The difficulty differentiating the symptoms of a mild transfusion reaction from early symptoms of serious reactions leads to unnecessary cessation of blood transfusions, blood product wastage and over utilisation of laboratory resources in investigating suspected reactions. Creating a direct cost burden on the health care system.

 

To determine the cost associated with investigating minor transfusion reactions and identify opportunities to improve the management of blood transfusion reactions through application of current national guidelines. 

 

This study retrospectively reviewed all suspected transfusion reactions reported to the laboratory at The Canberra hospital (TCH) between 2015 and 2020. TCH has mandatory training on recognition, clinical management, and reporting of suspected transfusion reactions. Suspected reactions were assessed for appropriateness of clinical management and associated investigations. Cost of inappropriate investigations and associated blood product discard was calculated using current national tariffs. 

 

A total of 274 suspected reactions were reported in the 6-year period under review. 148 cases were considered unnecessarily investigated for transfusion reactions, either because they lacked signs or symptoms of a transfusion-related event, or these were minor with the transfusion potentially able to be continued under national guidelines. The costs of unnecessary investigation for suspected transfusion reactions totalled AU $ 32,427.00. In addition, the costs of partially discarded blood products were AU$55,656.00. 12% of blood products cultured returned a positive result with microbes of low pathogenicity isolated.

 

The study demonstrated that unnecessary investigation of minor transfusion reactions adds a significant financial burden to the health care system. 

Significance: Improved guidance for clinicians at the point of care is required.

 

Cliford Joel1, Philip Crispin2,3, Maria Burgess4
 
 

1.     ACT pathology, Canberra Health Services, Garran, ACT 2605

2.     ACT Pathology – Haematology, Canberra Health Services, Garran, ACT 2605

3.     Medicine, The Australian National University, Acton, ACT, 2601

4.     ACT blood program, Canberra Health Services, Garran, ACT, 2605