Abstract
Purpose
Intraoperative anaphylaxis caused by blood products is uncommon, but it is unclear whether the rarity of this reaction is attributable to the difficulty of diagnosis, underreporting, or both. We investigated the incidence of intraoperative transfusion anaphylaxis and its reporting to the hemovigilance system.
Methods
We retrospectively reviewed cases wherein general anesthesia was used at a single hospital during a 12-year period. Cases of intraoperative anaphylaxis were extracted using an electronic search strategy and determined using the recently developed grading and clinical scoring system. The causative blood products were determined by the onset duration based on literature regarding intraoperative transfusion anaphylaxis cases.
Results
Among the 62,146 general anesthesia cases, 22 cases of intraoperative anaphylaxis were identified, and 11 of the 22 cases received transfusions before the onset of anaphylaxis. Intraoperative transfusion anaphylaxis was defined as occurring within 30 min of transfusion. Finally, nine cases of intraoperative transfusion anaphylaxis were analyzed. The overall incidence of intraoperative transfusion anaphylaxis was 1/3,994, with the highest incidence noted for fresh frozen plasma (1/2146; 95% confidence interval [CI] 1/6610–1/920), platelet concentrate (1/2348; 95% CI 1/92,742–1/422), and red blood cells (1/22,867; 95% CI 1/903,199–1/4,105). No evidence indicated that these cases were reported to the Japanese hemovigilance system, although all intraoperative transfusion anaphylaxis cases were diagnosed by anesthesiologists.
Conclusion
The incidence of intraoperative anaphylaxis caused by blood products was higher than that reported and may be underreported to the Japanese hemovigilance system. Further research, particularly multicenter studies, is needed to confirm our results.
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The authors thank all anesthesiology medical staff of the Nagoya University Hospital for their assistance.
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Study concept and design: YA, TT. Literature search and data collection: all authors. Data analysis and interpretation: all authors. Writing of paper and responsibility for its contents: all authors.
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Amano, Y., Tamura, T., Fujii, T. et al. Incidence of intraoperative anaphylaxis caused by blood products: a 12-year single-center, retrospective study. J Anesth 36, 390–398 (2022). https://doi.org/10.1007/s00540-022-03059-2
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DOI: https://doi.org/10.1007/s00540-022-03059-2