HEMOTRANSFUSION COMPLICATIONS IN HOSPITALS OF THE REPUBLIC ОF SAKHA (YAKUTIA)

The article presents the results of a retrospective analysis of hemotransfusion complications according to the acts of official investigations of the commissions of the Ministry of Health that arose during the transfusion of blood components in hospitals of the Republic of Sakha (Yakutia) in the period 1991–2023. The structure, causes and outcomes of hemotransfusion complications are presented. The most common mistakes leading to the development of posttransfusion complications, up to a fatal outcome, were identified. It was found that in the vast majority of the cases, violations during hemotransfusion were observed in district hospitals (70.3 %). Hemotransfusion complications in 12 cases (44.4 %) were associated with of ABO-incompatible transfusion; in 7 (25.9 %) cases – with transfusion of media infected with infection transmitted by hemotransmissive route; in 4 (14.8 %) cases – with transfusion of Rh-factor-incompatible; and in 4 (14.8 %) cases – with transfusion of hemolysed erythrocyte-containing blood components. It was shown that the most common complications of transfusion occurred in surgical (37.1 %) and obstetric departments (29.6 %). In 22.2 % of the cases, complications were detected in therapeutic departments; in 11.1 % – in departments of anesthesiology, intensive care and intensive care. Complications developed more often with transfusion of erythrocyte suspension and were observed in 21 (77.7 %) patients. The occurrence of posttransfusion complications was timely detected in 17 (85 %) patients who received emergency medical care, which led to a successful outcome. In 3 cases, a fatal outcome was recorded, which accounted for 11.1 % of the total number of complications. The causes of hemotransfusion complications are more often non-compliance with the rules for determining the blood group and Rh-factor, as well as non-compliance with the rules for conducting blood compatibility tests of the donor and recipient provided for in the instructions on hemotransfusion; therefore, it was concluded that it is necessary to increase the knowledge and training of medical personnel on transfusion therapy.

1. Transfuziologiya. Nacional`noe rukovodstvo / Ragimova A.A., 2018. – 1104 s. – ISBN 978-5-9704-4458-0.

2. Zhiburt E.B., Madzaev S.R., Chemodanov I.G. Oslozhneniya donorstva i perelivaniya krovi. – M.: Nacional`ny`j mediko-xirurgicheskij centr imeni N.I.Pirogova, – 2019. – 54 s.

3. Xarakteristika oslozhnenij, voznikshix posle perelivaniya donorskoj krovi i ee komponentov, v medicinskix organizaciyax Rossijskoj Federacii v 2018 godu / O.V. E`jxler, A.V. Chechetkin, E.V. Adzhigitova [i dr.] // Transfuziologiya. – 2019. – T. 20, № 4. – S. 301 – 309.

4. Guide to the preparation, use and quality assurance of blood components // European Directorate for the quality of medicines and healthcare (EDQM). — Council of Europe, 2017. – P. 23 – 440.

5. Chastota vy`yavleniya antitel k yadernomu antigenu virusa gepatita V u donorov krovi i ee komponentov v chety`rex sub``ektax Rossijskoj Federacii / R.R. Abakarov, D.S. Tixomirov, T.A. Tupoleva [i dr.] // Gematologiya i transfuziologiya. – 2021. – T. 66, № 2. – S. 242 – 252. – DOI: 10.35754/0234-5730-2021-66-2-242-252.

6. Pokazateli deyatel`nosti sluzhby` krovi Rossijskoj Federacii v 2018 godu / A.V. Chechetkin, V.V. Danil`chenko, M.Sh. Grigor`yan [i dr.] // Transfuziologiya. – 2019. – T. 20, № 3. – S. 160 – 170.

7. Pravila zagotovki, xraneniya, transportirovki i klinicheskogo ispol`zovaniya donorskoj krovi i ee komponentov. Utverzhdeny` postanovleniem Pravitel`stva Rossijskoj Federacii ot 22.06.2019 № 797. – Rezhim dostupa: http://www.consultant.ru/document/cons_doc_LAW_328029/ (Data obrashheniya: 1 oktyabrya 2019 g.).

8. Mineeva N.V. Immunologicheskie posttransfuzionny`e oslozhneniya / N.V. Mineeva // Transfuziologiya. – 2001. – № 2. – S. 40 – 49.

9. Ostatochny`j risk inficirovaniya pri perelivanii krovi / M.N. Gubanova, S.R. Madzaev, K.S. Avetisyan [i dr.] // Transfuziologiya. – 2013. – T. 14, № 4. – S. 13 – 23.

10. Oshibka pri perelivanii krovi v e`kstremal`noj situacii / O.V. Kozhemyako, A.Yu. Bakulina, E.I. Zejler, E.B. Zhiburt // Medicina katastrof. – 2017. – № 3(99). – S. 63 – 65.

11. Kozhemyako O.V., Zejler E.I., Bakulina A.Yu. Znachenie prakticheskoj podgotovki vrachej dlya obespecheniya bezopasnosti transfuzionnoj terapii / O.V. Kozhemyako, E.I. Zejler, A.Yu. Bakulina // Transfuziologiya. – 2022. – T.23. — № 3. – S. 28 – 29.

12. Zhiburt E.B. Gemoliticheskie transfuzionny`e reakcii / E.B. Zhiburt, E.A. Shestakov, S.I. Kuzneczov // Vestnik Nacional`nogo mediko-xirurgicheskogo centra im. N.I. Pirogova. – 2019. – T. 14, № 4. – S. 105 – 111. – DOI: 10.25881/BPNMSC.2020.17.22.020.