The role and impact of the transfusion medicine consultation service in the management of patients in the hematopoietic transplant service: A retrospective analysis.
BACKGROUND
Adverse reactions secondary to transfusion of incorrect blood components can be fatal. We have established numerous processes to prevent these reactions in patients with cancer who continuously need blood component support, especially hematopoietic transplant recipients. The development of an active transfusion medicine consultation service at our institution to serve patients undergoing hematopoietic transplantation has led to more organized and simpler management of providing blood components to such patients.


METHODS
Safety tools were employed to attain our goal of providing safe blood components to hematopoietic transplant recipients. These tools were consultation request forms, blood component selection stickers on the patients' charts, and transfusion medicine physician consultation notes posted in the patients' medical records. One hundred randomly selected hematopoietic transplant recipients were reviewed over 16 months. Fifty patients received blood components from ABO-compatible donors, whereas the other 50 patients received components from ABO-incompatible donors. Deviation reports regarding the issuance of blood components in these patients over the study period were reviewed retrospectively.


RESULTS
We identified eight reported deviations from the recommended blood components: red blood cells in one case, fresh frozen plasma in one case, single donor platelets in one case, and random donor platelets in five cases. Our transfusion service issued all eight components, but none of them were transfused. In all eight cases, the blood components were intended for transfusion to ABO-mismatched hematopoietic transplant recipients. Nurses identified the incorrect blood components by verifying the recommended blood groups on the patients' chart stickers, returned the components to the transfusion service, and transfused the correct blood components.


CONCLUSIONS
Use of these safety tools has improved the safety culture regarding transfusion of blood components in hematopoietic transplant recipients at our institution.
Narvios
A
A
Department of Laboratory Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, 77030, USA. anarvios@mdanderson.org
Rodriguez-Jackson
L
L
Reddy
V
V
Lichtiger
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D016913:Blood Component Transfusion / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D017707:Erythrocyte Transfusion; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006650:Histocompatibility Testing; D006801:Humans; D008875:Middle Aged; D010949:Plasma; D012017:Referral and Consultation / Q000458:organization & administration*; D012189:Retrospective Studies; D012308:Risk Management / Q000379:methods; D014184:Transplantation, Homologous / Q000009:adverse effects