National survey of transfusion practices

Introduction

The awakening of the residual risks of blood transfusion leads, everywhere in the world, to efforts to reduce them. The aim of the study was to assess the transfusion practices in Tunisia.

Patients and methods

A multicentric prospective observational study of about 1,000 transfusions practiced during 2004 in Tunisia. Data were determined by the prescriptor of the transfusion. The data were analyzed with SPSS 12.0.

Results

The mean age of the transfused patients was 35.78 years. The sex ratio was 1.2. A total of 48.3% of the patients had transfusion history. Allogeneic immunization and viral serology conversion were reported in 2.1% of these patients. The indications were generally carried in front of chronic medical pathologies (36.9%), acute medical pathologies (28.2%) and surgical pathologies (elective 11.7%, urgent 11.2%). The haemoglobin threshold for transfusion was 7.29 g/dl and depended on the indication of the red cell transfusion: 6.16 g/dl for urgent medical pathologies, 6.22 g/dl for chronic medical pathologies, 7.74 g/dl for urgent surgical pathologies, 10.38 g/dl for elective surgery, 6.15 g/dl for urgent obstetrical pathologies. The mean platelet count was 24,000 (patients transfused by platelet units). The ABO and rhesus determination were made in 99% of the cases. A phenotypic determination was required in only 34.5% of the cases. The search for irregular agglutinins was made in 20.7% of the cases. The test of compatibility at the laboratory was practiced in 95.4% of the cases. The amount of blood transfused was 2 units. Immediate incidents were reported in 2.5% of the cases. The post-transfusion haemoglobin average was of 9.15 g/dl.

Discussion and conclusion

The evolution of the blood transfusion was remarkable, since the use of total blood in the 1980s, with the acquisition of the first techniques of separation of the blood components. The transfusion practice in Tunisia is far from being to the standards. The results obtained make it possible to transmit to the clinician the failures of the system, to better include how to prescribe a blood product, to follow its effectiveness and its possible side effects, and to apprehend the impact of the innovated biotechnologies to improve quality of transfusion medicine in coherence with the security requirements.