Each year, approximately two million blood components are issued annually in the United Kingdom, and the vast majority are given safely without any adverse effects or events.

The Serious Hazards of Transfusion (SHOT) hemovigilance scheme collects and analyses data regarding serious adverse events (SAE) and serious adverse reactions (SAR) of blood components transfused in the United Kingdom.

Haemovigilance is the systematic surveillance covering the whole transfusion chain from collection of blood (components) to follow-up of its recipients. It assesses information on undesirable transfusion effects to prevent their occurrence.

SHOT work collaboratively with Medicines and Healthcare Products Regulatory Agency (MHRA). Under the Blood Safety and Quality Regulations 2005 (BSQR) there is a legal requirement to report serious adverse reactions and events to the MHRA.

What is major morbidity?

Admission to ICU or HDU, life threatening reactions, or sensitisation to D or K red cell antigen.

Always document the decision to transfuse, the consent discussion, and outcome.

<aside> 💡

Blood transfusion records must be kept for 30 years in the UK.

</aside>

4mLs/kg of red cells will increase Hb by 10g/L in adult patients. For low weight patients (& children), consider calculating transfusion volume in mLs/kg.

In a non-bleeding infant or child, it is important to consider the pre-transfusion Hb in relation to the transfusion threshold, and it is recommended that you aim for a post-transfusion Hb of no more than 20g/L above the threshold.

To avoid over transfusion, a factor of 4 is widely considered appropriate however each patient should be assessed on an individual basis (British Society for Haematology [BSH], 2016).

Paedipacks: One adult unit is divided into 4 - 8 aliquots. Several aliquots are allocated to one child, reducing donor exposure.

You should report all suspected cases of TACO through your local incident reporting process.