Allogeneic blood transfusions: benefit, risks and clinical indications in countries with a low or high human development index.

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Serval ID
serval:BIB_B0BD4B83F581
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Allogeneic blood transfusions: benefit, risks and clinical indications in countries with a low or high human development index.
Journal
British Medical Bulletin
Author(s)
Marcucci C., Madjdpour C., Spahn D.R.
ISSN
0007-1420 (Print)
ISSN-L
0007-1420
Publication state
Published
Issued date
2004
Peer-reviewed
Oui
Volume
70
Number
8
Pages
15-28
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: epublish
Abstract
The risks associated with allogeneic red blood cell (RBC) transfusions differ significantly between countries with low and high human development indexes (HDIs). In countries with a low HDI, the risk of infection (HIV, HBV, HCV and malaria) is elevated. In contrast, in countries with a high HDI, immunological reactions (haemolytic transfusion reactions, alloimmunization and immunosuppression) are predominant. Therefore the overall risk associated with RBC transfusions in low HDI countries is much more significant than that in high HDI countries. In view of these risks, the limited efficacy of RBC transfusion and its high costs, this procedure should be used sparingly and rationally. Therefore RBC transfusion protocols adapted to the local situation are essential. Such protocols should distinguish between physiological and haemoglobin-based transfusion triggers. In countries with a high HDI, relative tachycardia and hypotension, despite normovolaemia, ST-segment changes suggestive of myocardial ischaemia and an Hb level <6 g/dl can serve as general guidelines for transfusion. Higher haemoglobin transfusion triggers should be used for patients aged >80 years and those with coronary artery or cerebrovascular disease. In countries with a low HDI, clinical signs of circulatory failure or myocardial ischaemia and an Hb level <5 g/dl can serve as transfusion guidelines.
Keywords
Adult, Aged, Aged, 80 and over, Bacterial Infections/transmission, Blood Group Incompatibility, Blood Grouping and Crossmatching, Cardiovascular Diseases, Developing Countries, Erythrocyte Transfusion/adverse effects, Humans, Middle Aged, Patient Selection, Risk Assessment, Virus Diseases/transmission
Pubmed
Web of science
Open Access
Yes
Create date
15/09/2016 20:14
Last modification date
01/04/2023 5:51
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