Haemovigilance in the United Kingdom

Introduction. Haemovigilance is the set of surveillance procedures covering the entire blood transfusion chain, from the donation and processing of blood and its components, through to their provision and transfusion to patients, including patient follow-up. The United Kingdom (UK) haemovigilance system has been developing for 25 years and is one of the world's leading hemovigilance systems.

Aim — to review the analysis of adverse events in the UK blood service in 2021.

Methods. Analysis of the British haemovigilance system report for 2021.

Results. Blood transfusion remains safe in the UK, with a risk of death from a blood transfusion of 0.92 per 100,000 components issued. Transfusion delays and pulmonary complications (mostly circulatory overload) were responsible for 77.1 % (27 out of 35) of blood transfusion-related deaths in 2021. Errors (including near miss cases) still make up the majority of reports. In 2021, 2569 out of 3161 (81.3 %) of all reports were associated with errors. Prerequisites for reactions still make up a significant proportion: 1155/3161 (36.5 %) incidents. Understaffing, lack of proper training, poor supervision and poor safety culture have been identified as contributing factors to numerous incidents. They need to be addressed urgently to reduce the risk to patient safety. Ensuring the safety of process-based transfusions through a multi-pronged approach, proper training, appropriate resources, user-centric design, and learning by doing are essential. Reassignment warnings in laboratory health information systems continue to contribute to error reporting. Trends in abnormal transfusion reactions such as febrile, allergic, hypotensive and hemolytic reactions are similar to previous years. All personnel involved in blood transfusion should be competent and confident in recognizing and appropriately treating transfusion reactions in recipients.

Conclusion. Haemovigilance is an important tool for improving the efficiency and safety of blood transfusion.

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