Diversion of initial blood flow to prevent whole‐blood contamination by skin surface bacteria: an in vitro model

Wagner, Stephen J.; Robinette, Daniel; Friedman, Leonard I.; Miripol, Jeffrey E.

doi:10.1046/j.1537-2995.2000.40030335.x

Cited by 69 publications

(50 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several recent studies suggest that the diversion of the initial 15 to 30 mL of whole blood from the main container might be associated with reduced risk of bacterial contamination. [54][55][56] Several blood bag manufacturers have developed plastic software to accommodate such an option. Several countries, including Canada, have recently introduced this intervention to try to reduce the rate of transfusion-associated sepsis.…”

Section: Removal Of First Aliquot Of Donor Bloodmentioning

confidence: 99%

“…63 Similar findings were also shown in an artificial model of blood collection. 56 The diversion pouch approach, using two recently FDA approved collection systems, is now being adopted by many blood centers as a way to lower the contamination risk. However, the ability of initial aliquot diversion to prevent clinical cases of transfusion-associated sepsis has not, as yet, been reported.…”

Section: Regulation and Regulatory Approachesmentioning

confidence: 99%

See 1 more Smart Citation

Bacterial Contamination of Blood Components: Risks, Strategies, and Regulation

Hillyer

Josephson²,

Blajchman³

et al. 2003

Hematology

221

210

View full text Add to dashboard Cite

Bacterial contamination of transfusion products, especially platelets, is a longstanding problem that has been partially controlled through modern phlebotomy practices, refrigeration of red cells, freezing of plasma and improved materials for transfusion product collection and storage. Bacterial contamination of platelet products has been acknowledged as the most frequent infectious risk from transfusion occurring in approximately 1 of 2,000-3,000 whole-blood derived, random donor platelets, and apheresis-derived, single donor platelets. In the US, bacterial contamination is considered the second most common cause of death overall from transfusion (after clerical errors) with mortality rates ranging from 1:20,000 to 1:85,000 donor exposures. Estimates of severe morbidity and mortality range from 100 to 150 transfused individuals each year.Concern This Joint ASH and AABB Educational Session reviews the risks, testing strategies, and regulatory approaches regarding bacterial contamination of blood components to aid in preparing practitioners of hematology and transfusion medicine in understanding the background and clinical relevance of this clinically important issue and in considering the approaches currently available for its mitigation, as well as their implementation.In this chapter, Drs. Hillyer and Josephson review the background and significance of bacterial contamination, as well as address the definitions, conceptions and limitations of the terms risk, safe and safety. They then describe current transfusion risks including non-infectious serious hazards of transfusion, and current and emerging viral risks. In the body of the text, Dr. Blajchman reviews the prevalence of bacterial contamination in cellular blood components in detail with current references to a variety of important studies. He then describes the signs and symptoms of transfusion-associated sepsis and the sources of the bacterial contamination for cellular blood products including donor bacteremia, and contamination during whole blood collection and of the collection pack. This is followed by strategies to decrease the transfusion-associated morbidity/mortality risk of contaminated cellular blood products 576American Society of Hematology including improving donor skin disinfection, removal of first aliquot of donor blood, pretransfusion detection of bacteria, reducing recipient exposure, and pathogen reduction/inactivation. In the final sections, Drs. Vostal, Epstein and Goodman describe the regulations and regulatory approaches critical to the appropriate implementation of a bacterial contamination screening and limitation program including their and/or the FDA's input on prevention of bacterial contamination, bacterial proliferation, and detection of bacteria in transfusion products. This is followed by a discussion of sampling strategy for detection of bacteria in a transfusion product, as well as the current approval process for bacterial detection devices, trials recommended under "actual clinical use" conditions, pathogen reduction ...

show abstract

Section: Removal Of First Aliquot Of Donor Bloodmentioning

confidence: 99%

Section: Regulation and Regulatory Approachesmentioning

confidence: 99%

Bacterial Contamination of Blood Components: Risks, Strategies, and Regulation

Hillyer

Josephson²,

Blajchman³

et al. 2003

Hematology

221

210

View full text Add to dashboard Cite

show abstract

“…In a study which evaluated 3385 whole blood units collected using a special bag that allowed for the collection of two separated 15 ml aliquots at the beginning of venepuncture, bacteria were detected in at least one of the two aliquots taken in 2AE2% of blood units drawn (most, but not all, were detected only in the first aliquot) [16]. Moreover, Wagner et al reported that diverting the first 21-42 ml of saline or whole blood reduces the downstream bioburden of deliberately introduced surface Staphylococcus aureus by approximately 1 log [17].…”

Section: Removal Of the First Aliquot Of Donated Bloodmentioning

confidence: 99%

Bacterial contamination of blood products

Lee¹

2011

ISBT Science Series

View full text Add to dashboard Cite

“…Several recent studies suggest that the diversion of the first 15 to 30 mL of blood from the main container might be associated with a reduced risk of bacterial contamination. [14][15][16] Several blood bag manufacturers have developed plastic software to accommodate such an option.…”

Section: Attempts To Decrease the Morbidity/mortality Riskmentioning

confidence: 99%