Blood banking in small animal medicine: a survey of current practices and assessment of a technique to prevent transfusion-related complications

Denise Poh

Blood transfusions can be life-saving in dogs and cats, but they are not without risk. Transfusion-related complications occur despite following expert recommendations on blood banking and transfusion administration. The risk of these complications is likely exacerbated when expert recommendations are neglected. Prior to our survey of Australian veterinarians, there were no published reports outlining common blood banking or transfusion practices in Australia. We found Australian veterinary blood banking and transfusion practices were largely inconsistent with expert recommendations. For example, only around half of veterinarians surveyed compatibility-tested dogs and cats prior to transfusion, and more than half pre-medicated animals prior to transfusion. The causes for the inconsistences must be identified and addressed to align blood banking and transfusion practices with expert recommendations, with the overall goal of decreasing transfusion-related complications in dogs and cats. Even with optimal blood banking practices, transfusion-related complications including post-transfusion inflammation can occur. Inflammatory mediators are known to accumulate in blood during storage, and a pre-storage blood banking technique, leukoreduction, prevents this accumulation. Our randomised, blinded, interventional clinical trial was designed to determine if leukoreduction, compared with no leukoreduction, decreases inflammatory biomarker concentrations over time in critically ill dogs. We found no significant difference in the concentrations of inflammatory biomarkers over time between the two groups, however the heterogeneity of our small population likely precluded us from finding a difference. Our randomisation and blinding protocol was successful, and together with the data to now power a larger study, we can plan a trial to determine if leukoreduction will help decrease post-transfusion inflammation in critically ill dogs. In conclusion, we have found that there is a high risk for transfusion-related complications in dogs and cats due to poor alignment with veterinary expert recommendations on blood banking and transfusion administration. Additionally, there may still be room to improve upon expert recommendations on blood banking to help decrease the risk for transfusion-related inflammation with the implementation of leukoreduction, however additional research is required.

Blood banking in small animal medicine: a survey of current practices and assessment of a technique to prevent transfusion-related complications

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