[Blood transmission and infections]

A blood transfusion can never become a completely risk free event. Almost all kinds of infectious agents; viruses, bacteria and parasites, can be transmitted by blood. So far, hepatitis and HIV-infections have been focused. The state of readiness to meet these infections must be kept while we prepare for "new" agents, like parvovirus B19. Extensive international travelling will increase the possibility of blood-borne parasitic infections, like malaria and Chagas' disease, even with the very high quality demands imposed for Norwegian blood donors. We can keep a better eye on the infectivity of the blood products by strictly realizing our objective of national self-sufficiency. Recent research results indicate transfusion-mediated effects to the immune system, particularly of allogeneic transfusions containing leucocytes. This immunomodulation seems to enhance the risk of secondary infections. So far, it is impossible to tell whether this immunomodulation has any impact on the long-term outcome of malignant diseases. A blood transfusion will always represent a risk, although small, to the patient. This recognition makes it essential to carefully consider whether to give a patient a transfusion, and to document this decision properly.