Transfusion medicine
Transfusion transmitted disease
Transfusion transmitted disease-general


Topic Completed: 1 September 2011

Minor changes: 4 March 2021

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PubMed Search: "Transfusion transmitted disease"

Huy P. Pham, M.D., M.P.H.
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Cite this page: Pham H. Transfusion transmitted disease-general. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/transfusionmedgeneral.html. Accessed May 15th, 2021.
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:
  • 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:
Syphillis
  • No cases of transfusion transmitted syphilis in U.S. since 1966
  • Detected by serologic testing although blood with positive test in U.S. is unlikely to be infectious (Transfusion 2002;42:94)
  • 1,200 cases detected in U.S. donors during 1995 - 2000 (J Infect Dis 2002;185:545)
  • Test may contribute little to transfusion safety (NIH Consens Statement 1995;13:1), although some consider it a marker (although nonspecific) for high risk behavior associated with other sexually transmitted diseases

Donor positive rates:
  • Can be transmitted by blood transfusion; refrigeration kills most (but not all) spirochetes within 1 - 2 days but platelets are stored at room temperature and some red cells are transfused immediately without refrigeration
Variant Creutzfeldt-Jakob
  • Prion disease results from the benign form of a prion protein changing to an insoluble protease resistant form → formation of plaques in brain
  • Caused by prion protein that assumes an abnormal configuration, which promotes change to abnormal configuration of other proteins

Three forms of classic CJD:
  • Sporadic (85%)
  • Hereditary
  • Acquired (through corneal transplants, pituitary gland derived growth hormone, dura mater transplants, inadequately sterilized brain electrodes)

  • vCJD is human equivalent of "mad cow disease", due to epidemic of bovine spongiform encephalopathy, possibly due to prion in cattle entering human food supply
  • In 1995, vCJD was documented in U.K.; transmission was through food chain

vCJD symptoms:
  • Behavioral change, cerebellar ataxia and dementia; death in 7 - 38 months

Unknown or future pathogens (pending)
Case reports
Variant Creutzfeldt-Jakob
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