{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:08:32Z","timestamp":1747188512320,"version":"3.40.5"},"reference-count":16,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,8,7]],"date-time":"2019-08-07T00:00:00Z","timestamp":1565136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vox Sanguinis"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec><jats:title>Background &amp; Objectives<\/jats:title><jats:p>Serologic testing after transfusion reactions (TRs) aims to find accountable immune haemolytic incompatibility. Our hospital policies recommend serologic testing in all TR, except for low\u2010risk fevers (subclinical temperature &lt;39\u00b0C) or uncomplicated allergic reactions. Assessing compliance with these guidelines and serologic testing yields may provide insights on quality of practice and value.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials &amp; Methods<\/jats:title><jats:p>Interrogation of two haemovigilance databases identified all possible\u2010to\u2010definite TR over a 4\u2010year period (2013\u20132016) at four academic hospitals. We reviewed the performance and outcome of serologic testing by site, year, reaction type, implicated product and service.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Serologic testing occurred in 769 (55%) of 1408 referrals, with 1153 (82%) compliant with guidelines. Similar proportions deviated to overtesting (85\/550 [15%]) and undertesting (174\/858 [20%]), with undertesting seen most often in atypical TR. Overall, 30 (4.4%) of 769 cases had a new finding, but only 2 (0.3%) reflected host\u2010derived antibodies. Overall, the number needed to test to discover an unexpected allospecificity was 385, or 253 if limited to high\u2010risk fevers. Reaction\u2010 and product\u2010specific yields ranged from 0% to 48%. The yield in complicated allergic reactions was low at 2%, constituting only predictable passive isohaemagglutinin(s) in retrospect. Investigated IVIG TR accounted for most of this cohort\u2019s signal by passive isohaemagglutinins in 48%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The performance of post\u2010TR serologic testing revealed practice gaps and expected context\u2010specific yields. Tailored serologic testing (i.e. indirect antiglobulin tests for alloantibodies in post\u2010RBC\/high\u2010risk febrile reactions, \u00b1 isoagglutinin\u2010focused tests after IVIG or ABO\u2010minor\u2010mismatched platelets) may improve value and liberate resources for other unmet needs in TR investigation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/vox.12830","type":"journal-article","created":{"date-parts":[[2019,8,8]],"date-time":"2019-08-08T00:23:11Z","timestamp":1565223791000},"page":"749-761","source":"Crossref","is-referenced-by-count":1,"title":["Serologic assessments in acute transfusion reactions: practices and yields"],"prefix":"10.1111","volume":"114","author":[{"given":"Robert","family":"Cohen","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and Molecular Diagnostics Sunnybrook Health Sciences Centre Toronto Ontario Canada"},{"name":"University of Toronto Quality Efficacy &amp; Safety in Transfusion (QUEST) Research Program Utilization Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Lima","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Molecular Diagnostics Sunnybrook Health Sciences Centre Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alioska","family":"Escorcia","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Program, Blood Transfusion Laboratory University Health Network Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farzana","family":"Tasmin","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Program, Blood Transfusion Laboratory University Health Network Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5562-9020","authenticated-orcid":false,"given":"Yulia","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Molecular Diagnostics Sunnybrook Health Sciences Centre Toronto Ontario Canada"},{"name":"University of Toronto Quality Efficacy &amp; Safety in Transfusion (QUEST) Research Program Utilization Toronto Ontario Canada"},{"name":"Department of Laboratory Medicine and Pathobiology University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lani","family":"Lieberman","sequence":"additional","affiliation":[{"name":"University of Toronto Quality Efficacy &amp; Safety in Transfusion (QUEST) Research Program Utilization Toronto Ontario Canada"},{"name":"Laboratory Medicine Program, Blood Transfusion Laboratory University Health Network Toronto Ontario Canada"},{"name":"Department of Laboratory Medicine and Pathobiology University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Pendergrast","sequence":"additional","affiliation":[{"name":"University of Toronto Quality Efficacy &amp; Safety in Transfusion (QUEST) Research Program Utilization Toronto Ontario Canada"},{"name":"Laboratory Medicine Program, Blood Transfusion Laboratory University Health Network Toronto Ontario Canada"},{"name":"Department of Laboratory Medicine and Pathobiology University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeannie","family":"Callum","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Molecular Diagnostics Sunnybrook Health Sciences Centre Toronto Ontario Canada"},{"name":"University of Toronto Quality Efficacy &amp; 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