Frequência dos incidentes transfusionais imediatos em receptores de hemocomponentes

Objectives: To identify the frequency and gravity of the most common Adverse Reactions (ARs) related to acute transfusions reactions. Methods: A retrospective cross-sectional study ARs notified to the National Hemovigilance System from May 2002 to May 2016 was carried out in a Teaching Hospital of high complexity with 862 beds. The study was preceded by approval of the Ethics Committee of the institution, on 26 October 2016. Results: We analyzed 1.462 notification forms reporting transfusion reactions. The profile found was mostly of acute events associated to transfusion of Red Blood Cells, being Febrile Nonhemolytic Transfusion and Allergic Reaction the most frequent ARs; as for the gravity, the ARs were considered as mildAmong the cases considered as serious, these two types of ARs occurred in 13 (62%) of the cases. Conclusions: The study allowed a better evaluation and understanding of transfusion reactions, which allows improvement in the quality of the blood cycle and greater safety of patients undergoing transfusion therapy.Objetivo: Identificar a frequência e a gravidades dos eventos adversos mais comuns relacionados às reações transfusionais imediatas. Método: Análise retrospectiva do registro de eventos adversos, ocorridos em um Hospital Universitário de alta complexidade, com 862 leitos e que foram notificados ao Sistema Nacional de Hemovigilância, no período de maio de 2002 a maio de 2016. O estudo foi precedido de aprovação do Comitê de Ética da instituição, em 26 de outubro de 2016. Resultados: Foram notificadas 1.462 reações transfusionais. As reações mais frequentes foram por concentrado de hemácias, sendo a reação febril não hemolítica e a reação alérgica as mais frequentes e de gravidade considerada leve. Entre os eventos considerados graves, estes dois tipos de reações ocorreram em 13 (62%) dos pacientes. Conclusão: O estudo permitiu uma melhor análise e compreensão das reações transfusionais e dá subsídios para melhoria na qualidade do ciclo do sangue e maior segurança dos pacientes submetidos a terapia transfusional

RHD gene polymorphisms in alloimmunized RhD-negative individuals with high rate of racial admixture

Background: the D-negative phenotype is the result of the total RHD gene deletion in almost all Caucasians, but it accounts for only about 20% in Africans and 70% in Asians. in Africans the RHD Psi that is one of the most important causes of the D-negative phenotype. We investigated the RHD polymorphisms in D-negative phenotype mixed Brazilians who have anti-D alloantibody.Study design and methods: Blood samples from 130 individuals previously typed as D-negative were phenotyped again using: (a) two tube reagents (Anti-D blend reagent, Cellular line TH-28, MS-26; and Anti-D polyclonal); (b) one gel test ID-Card for Rh subgroups including C-w and K antigen; and (c) ABO/Rh (Anti-D blend reagent, Cellular line 175-2, LDM3). the method used for RHD screening detected the presence of RHD exon 10 and intron 4. Sequence analysis was performed on PCR products amplified from genomic DNA for all 10 exons RHD gene.Results: We found that 1181130 (90.8%) of D-negative tested individuals had total RHD gene deletion, while 12/130 (9.2%) showed RHD gene polymorphisms. the RHD Psi was found in 10 (7.7%) individuals, one sample (0.77%) hybrid RHD-CE-D-s /RHD Psi, and another (0.77%) weak D type 4.2.Conclusions: the results showed that the RHD gene was present in 9.2% of racially mixed Brazilians who produced usually clinically significant anti-D alloantibodies. Therefore, the data showed that careful attention is necessary for clinicians in applying RhD genotyping to transfusion medicine in populations with high rate of racial admixture. (C) 2012 Elsevier B.V. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo, Disciplina Hematol & Hemoterapia, São Paulo, BrazilFac Ciencias Med Santa Casa São Paulo, Disciplina Hematol & Hemoterapia, São Paulo, BrazilUniversidade Federal de São Paulo, Disciplina Ginecol & Obstet, São Paulo, BrazilUniversidade Federal de São Paulo, Disciplina Hematol & Hemoterapia, São Paulo, BrazilUniversidade Federal de São Paulo, Disciplina Ginecol & Obstet, São Paulo, BrazilFAPESP: 05/55.237-9Web of Scienc