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Transfusion practices in human immunodeficiency virus-infected patients

M A Popovsky1, K Benson, A B Glassman

  • 1American Red Cross Blood Services, New England Region, Dedham, Massachusetts, USA.

Transfusion
|July 1, 1995
PubMed
Summary

Transfusion practices for human immunodeficiency virus (HIV)-infected patients vary significantly. Many institutions modify blood components to mitigate risks like virus activation and tumor growth, despite a lack of standardized protocols.

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Area of Science:

  • Hematology
  • Infectious Diseases
  • Immunology

Background:

  • Transfusion's immunomodulatory effects raise concerns for HIV-infected patients, potentially increasing virus activation and tumor growth.
  • Lack of standardized transfusion practices necessitates an understanding of current approaches in specialized centers.

Purpose of the Study:

  • To survey and delineate current transfusion policies and practices for human immunodeficiency virus (HIV)-infected patients.
  • To identify variations in blood component modification and treatment strategies.

Main Methods:

  • A survey developed by the American Association of Blood Banks Transfusion Practices Committee was distributed.
  • The survey targeted 47 AIDS clinical trial units and 14 regional hemophilia centers in North America.

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Main Results:

  • 81% of centers used identical red cell transfusion criteria for HIV-infected and non-infected patients.
  • 52% used recombinant human erythropoietin for zidovudine-induced anemia; 35% used white cell-reduced components for CMV-seronegative patients.
  • Common reasons for white cell reduction included mitigating febrile reactions, cytomegalovirus (CMV) risk, and immunomodulatory consequences.

Conclusions:

  • Significant heterogeneity exists in transfusion practices for HIV-infected patients.
  • Modification of cellular blood components is a routine practice in many centers to address specific patient needs and risks.