Cite this page: Pham, H.P. Transfusion transmitted disease - general. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/transfusionmedgeneral.html. Accessed April 21st, 2018.
Definition / general
- 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
Donor selection, screening, and donor questionnaire:
In US, currently test blood products for:
- 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: U.S. Food and Drug Administration: Complete List of Donor Screening Assays for Infectious Agents and HIV Diagnostic Assays [Accessed 27 October 2017] 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:S18, Arch Pathol Lab Med 2007;131:702)