic
Refrigeration
Reproducibility of Results
Specimen Handling
Uganda
Humans
Anemia
Hemoglobins
Hematocrit
Specimen Handling
Refrigeration
Blood Transfusion
Reproducibility of Results
Hematology
Pediatrics
Quality Control
Child
Blood Donors
Blood Banks
Hospitals
Quality Assurance, Health Care
Uganda
Malawi
Randomized Controlled Trials as Topic
Cardiovascular System & Hematology
1103 Clinical Sciences
Publication Status: Published
Online Publication Date: 2019-03-05
Appears in Collections:Department of Infectious Diseases