October 3, 2006 Source: :
http://dailynews.mcmaster.ca/story.cfm?id=4262 Blood transfusion-transmitted
infections: A global
perspective by FHS
Advancement
October 03, 2006 Thanks to the many blood-safety interventions introduced since 1984, the
overall risk for most transfusion-transmitted infections has become
exceedingly small. In the Sept. 28 issue of The New England Journal of Medicine, Dr. Morris
Blajchman, professor of medicine at McMaster University, and medical
director, Canadian Blood Services (Hamilton Centre), with co-author Dr.
Eleftherios Vamvakas of Ottawa, put into perspective the continuing risk of
transfusion-transmitted infections as well as the possible safety
interventions that might reduce that risk even further, particularly those
due to emerging agents including variant Creutzfeldt-Jakob disease (vCJD),
the human counterpart to mad cow disease. With regard to the emerging pathogens, several newly-developed
pathogen-reduction technologies have been shown to be effective in
destroying most bacteria, viruses and parasites in donated blood, but
ineffective against the pathogens that cause neurodegenerative diseases and
those viruses that are present in exceedingly high concentrations in blood. Newer technologies can also have a downside, notes Blajchman. They tend to
reduce the effectiveness of the blood components, necessitating the
transfusion of greater quantities and thus exposing patients to blood from
more donors, thereby increasing the risk of infection transmission by
transfusion. "The possible additional safety interventions that might further reduce the
risk of transfusion-transmitted infections will be debated extensively over
the next few years," says Blajchman. "Regardless of the outcomes of these
debates, it is clear that the risk of transmission is not static. As new
agents continue to emerge, old ones change their properties and
epidemiologic patterns, and new information and technology become available
to change our understanding of that risk." The commentary by Blajchman and Vamvakas was written in relation to an
article in the same issue of the journal concerning the
transfusion-transmission of HHV-8, a virus that has the potential to cause
skin tumors (Kaposi's Sarcoma) in immunocompromised recipients.
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