Chicago - Sept 1999.pptVIP

Many problems with transfusions are related to infection. In 1985, the chance for hepatitis was 10% and HIV 0.5% TABLE 47-11Percentage Risk of Transfusion-Transmitted InfectionWith a Unit of Screened Blood in the United States RISK WINDOW PERIOD (DAYS) HIV 1/800,000 22 11 HTLV I II 1/641,000 51 Cytomegalovirus 1.0% rapidly HCV 1/600,000 82 8-10 HBV 1/200,000 59 TABLE 47-12Infectious Disease Testing For Blood Transfusions (1998) Discontinue serum alanine aminotransferase testing Hepatitis C antibody testing Antibody to hepatitis B core antigen HIV-1 HIV-2 HIV Ag (p24 antigen) HTLV I/II Serologic test for syphilis) TABLE 47-13Tests Used For Detecting Infectious Agents In All Units Of Blood (2004) VIRUS RNA MINPOOL ANTIBODY TO HIV NAT HIV, I, II O HCV NAT HCV HBV HBC HTLV HTLV I II WNV NAT NAT = nucleic acid technology WNV = West Nile Virus NUCLEIC ACID TECHNOLOGY (NAT) TESTING WILL BE USED ON: HBV Hepatitis A Parvovirus 19 West Nile Virus TABLE 47-14INFECTIOUS DISEASES (2004) - NO TEST DISEASE RISK Malaria 2-3 cases per year in USA Chagas 0.1 -0.2% of units SARS ? VCJD ? V CJD = Variant Creutzfeldt-Jakob Disease SARS = Severe Acute Respiratory Syndrome *DONATED BLOOD WILL BE BANNEDFROM DONORS WHO: Lived in UK 3 months or longer since 1980 Lived in Europe 6 months since 1980 Anyone who has received blood in UK Will decrease donors by 8-9% MALARIA 2 to 3 cases/year for 40 years Since 1982, all cases were from emigrants or residents from endemic areas WEST NILE VIRUS 4,000 cases of which 21 are transmitted by transfusion* In 2002, 23 cases** 43% were immunocompromised 8% were 70 years TABLE 47-8TRANSFUSION FATALITIES (2001-2002) IN THE UNITED STATES* Bacterial contamination - 17 TRALI - 16 Mistransfusion - ABO mismatch - 14 *From the Federal Drug Administration (Oct. 1, 2001 to September, 30, 2002) TRALI = transfusion related acute lung injury PLATELET INDUCED SEPSIS 33 year old male with chronic pancytopeni