Existing and Emerging Blood-Borne Pathogens: Impact on the Safety of Blood Transfusion for the Hematology/Oncology Patient
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Published on: March 19, 2016
Stephen J Wagner1, David A Leiby2, John D Roback3
1Transfusion Innovation Department, American Red Cross Holland Laboratory, 15601 Crabbs Branch Way, Rockville, MD 20855, USA.
Abstract:
Despite measures to mitigate risk of transfusion-transmitted infections, emerging agents contribute to morbidity and mortality. We outline the epidemiology, risk mitigation strategies, and impact on patients for Zika virus, bacteria, Babesia, and cytomegalovirus. Nucleic acid testing of blood has reduced risk of Zika infection and reduced transfusion-transmitted risk of Babesia. Other collection and testing measures have reduced but not eliminated the risk of sepsis from bacterially contaminated blood components. Cytomegalovirus has almost been eliminated by high-efficiency leukoreduction, but residual transmissions are difficult to distinguish from community-acquired infections and additional antibody testing of blood may confer further safety of susceptible recipients.
Insights
Emerging transfusion-transmitted infections like Zika virus and Babesia pose risks despite testing. Nucleic acid testing and leukoreduction improve blood safety, but vigilance is crucial for preventing sepsis and cytomegalovirus transmission.
Area of Science:
- Infectious Diseases
- Hematology
- Public Health
Background:
- Transfusion-transmitted infections (TTIs) remain a concern despite existing safety measures.
- Emerging infectious agents continue to pose risks for transfusion recipients.
- Key pathogens include Zika virus, bacteria, Babesia, and cytomegalovirus (CMV).
Purpose of the Study:
- To review the epidemiology of emerging TTIs.
- To discuss risk mitigation strategies for blood transfusion.
- To evaluate the impact of these infections on patient health.
Main Methods:
- Review of current literature on TTIs.
- Analysis of risk mitigation strategies, including nucleic acid testing (NAT) and leukoreduction.
- Assessment of pathogen-specific impacts and control measures.
Main Results:
- NAT has significantly reduced the risk of Zika virus and Babesia transmission.
- Bacterial contamination risk is reduced but not eliminated by collection and testing measures.
- High-efficiency leukoreduction has greatly decreased CMV transmission, though residual risk and diagnostic challenges persist.
Conclusions:
- Ongoing vigilance and advanced testing are necessary to further enhance blood safety.
- Nucleic acid testing and leukoreduction are critical tools in minimizing TTI risks.
- Additional measures, like antibody testing for CMV, may offer enhanced protection for vulnerable populations.
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