Haemovigilance in Polytransfused patients reported with adverse transfusion reactions in Colombia

Introduction: Since January 1, 2018, the Colombian National Institute of Health has collected all the information related to blood transfusion nationwide in the National Haemovigilance System (SIHEVI-INS). By the end of 2022, 6,636,499 blood components were transfused to 1,794,315 patients, determining an index of 3.7 blood components per patient (Figure 1). There has yet to be an international consensus regarding the definition of polytransfused patients. In 2019, Colombia established that any patient who received six or more blood components should be classified as such. How many Colombians have received six or more blood components and presented adverse transfusion reactions (ATR) is unknown. These data are required to characterize the population, assess potential transfusion-transmitted infections and the spread of them to close contacts. Likewise, these data are required to reduce the probability of alloimmunization, refractoriness, incompatibility, defective hematopoiesis due to iron overload, and endocrine alterations. This work aims to present the characterization of the population notified with ATR that meets the defined criteria of polytransfused in Colombia. Methods: Patients were identified according to their unique identification number in SIHEVI-INS. Those patients with ATR and transfusion of six or more blood components at one or more moments during the study period were included. The Single Database of Affiliates of the General System of Social Security in Health determined their status until April 2023 (alive or deceased). Results: Of the people registered with ATR between 2018-2022, 592 were identified who received an average of 8.2 blood components. 54% of the living patients were women (OR: 0.61; 95% CI: 0.43-0.86) (Figure 2). 59.6% of polytransfused patients were O positive, followed by A positive (26.2%), B positive (7.0%), and O negative (3.6%). Of the deceased patients, 53% were men (OR: 1.54, 95% CI: 1.08-2.21). Of the total adverse reactions, 77.3% corresponded to allergic events, 7.9% to non-hemolytic febrile events, and 4.1% to Transfusion-associated circulatory overload. The frequency of 1 polytransfused was estimated for every 3,030 patients notified. Therefore, if there are around 358,863 patients transfused annually, it could be inferred that 118 would be potentially polytransfused. Discussion: Being polytransfused and presenting ATR is a predictor of death five years after notification.