The infectious risks in blood transfusion as of today – A no black and white situation

Garraud, Olivier; Filho, Luiz Amorim; Laperche, Syria; Tayou-Tagny, Claude; Pozzetto, Bruno

doi:10.1016/j.lpm.2016.06.022

Cited by 19 publications

(15 citation statements)

References 87 publications

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“…For example, is the residual risk of HIV-1 infection defined by less than 1 in 10 6 donations, considered within the acceptable range? This may be unacceptable in countries that control HIV transmission well (i.e., in Europe or the USA), but unachievable in countries with a high prevalence of HIV in their population such as Middle Africa ( 21 ). It is clearly not the responsibility of HBB or Blood Establishment (BE) professionals to define such criteria, but rather the national public health authorities.…”

Section: The “A B C” Of the Blood Collection And Transfusion Procesmentioning

confidence: 99%

How Can Eastern/Southern Mediterranean Countries Resolve Quality and Safety Issues in Transfusion Medicine?

2018

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Unlike their Western counterparts, some of the Eastern/Southern Mediterranean countries lack centralized coordinated blood transfusion services leading to an unequal blood safety level. This was recently highlighted by a recent World Health Organization (WHO) regional committee report in which WHO urges these countries to establish and implement a national blood system with well-coordinated blood transfusion activities and to make attempts to reach 100% voluntary non-remunerated blood donation. The objective is thus to meet the same levels or standards as Western countries in term of self-sufficiency and blood safety. This raises the question whether these countries can either comply with Western countries’ guidelines and experiences or develop their own safety scheme based on proper sociopolitical and economic features. Another option is to identify efficient and cost-effective strategies setup successfully in neighbor countries sharing cultural and economic features. To address this issue—and make an attempt to achieve this goal—we designed a number of surveys specifically addressed to Mediterranean countries, which were sent out to the national authorities; so far, five surveys aim at covering all aspects in blood collection, processing, testing, inventory and distribution, as well as patient immune-hematological testing and follow-up (including surveillance and vigilances). It is anticipated that such practice can help identifying and then sharing the more successful and cost-effective experiences, and be really focused on Mediterranean areas while not necessarily copying and pasting experiences designed for Western/Northern areas with significantly distinct situations.

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Section: The “A B C” Of the Blood Collection And Transfusion Procesmentioning

confidence: 99%

How Can Eastern/Southern Mediterranean Countries Resolve Quality and Safety Issues in Transfusion Medicine?

2018

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“…Blood transfusion is the oldest and most common therapeutic modality used to treat and prevent inadequate O 2 release to tissues. As are other therapeutic modalities, it is associated with both acute and delayed adverse effects [ 10 – 12 ]. The major complications of blood transfusion are mostly related to hemolytic reactions [ 13 ], transfusion-related acute lung injury (TRALI) [ 14 ], and infections [ 12 ]; multiple organ failure, renal dysfunction, and mortality can occur [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…As are other therapeutic modalities, it is associated with both acute and delayed adverse effects [ 10 – 12 ]. The major complications of blood transfusion are mostly related to hemolytic reactions [ 13 ], transfusion-related acute lung injury (TRALI) [ 14 ], and infections [ 12 ]; multiple organ failure, renal dysfunction, and mortality can occur [ 10 ]. To reduce these risks, blood donors are rigorously screened and selected following national and international rules for eligibility, defined in accordance with criteria for past medical history and physical examination, as well as hematological and serological testing [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Smoking fewer than 20 cigarettes per day and remaining abstinent for more than 12 hours reduces carboxyhemoglobin levels in packed red blood cells for transfusion

Boehm¹,

Arbo²,

Leal³

et al. 2018

PLoS ONE

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BackgroundThe prevalence of smokers among blood donors and the effect of smoking on the quality of donated blood have not been extensively explored. In the present study, we determined the prevalence of smoker donors in a large blood bank in Southern Brazil and evaluated the quality of packed red blood cells (RBCs) from these donors through recommended quality control tests and measurement of carboxyhemoglobin (COHb) levels. We then assessed the influence of smoking habits and abstinence before donation on these parameters.Material and methodsAn observational study was conducted to determine the prevalence of smoking donors, while a prospective cohort study compared conventional hematological and serological parameters and COHb levels at 0, 15, and 30 days after donation in RBCs donated by smokers (N = 31) and nonsmokers (N = 31) and their association with smoking habits and abstinence before donation.ResultsOf 14,428 blood donations received in 1 year, 5.9% were provided by smokers. Storage over time slightly altered some quality parameters, such as hematocrit, hemoglobin, hemolysis, and COHb levels, in RBC packs. COHb levels were higher in RBC packs from smokers (8%) than from non-smokers (2%), and increased as a function of the number of cigarettes smoked daily and time elapsed since the last cigarette smoked before donation. Lower levels were found in RBC packs from donors who smoked fewer than 20 cigarettes per day or remained abstinent for more than 12h before giving blood.ConclusionAlthough cigarette smoke had no significant effect on blood quality parameters such as hematocrit, hemoglobin, or hemolysis, it quadrupled COHb levels in packed RBCs. Abstinence from smoking for more than 12h or smoking fewer than 20 cigarettes daily helped decrease COHb levels.ImplicationsGiven the increasing prevalence of tobacco use worldwide, we suggest blood banks recommend 12h of tobacco abstinence before donation and analyze COHb levels in donated blood as an approach to reduce risk for high-risk recipients.

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“…Patients can present with ongoing infections, either because infection or sepsis is the primary disease, or because they are accidentally infected during healthcare (iatrogenic infection): the latter situation is unfortunate and, depending on the patient or the causality, is considered acceptable or not [22]. What is generally unacceptable is being infected with an infectious pathogen due to error, or with an agent that is only transmitted by iatrogenic exposure.…”

Section: How Do Blood Establishments Mitigate the Infectious Risks Anmentioning

confidence: 99%

Blood donation and/or donated blood acceptance: The different stakeholders’ ethical considerations

Garraud

Tissot

2016

Ethics, Medicine and Public Health

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The infectious risks in blood transfusion as of today – A no black and white situation

Cited by 19 publications

References 87 publications

How Can Eastern/Southern Mediterranean Countries Resolve Quality and Safety Issues in Transfusion Medicine?

How Can Eastern/Southern Mediterranean Countries Resolve Quality and Safety Issues in Transfusion Medicine?

Smoking fewer than 20 cigarettes per day and remaining abstinent for more than 12 hours reduces carboxyhemoglobin levels in packed red blood cells for transfusion

Blood donation and/or donated blood acceptance: The different stakeholders’ ethical considerations

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