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Haemovigilance: progress and prospects Volume 8, issue 2, Mars - Avril 2002

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Authors
Correspondant d'hémovigilance de l'AP-HP, unité de sécurité transfusionnelle et d'hémovigilance, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex.

Implemented by decree in 1994, haemovigilance has set up a blood transfusion information system integrated within the transfusion safety mechanism. As such it aims to identify the risk associated with transfusion of blood component (red cells and platelet concentrates, fresh frozen plasma) and their related causes in order to propose appropriate control measures. The system covers the transfusion process at all stages and therefore involves individuals and institutions at both national, regional and local levels. The nature of the information required relies on obligatory notification of transfusion-related reactions, on the traceability of blood components and on the follow-up of transfused patients. Hemovigilance data, with almost 40 000 notifications of transfusion incidents, have led to a better appreciation of certain risk factors (bacterial contamination, ABO incompatibility, vascular overload) but many questions remain unanswered (the majority of incidents are of unknown cause). The operation of the haemovigilance network over more than 6 years has demonstrated that new measures aimed at improving organisational aspects as well as management and analysis of data have to be taken. The critical points are improvement of the collaborative work and sharing of data between hospitals and blood centers and optimisation of the collection and analysis of transfusion-related events. Using clinical and epidemiological research tools, data obtained from the hemovigilance network could help evaluate the efficiency and morbidity of current transfusion as well as the overall need for blood components. Medical and economic assessments of the French system are now necessary in order to establish whether the objectives of surveillance have been met and to make performance-related organisations. France, the most experienced country in the field of haemovigilance, could then contribute most efficiently to the establishment and spreading of Europe-wide guidelines in this context.