Transfusion Transmitted Injuries Surveillance System, 2022: Infographic

Highlights

The Transfusion Transmitted Injuries Surveillance System (TTISS) network monitors over 95% of transfusion activities in Canadian hospitals. The 2022 data are summarized below:

• A total of 866 blood recipients resulted in adverse transfusion reactions (ATRs)^{Footnote 1};
• 68.5% (n=593/866) were related to blood components and 31.5% (n=273/866) were caused by plasma derivatives.
• 9.5% (n=82/866) of ATRs were definitely and 90.5% (n=784/866) were probably or possibly related to transfusions.
• 7.2% (n=62/866) of ATRs resulted in grade 3 (life threatening) injuries.
• 1.4% (n=12/866) of ATRs resulted in transfusion related deaths
• 6 deaths reported per million units of blood components transfused

ATRs by type

• Please find below a breakdown of the counts and proportions of reported cases according to ATR types.
• Acute haemolytic reaction (AHR): 3.3%
• Delayed haemolytic reaction (DHR): 3.7%
• Hypotensive reaction (HYPT): 10.3%
• Intravenous Immune Globulin Headache (IVIG-HD): 11.2%
• Severe anaphylactic/anaphylactoid reaction (SAAR): 9.5%
• Transfusion-associated circulatory overload (TACO): 36.5%
• Transfusion associated dyspnea (TAD): 8.8%
• Transfusion-related acute lung injury (TRALI): 1.3%
• Other: 11.4%
• ATRs with few cases are not shown here, i.e., ASPT (0.6%), BACT (0.9%), and Unknown (2.5%)

"Other" indicates ATRs with too few occurrences, are not classified, or not listed in the User's Manual. These events may include severe electrolyte imbalance, atypical pain syndrome, malaria (P. Falciparum, P. Vivax, babesiosis), Lyme disease, syphilis, toxoplasmosis, Creutzfeldt-Jacob Disease, etc.

ATRs by severity^{Footnote 2}

• Grade 1 (non-severe) (616, 71.1%)
• Grade 2 (severe) (174, 20.1%)
• Grade 3 (life-threatening) (62, 7.2%)
• Not determined (14, 1.6%)

ATRs by outcome

• Minor or no sequelae (793, 91.6%)
• Major or long-term sequelae (22, 2.5%)
• Death (transfusion related: 12, 1.4%)^{Footnote *}
• Death (non-transfusion related: 4, 0.5%)^{Footnote **}
• Not determined (35, 4.0%)

Deaths related to ATRs

• AHR (1, 8.3%)
• TACO (4, 33.3%)
• TAD (3, 25.0%)
• TRALI (3, 25.0%)
• SARR (1, 8.3%)

ATR and death rate per million units of blood components transfused

• Units of blood components transfused: 1,181,035
• ATRs related to blood components: 593
• ATR rate: 502 / million units of blood components
• ATR risk: 1 case / 1,992 units of blood components
• Deaths related to blood components: 7
• Death rate: 6 / million units of blood components
• Death risk: 1 case / 168,719 units of blood components

Conclusion

The proportions of ATR types are consistent with results from previous years. Additionally, while TACO is the leading cause of death, the overall fatality risk in comparison to the total number of transfusions is still very low in Canada