Evaluation of Transfusion Reactions in Thalassemic Patients Referred to the Thehran Adult Thalssemia Clinic

Background and Objectives: Thalassemia is a hereditary hemolytic anemia requiring life-long transfusion treatment. The frequent blood transfusion has some side effects, including immunologic reaetions and non-immunologics such as iron overload and transmission of some infections such as HBV, HCV and HIV. This cross-sectional study was aimed to investigate the transfusion effects in patients referred to the Adult Thalassemia Clinic, Tehran. Materials and Methods: For data collection, the patients were asked for the history of transfusion reactions, their files of medical records were surveyed with concern to transfusion status and reactions, and some laboratory data including serum ferritin and TTI were also collected. The results were analyzed using SPSS software. Results: Foun hundreds and forty one patients comprises of ۵۳% males and ۴۷% females with mean age of ۲۲.۶ years were studied. They consisted of ۳۶۲ (۸۲.۱%) thalassemia major and ۷۹ (۱۷.۹%) thalassemia intermediate. The mean of ferritin level was ۱۸۵۶.۴ ng/dl. From the studied subjects, ۷ (۱.۶%) had history of delayed hemolytic disorder, ۲۵ (۶.۱%) presented with allergy and ۴۱ (۹.۹%) showed febrile transfusion reaction. The remaining ۳۶۸ subjects (۸۲.۴%) showed no evidence of transfusion reactions. The records showed that ۱۱۷ patients (۲۸.۴%) were HCV Ab positive, ۳۶۹ (۸۸.۷%) were HBsAb positive and ۸۰ (۱۹.۲%) were HBcAb positive, ۳(۰.۷%) HBsAg positive. According to this results, ۳۰۰ patients (۷۰.۳%) were vaccinal positive; ۶۶ (۱۵.۵%) were immune to HBV from past infections; ۴۰ (۹.۴%) were negative and ۳ (۰.۷%) were carrier of HBV. Totally, ۳۶۶ (۸۵%) patients were immune to HBV. We had no case of HIV positive. Conclusion: Transfusion reaction and their documentation are very important for blood transfusion services and programming. Unfortunately, there is no statistic records of these reactions in the hospitals or there may be some unclassified data in the patients’ files. Regular co-operation between hospitals and blood transfusion centers is required for collecting the information and finding total incidence of transfusion reactions. Hemovigilance or computerized network between blood bank centers in hospitals and Iran transfusion organization is the best way for collecting such data.

Keywords:

Thalassemia , Transfusion Reaction Transfusion Transmitted Infections (TTI) , HBV