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Clinical Studies
Every one counts: A retrospective cohort study examining the safety of extending pre-transfusion compatibility testing from 72 hours to 7 days in hematology patients receiving red blood cell transfusions
1 NSW Health Pathology – North, New Lambton Heights, NSW, Australia
2 Hunter New England Health Service, New Lambton Heights, NSW, Australia
3 Calvary Mater Haematology Department, Newcastle, NSW, Australia
4 School of Medicine and Public Health, University of Newcastle, NSW, Australia
5 Hunter Medical Research Institute, New Lambton, Australia
Address correspondence to:
Anoop K Enjeti
Haematology Department, Calvary Mater Newcastle, Corner Edith and Platt Street, Waratah, NSW 2298,
Australia
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Article ID: 100079Z02HA2023
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How to cite this article
Ambrose H, Hedrick A, de Leur M, Elton G, Evans (Bruce) A, Mullen R, Rowlings P, Ross B, Prasad R, Enjeti AK. Every one counts: A retrospective cohort study examining the safety of extending pretransfusion compatibility testing from 72 hours to 7 days in hematology patients receiving red blood cell transfusions. Int J Blood Transfus Immunohematol 2023;13(2):8–16.ABSTRACT
Aims: To investigate the safety of extending the pretransfusion compatibility testing (PTCT) interval from 72 hours to 7 days in hematology patients receiving packed red blood cells (PRBC).
Methods: We undertook a retrospective cohort study over two years when the local protocol for PTCT in recently transfused hematology patients was changed from 72 hours to 7 days. All transfusions from 12 months prior and post this date were exported from eBlood and analyzed. The primary outcome was the incidence of transfusion reactions. Subgroup analysis was conducted for the chronically transfused patient group and patients with PTCT > 72 hours.
Results: A total of 2079 packs were analyzed from 227 patients. Only 37 transfusions that fulfilled the extended crossmatch. There were five (0.69%) transfusion reactions within the post-protocol change cohort and no transfusion reactions in the pre-protocol change cohort. All transfusion reactions occurred in the <72-hour subgroup of the post-protocol change cohort. At the time of reaction, there were no alloantibodies identified. No patients demonstrated new alloantibodies post-reaction.
Conclusion: This study found no evidence for an increased risk of transfusion reactions associated with increasing the PTCT interval from 72 hours to 7 days in a subset of chronically transfused hematology patients. Extending the PTCT interval could decrease costs, decrease patient infection risk, improve comfort, and conserve public health resources. Further evaluation in a larger cohort is necessary.
Keywords: Extended compatibility, Packed red blood cells, Pre-transfusion testing, Transfusion, Transfusion reactions
SUPPORTING INFORMATION
Author Contributions
Harriet Ambrose - Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Ashlee Hedrick - Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Marcus de Leur - Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Georgina Elton - Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Alicia Evans (Bruce) - Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Rebecca Mullen - Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Philip Rowlings - Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Bryony Ross - Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Ritam Prasad - Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Anoop K Enjeti - Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2023 Harriet Ambrose et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
