Transfusion Transmitted Injuries Surveillance System, 2020 to 2021: Infographic

Highlights

The Transfusion Transmitted Injuries Surveillance System (TTISS) network monitors over 95% of transfusion activities in Canadian hospitals. This is a summary of the 2020 to 2021 data:

• A total of 1,765 adverse transfusion events (ATEs)^{Footnote 1} were reported, with 897 cases in 2020 and 868 cases in 2021
• 65% (n=1,147/1,765) of ATEs were caused by transfusion of blood components and 35% (n=618/1,765) of ATEs were caused by transfusion of plasma derivatives
• 4.9% (n=87/1,765) of ATEs resulted in life-threatening injuries
• 1.1% (n=19/1,765) of ATEs resulted in transfusion-related deaths
• 8 deaths occurred per million units of blood components transfused

ATEs By Type

Breakdown of the counts and proportions of reported cases according to ATE types.

• Delayed Haemolytic Reaction (DHR): 3.9%
• Hypotensive Reaction (HYPT): 9.4%
• Intravenous Immune Globulin Headache (IVIG-HD): 11.8%
• Severe Anaphylactic or Anaphylactoid Reaction (SAAR): 10.5%
• Transfusion-Associated Circulatory Overload (TACO): 32.1%
• Transfusion-Associated Dyspnea (TAD): 6.3%
• Transfusion-Related Acute Lung Injury (TRALI): 2.7%
• Other: 20.3%

ATEs by Severity^{Footnote 2}

• Grade 1 (non-severe): 1,199 (67.9%)
• Grade 2 (severe): 453 (25.7%)
• Grade 3 (life-threatening): 87 (4.9%)
• Not determined: 26 (1.5%)

ATEs by Outcome

• Minor or no sequelae: 1,589 (90.0%)
• Major or long-term sequelae: 63 (3.6%)
• Death: (transfusion related): 19 (1.1%) (Definite, probable or possible)
• Death: (non-transfusion related): 13 (0.7%) (Doubtful, ruled out or not determined)
• Not determined: 81 (4.6%)

Deaths Related to ATEs

• TACO: 10 (52.6%)
• TAD: 3 (15.8%)
• TRALI: 3 (15.8%)
• HYPT: 1 (5.3%)
• BACT: 1 (5.3%)
• OTHER: 1 (5.3%)

ATE and Death Rate per Million Units of Blood Components Transfused

• Units of blood components transfused: 2,327,764
• ATEs related to blood components: 1,147
• ATE rate: 492 / million units of blood components
• ATE risk: 1 case / 2,029 units of blood components
• Deaths related to blood components: 19
• Death rate: 8 / million units of blood components
• Death risk: 1 case / 122,514 units of blood components