Recipient Hemovigilance

AABB continues to work with facilities throughout the world on international hemovigilance efforts. Through its expert committees, AABB collaborates with government agencies and international organizations to establish and promote standard definitions related to transfusion reactions. Additionally, AABB committees develop education and support research to further the goals of hemovigilance.

Under-Transfusion Incident Codes

A working group of the AABB Hemovigilance Committee developed four incident codes to assist in the recognition and reporting of instances of under-transfusion due to inventory. The codes, described in a recent report in Transfusion, are:

  • No Blood (NB) 01 (Inventory less than usual level due to supplier shortage)
  • NB 02 (Demand for blood product exceeding usual inventory levels)
  • NB 03 (Substitution with incompatible/inappropriate units)
  • NB 04 (Suboptimal dose/no transfusion given)

The sub-group is hopeful that adoption of these codes within the global hemovigilance system will help improve recognition and reporting of instances of under-transfusion due to inventory, thus supporting the development of better collection strategies and inventory management techniques, as well as effective policies to advance blood safety and availability.

Proposed incident codes to the Centers for Disease Control and Prevention (CDC), National Healthcare Safety Network Biovigilance Component (NHSN).

Process Code: No Blood (NB) Transfusion Service or Supplier Events that occur when the transfusion service or supplier is unable to meet request for transfusion orders within the critical time frame as defined by the institution and as appropriate to the clinical indication.
Incident Code Description Reason for proposal
NB 01 Inventory less than usual par level due to supplier unable to meet usual steady demand.
  • Report unfilled orders when supplier(s) is not meeting the par inventory level demands from their hospitals.
NB 02 Demand for blood product exceeding usual par inventory levels.
  • Report unfilled orders to distinguish situation(s) in which demand is higher than usual par inventory levels.
NB 03 Incompatible/inappropriate units issued due to inventory constraints when demand for blood product exceeds usual par inventory levels.
  • While hospitals may be able to change their par inventory levels, UI 19 currently does not distinguish between erroneous versus inventory issues that led to incompatible/inappropriate units issued.
NB 04 Suboptimal dose (less than optimal quantity) transfusion or no transfusion due to inventory constraints when demand for blood product exceeds usual par inventory levels.
  • NB 04 would be used for inventory constraints vs. UT 14 (technical or other issues while inventory was adequate)

Please check the resource section to access the publication.

Common Transfusion Reaction Reporting Form version 2.0

Common Transfusion Reaction Reporting Form ThumbnailThe AABB Common Transfusion Reaction Reporting Form is intended for use by hospitals and blood centers for communicating information about transfusion reactions to the blood supplier, particularly when there are multiple suppliers to the hospital transfusion service. The form is intended to streamline the process for hospitals and provide complete information for blood suppliers when investigating transfusion reactions. The AABB Donor Hemovigilance Working Group and Hemovigilance Committee recently reviewed and updated the form, after the end of a successful first year use.

Common Transfusion Reaction Reporting Form (Updated)
Common Transfusion Reaction Reporting Form FAQ
Provide your Feedback

Revised TACO Definition

The revised transfusion associated circulatory overload (TACO) definition (2018) developed and validated by the International Society of Blood Transfusion (ISBT) working party on Haemovigilance in collaboration with the International Haemovigilance Network (IHN) and AABB, is now available online and results of the formal validation have been published (The Lancet Haematology, 2019). The revised definition is applicable to cases that occur up to 12 hours after transfusion. Combinations of signs and symptoms which can add up to meet the surveillance diagnostic criteria will help qualify cases where there may be no chest x-ray and/or record of elevated BNP concentrations as TACO. Notes on signs and symptoms and didactic table listing of key features has been added to assist in making diagnosis. The revision group emphasizes that the chief priority is to adopt standard reporting criteria, which will enable professionals to raise awareness of TACO and lead to improved reporting, research and reduction of transfusion complications.

Transfusion-associated circulatory overload (TACO) Definition (2018)

Hemovigilance Data

Hemovigilance Data NBCUS

Resources

  1. Quick Reference Guide Thumbnail AABB Quick Reference Guide for NHSN Hemovigilance Module: Adverse Reaction Definitions (Updated)

  2. Rajbhandary S, Andrzejewski C, Fridey J, Stotler B, Tsang HC,Hindawi S, et al. Incorporating the entity of under-transfusion into hemovigilance monitoring:Documenting cases due to lack of inventory.Transfusion. 2022;62:540–5. https://doi.org/10.1111/trf.16792

  3. CDC National Healthcare Safety Network (NHSN), Blood Safety Surveillance: https://www.cdc.gov/nhsn/acute-care-hospital/bio-hemo/index.html

  4. Mowla SJ, Sapiano MRP, Jones JM, Berger JJ, Basavaraju SV. Supplemental findings of the 2019 National Blood Collection and Utilization Survey. Transfusion. 2021 Sep;61 Suppl 2(Suppl 2):S11-S35. doi: 10.1111/trf.16606. Epub 2021 Aug 1. PMID: 34337759; PMCID: PMC8441766.

  5. Commonwealth of Massachusetts, Reporting Requirements for Blood Banks and Hemovigilance in Massachusetts. https://www.mass.gov/service-details/reporting-requirements-for-blood-banks-and-hemovigilance-in-massachusetts