Patient blood management (PBM) is an evidence based multidisciplinary approach to optimizing the care of patients who may require a transfusion. One aspect of PBM is hemovigilance, which focuses on recognizing and reporting transfusion reactions. The potential for fatal consequences make the prevention, rapid recognition, and treatment of transfusion reactions a critical requirement for the safety of veterinary patients receiving blood products. The objective of this study was to describe the development and implementation of a small animal hemovigilance program at a university veterinary teaching hospital. A hemovigilance working group composed of veterinary specialists in clinical pathology, internal medicine, and emergency and critical care was established. This group developed evidence based definitions of transfusion reactions, reaction classification systems, and a transfusion reaction reporting form. The reporting form contained sections for patient information, transfusion information, administration details, and reaction details. Reaction events were classified by reaction type, severity grade, and imputability to transfusion. Following implementation of the hemovigilance program, transfusion reaction data was collected and examined for the period spanning October 2014 and March 2019. During the study period 718 canine transfusions [4 whole blood, 400 packed red blood cell (pRBC), 300 fresh frozen plasma (FFP), 7 platelet rich plasma, 7 cryoprecipitate) and 124 feline transfusions [5 whole blood, 95 pRBC, 24 FFP] were administered. There were 32 total reactions (27 canine and 5 feline), with the most common reaction being febrile non-hemolytic transfusion reactions (19/32, 59%). The incidence rate of transfusion reactions was found to be 3.8% in dogs and 4.0% in cats. For the confirmed reactions, classification criteria for case definition, reaction severity grade, and imputability were able to be determined and recorded. This allowed targeted interventions to be implemented in order to potentially reduce future reactions. This report shows that a hemovigilance program can be instituted successfully in a veterinary hospital setting. Once developed, standardized reporting tools could be utilized by multiple hospitals and provide the basis for more widespread reaction reporting in veterinary medicine.
Learning Objectives:
Understand the components of a patient blood management program.
Describe hemovigilance and understand its purpose as part of a patient blood management program.
Understand the process of developing and implementing a hemovigilance program in a veterinary teaching hospital.
