Wednesday, September 27, 2006

transfusion related infections

Blajchman MA and Vamvakas EC. The Contining risk of transfusion-transmitted infections. NEJM 355:13: 1303-1305 Sept 28 2006

Authors remind us of risks to the blood supply. Neurologically speaking, culprits include West Nile Virus which is now mandated to be screened. vCJD (Variant CJD) with an incubation period oo up to 50 years has probably been transmitted in three cases in Britain. HHV8 a herpesvirus akin to CMV causes lifelong infections with periodic reactivations during which virus can circulate in WBC's and be transmitted. Risk factors probably overlap with HBV HCV and HIV andmayinduce Kaposi's sarcoma. No simple screening assay exists. Transfusing leukocyte reduced PRBC's may reduce transmission but this is unproved.

Discussion in blood bank circles includes whether to use pathogen reduction technologies such as methylene blue or solvent detergent, amotosalen for platelets, and UVA for RBC's.

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