Hemovigilance network in France: organization and analysis of immediate transfusion incident reports from 1994 to 1998.
BACKGROUND
Hemovigilance networks have been introduced in several countries to improve knowledge of blood transfusion-related morbidity and mortality. The general organization of the French network and its results from 1994 through March 1999 are presented here.


METHODS
The hemovigilance network relies on blood transfusion centers and hospital correspondents, who analyze unexpected and untoward blood transfusion-related effects and transmit a Transfusion Incident Report (TIR) to a national database (Transfusion Incident Reports Electronic Data Management [GIFIT]).


RESULTS
As of March 1, 1999, the GIFIT database contained 24,234 TIRs related to incidents that occurred from the start of the hemovigilance network until December 31, 1998. The network was not fully implemented until 1996; but the reporting rate seems to have since stabilized at approximately 7000 per year (2.5 reports per 1000 blood components). The highest reporting rate is observed with platelet concentrates (4.02/1000), followed by RBCs (1.71/1000) and FFP (0.34/1000). Bacterial contamination quickly appeared as a major cause of morbidity and mortality (185 cases and 18 fatalities). However, a general trend of reduction in this type of incident was observed over time, which can be attributed to adoption of several preventive measures. In contrast, major ABO mismatchings during RBC transfusion remained at a constant rate throughout this period and accounted for six fatalities. After the implementation of universal WBC reduction, some incidents known to be related to WBCs, such as nonhemolytic febrile transfusion reactions (NHFTR) and HLA immunization, were dramatically reduced.


CONCLUSIONS
Hemovigilance is an important tool not only to analyze blood transfusion incidents, but also to measure the effects of new processes or corrective actions at a national level.
Andreu
Georges
G
French Blood Establishment-Atlantique Region, 2 Boulevard Tonnellé, 37020 Tours Cedex, France. georges.andreu@efs.sant.fr
Morel
Pascal
P
Forestier
François
F
Debeir
Joëlle
J
Rebibo
Danielle
D
Janvier
Gérard
G
Hervé
Patrick
P
D001424:Bacterial Infections / Q000453:epidemiology / Q000209:etiology; D001771:Blood Banks / Q000458:organization & administration* / Q000706:statistics & numerical data; D016913:Blood Component Transfusion / Q000009:adverse effects / Q000706:statistics & numerical data; D001787:Blood Group Incompatibility / Q000401:mortality; D001803:Blood Transfusion / Q000706:statistics & numerical data; D016208:Databases, Factual; D005334:Fever / Q000453:epidemiology / Q000209:etiology; D005568:Forms and Records Control; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000458:organization & administration; D007962:Leukocytes; D019300:Medical Errors; D012308:Risk Management / Q000458:organization & administration* / Q000706:statistics & numerical data; D012449:Safety; D012720:Severity of Illness Index; D065227:Transfusion Reaction