Clinical Use of Plasma and Plasma Fractions Chapter: Viral Inactivation Techniques
YALE UNIV NEW HAVEN CT
Pagination or Media Count:
Even though the blood supply is very safe, concerns regarding transmission of transfusion-related pathogens exist. Risks are reduced by donor screening, arm-preparation techniques, first aliquant diversion, screening for pathogens and, in many countries, pathogen reductioneradication technology. The risk for viral infection from transfusion is now reported at 12,135,000 for HIV, 1138,700-233,000 for HBV, 11935,000 for HCV, 1250,000 for HTLV 1 and 2 after screening peripherally, 11,000,000 HAV, 110,000 for parvovirus B19, and 1250 unfiltered blood CMV. Prior to NAT testing, risk for WNV is 1833 risk is suspected to decrease with NAT testing. Risk for bacterial infection is 1500,000 RBC units or 113,500 random or apheresis platelet units. Two technologies are FDA approved for screening of platelet units, though not all bacterial contamination is thought to be eliminated by such screening. Seroprevalence of parasite Trypanosome cruzi 17,500 to 33,000, Babesia microti up to 1100 levels vary depending on donor population. Also, risks are unknown for Leishmaniasis and Toxoplasma. Other viruses known to be transmitted by transfusion but with less or unknown clinical significance include Transfusion-Transmitted Virus TTV, a non-enveloped single strand DNA virus, SEN -V a non-enveloped single strand DNA virus which is involved in 83 of non A-E Hepatitis, and Hepatitis 0 virus single strand RNA enveloped virus. Wide prevalence has been demonstrated in donor populations. Though the risk is low, significant risk for transfusion- transmitted infections remains. Emerging pathogens and unknown future pathogens are not screened for or may contaminate blood components. A new tier of protection-pathogen reduction technology- is being developed to further decrease risks. Various additives are added to blood products to inactivate viruses, bacteria, fungi, protozoa, and other knowunknown transfusion- transmitted pathogens.
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