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Abstract:

Hemovigilance is a quality system monitoring and registering systematically the incidents and adverse events occurring during the blood preparation and transfusion process, from donor to receptor. The main goal of this quality system is the development of ever more efficient preventive measures to reduce the probability of serious and sometimes life-threatening transfusion complications. Since the implementation of the European Directive 2002/98, all member states of the European Union are obliged to have a functioning hemovigilance system. In Belgium, all blood banks and hospitals report on a yearly basis the transfusion incidents and reactions to the FAGG (Federaal Agentschap voor Geneesmiddelen en Gezondheidsproducten). Next, FAGG describes yearly all reported reactions and incidents in our country. The three main causes of transfusion related mortality are actually: TRALI, acute hemolytic transfusion reactions due to infusion of ABO-incompatible blood products, and transfusion-related sepsis. Measures to further decrease this mortality are, respectively, a) screening of blood donors for granulocyte antibodies and exclusion of multiparous female donors, b) implementation of a machine-readable identification system (systematic check of the identity of donor and receptor) and c) pathogen inactivation techniques for platelets and plasma. In conclusion, it is crucial that the indication for transfusion of a blood product is always based on scientific arguments and that the benefit for the patient of a tranfusion always outweighs its possible complications.