NR AYGB
AU O'Riordan,J.M.; Fitzgerald,J.; Smith,O.P.; Bonnar,J.; Gorman,W.A.
AK National Blood Users Group
TI Transfusion of blood components to infants under four months: review and guidelines.
QU Irish Medical Journal 2007 Jun; 100(6): suppl 1-24 following 496
IA http://imj.imaxan.ie//Issue_detail.aspx?issueid=+&pid=3667&type=Contents
PT journal article; practice guideline; review
VT
(Auszug) ...
2.1 Transfusion transmitted Infections
2.1.1 Known viruses
Because of their long life expectancy and relatively immature immune system, transfusion transmitted diseases in infants can have serious consequences. Current blood donor selection procedures and testing using serological immunoassays and nucleic amplification testing (NAT) for HCV and HIV-1 have reduced the residual risk of transfusion transmitted HIV and HCV to an estimated 1 in 4 million per units transfused. Risk estimates for hepatitis B virus (HBV) are the most difficult to calculate because of the transient nature of HBV in adults, but a conservative estimate is of the order of 1 in 200,000 per unit transfused. Whilst 95% of immunocompetent adults will clear HBV infection, a newborn infected with HBV almost invariably becomes a carrier.
2.1.2 Variant (v)CJD
vCJD, a fatal disease, for which there is no treatment, must now be considered a transfusion transmissible disease, following reports of transmissions in the UK from donors who, subsequent to donation, went on to develop vCJD.13,14 Although the actual risk of transfusion transmitted vCJD may be low in Irish transfusion recipients, the recent diagnosis of vCJD in an Irish donor subsequent to donation means that, in the absence of a blood screening test, transmission remains a possibility for transfusion recipients.
Rodent experimental models of Transmissible Spongiform Encephalopathies suggest that most infectivity in blood resides in the buffy coat and plasma.
A number of measures have been introduced by the Irish Blood Transfusion Service (IBTS) to protect the Irish blood supply including:
- The leucocyte reduction of blood components.
- The exclusion of donors who have spent extended periods of time in the UK during the BSE epidemic (1980-1996).
- The exclusion of donors who have themselves been transfused.
- The replacement of single donor Irish fresh frozen plasma (FFP) with pooled solvent detergent (SD) treated, US sourced, plasma (so-called SD-Plasma). Solvent detergent treatment effectively eliminates the risk of HBV, HCV and HIV because they are enveloped viruses; however the process has no effect on non-enveloped viruses such as Hepatitis A and Parvovirus. Although the manufacturer takes measures to reduce the risk of transmission of these small non-enveloped viruses in SD-Plasma, the risk has not been eliminated because these are pooled blood products.
- The use of prion removal filters for red blood cells is currently being evaluated by the IBTS.
...
ZR 169
MH Acute Disease; Blood Banks/standards; Blood Component Transfusion/adverse effects/*standards; Blood Specimen Collection/adverse effects; Graft vs Host Disease/etiology; Humans; Infant; Infant, Newborn; Infant, Premature; Intensive Care, Neonatal/*standards; Ireland; Prion Diseases/etiology; Thrombocytopenia
SP englisch
PO Irland