Haematological quality and age of donor blood issued for paediatric transfusion to four hospitals in sub-Saharan Africa.

Uyoga, Sophie, Mpoya, Ayub, Olupot-Olupot, Peter, Kiguli, Sarah, Opoka, Robert. O, Engoru, Charles, Mallewa, Macpherson, Kennedy, Neil, M'baya, Bridon, Kyeyune, Dorothy, Wabwire, Benjamin, Bates, Imelda ORCID: https://orcid.org/0000-0002-0862-8199, Gibb, Diana. M, Walker, A. Sarah, George, Elizabeth. C, Williams, Thomas. N and Maitland, Kathryn (2019) 'Haematological quality and age of donor blood issued for paediatric transfusion to four hospitals in sub-Saharan Africa.'. Vox Sanguinis, Vol 114, Issue 4, pp. 340-348.

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Abstract

Background and Objectives
Paediatric blood transfusion for severe anaemia in hospitals in sub-Saharan Africa remains common. Yet, reports describing the haematological quality of donor blood or storage duration in routine
practice are very limited. Both factors are likely to affect transfusion outcomes.
Materials and Methods
We undertook 3 audits examining the distribution of pack types, haematological quality and storage duration of donor blood used in a paediatric clinical trial of blood at four hospitals in Africa (Uganda
and Malawi).
Results
The overall distribution of whole blood, packed cells (plasma-reduced by centrifugation) and red cell concentrates (RCC) (plasma-reduced by gravity-dependent sedimentation) used in a randomised trial was 40.7% (N=1215), 22.4% (N=669) and 36.8% (N=1099) respectively. The first audit found similar median haematocrits of 57.0% (50.0,74.0), 64.0% (52.0,72.5; p=0.238 vs whole blood) and
56.0% (48.0,67.0; p=0.462) in whole blood, RCC and packed cells respectively, which resulted from unclear pack labelling by blood transfusion services (BTS). Retraining of the BTS, hospital blood
banks and clinical teams led to, in subsequent audits, significant differences in median haematocrit and haemoglobins across the 3 pack types and values within expected ranges. Median storage
duration time was 12 days (IQR 6,19) with 18.2% (537/2964) over 21 days in storage. Initially, 9 (2.8%) packs were issued past the recommended duration of storage, dropping to 0.3% (N=7) in the
third audit post training.
Conclusion
The study highlights the importance of close interactions and education between BTS and clinical services and the importance of haemovigilence to ensure safe transfusion practice.

Item Type:	Article
Subjects:	WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WB Practice of Medicine > Therapeutics > WB 356 Blood transfusion WH Hemic and Lymphatic Systems > WH 100 General works WS Pediatrics > WS 20 Research (General)
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1111/vox.12764
Depositing User:	Stacy Murtagh
Date Deposited:	08 Mar 2019 11:32
Last Modified:	22 Oct 2019 08:23
URI:	https://archive.lstmed.ac.uk/id/eprint/10060

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