The Hemovigilance system has registered adverse reactions after transfusion in Norway since 2004. 119 adverse reactions after blood transfusion were reported in 2020, 57 per 100 000 transfused units. Geographical distribution of adverse reactions after blood transfusion are similar to the regional distribution of blood transfusions. Forty-five per cent of adverse reactions after blood transfusion are reported in women.
In 2020 the distribution of adverse reactions after blood transfusion is as follows;
- 36 (30.3 %) mild allergic reactions
- 23 (19.3 %) severe febrile non-hemolytic transfusion reactions (FNHTR)
- 13 (10.9 %) anaphylactic reactions
- 12 (10.1 %) «cannot conclude» reactions
- 11 (9.2 %) transfusion associated circulatory overload reactions (TACO)
- 10 (8.4 %) hypotensive transfusion reactions
- 6 (5.0 %) unclassifiable complication
- 3 (2.5 %) transfusion-associated dyspnea (TAD)
- 5 (4.0 %) other reactions.
One acute hemolytic transfusion reaction (AHTR) due to ABO incompatibility were reported, but there were no reports of transfusion related acute lung injury (TRALI), post-transfusion purpura (PTP), transfusion transmitted infections (TTI) or graft-versus-host disease (TA-GVHD).
Most adverse reactions after blood transfusion are reported from medical wards (49.6 %), but some did also occur in surgical- or pediatric wards (21 % and 15,1 % of all respectively). 19.3 % of the adverse reactions after blood transfusion were serious, 5.9% were life-threatening and there was one death with imputability level of 1.
There were more anaphylactic reactions after transfusion in 2020 than in 2019. Two of the seven life-threatening adverse reactions were of this type. It is important to have focus on these reactions, as early detection and treatment might improve the prognosis. It is however, often difficult to find the cause of the anaphylactic reactions, as many patients receive many drugs and blood products simultaneously. A good interdepartmental cooperation is important to succeed in this task.