Transfusion Medicine - Transfusion-transmitted disease

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Transfusion medicine

Transfusion-transmitted disease – general

Reviewer: Huy Phu Pham, M.D. (see Reviewers page)
Revised: 1 November 2011, last major update September 2011
Copyright: (c) 2007-2011, PathologyOutlines.com, Inc.

General
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● In theory, any pathogen (bacteria, viruses, parasites) can be transmitted via transfusion; blood is nutritious media for microorganisms
● Most transmissions result in transient and self-limited illnesses without major sequalae
● Mitigation of transfusion transmission of infectious pathogens is mainly based on donor selection and donor testing
● Most transfusion transmitted infections occur in the window period – between the infection and the ability to initially detect the infectious pathogen

Prevention
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Donor selection, screening, and donor questionnaire:
● Questionnaire is based primarily on the honesty of the donors, donor education (don't donate if sick) and selection (volunteer, not paid donors)
● Demographic exclusions based on potential exposure
● Check list of prior deferred donors
● Examine and prepare phlebotomy site to minimize skin related microorganisms
● Test blood for selected known agents
● Discard components if post donation evidence of exposure or illness
● Can also limit unnecessary transfusions and increase autologous donations (may be infectious, but rarely are given to nondonors (Arch Pathol Lab Med 2005;129:1212, Arch Pathol Lab Med 2005;129:981)

In US, currently test blood products for:
● Viruses: HIV, Hepatitis B and C, West Nile virus, HTLV-1 and HTLV-2, CMV, EBV
● Bacteria: Treponema palladium (syphilis)
● Parasites: Trypanosoma cruzi
● Click here for list of current FDA licensed tests
● Testing increases safety of blood supply and provides diagnostic information to tested donor (when informed of results - not done in all countries)
● Nucleic acid testing has improved sensitivity of testing (Crit Care 2004;8 Suppl 2:S18, Arch Pathol Lab Med 2007;131:702)

End of Transfusion Medicine > Tranfusion-transmitted disease > Transfusion-transmitted disease – general

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