Transfusion Transmitted Infection: Viral and Exotic Diseases

The transmission of malaria by blood transfusion was one of the first recorded incidents of transfusion-transmitted infections (TTIs). Although the World Health Organization (WHO) recommends that blood for transfusion should be screened for TTIs, malaria screening is not performed in most malaria-endemic countries in sub-Saharan Africa (SSA). The transfusion of infected red blood cells may lead to severe post-transfusion clinical manifestations of malaria, which could be rapidly fatal. Ensuring that blood supply in endemic countries is free from malaria is highly problematical, as most of the donors may potentially harbour low levels of malaria parasites. Pre-transfusion screening within endemic settings has been identified as a cost-effective option for prevention of transfusion-transmitted malaria (TTM). But currently, there is no screening method that is practical, affordable and suitably sensitive for use by blood banks in SSA. Even if this method was available, rejection of malaria-positive donors would considerably jeopardize the blood supply and increase morbidity and mortality, especially among pregnant women and children who top the scale of blood transfusion users in SSA. In this context, the systematic prophylaxis of recipients with anti-malarials could constitute a good alternative, as it prevents any deferral of donor units as well as the occurrence of TTM. With the on-going programme, namely the Affordable Medicine Facility - Malaria, there is an increase in the availability of low-priced artemisinin-based combination therapy that can be used for systematic prophylaxis. It appears nonetheless an urgent need to conduct cost-benefit studies in order to evaluate each of the TTM preventive methods. This approach could permit the design and implementation of an evidence-based measure of TTM prevention in SSA, advocating thereby its widespread use in the region.

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“…Transmission of malaria has been reported to occur mainly from single-donor products [26]. Any blood component may harbour viable parasites.…”

Section: Introductionmentioning

confidence: 99%

What is the best strategy for the prevention of transfusion-transmitted malaria in sub-Saharan African countries where malaria is endemic?

Nansseu

Noubiap²,

Ndoula³

et al. 2013

Malar J

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“…Transfusion-induced malaria was first reported in 1911 [1], and it is well-established that all five human malaria parasites ( Plasmodium falciparum , Plasmodium malariae , Plasmodium vivax, Plasmodium ovale, and Plasmodium knowlesi ) may be transmitted via blood transfusion [2]. Blood is mainly used in the emergency management of patients with life-threatening anaemia accompanied by severe malaria and malnutrition [3].…”

Section: Introductionmentioning

confidence: 99%

Is a Plasmodium lactate dehydrogenase (pLDH) enzyme-linked immunosorbent (ELISA)-based assay a valid tool for detecting risky malaria blood donations in Africa?

Atchade

Doderer-Lang

Chabi

et al. 2013

Malar J

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“…The risk of developing moderate or mild (flush, exanthem) reactions to high-molecular dextran infusions is 1/100000 (if preceded by hapten inhibition), while the risk for lethal reactions is small: 1 /24.4 million (Ljungstrom et al 1988). The hazards of allogenic blood transfusion have been discussed recently (Crosby 1992;Gottlieb 1993;Isbister 1993;Nicholls 1993;Wylie 1993). Allogenic transfusions may compromise immune defences (Blumberg & Heal 1989) and the estimated risk of developing mild to severe immunozogic reactions is not negligible: febrile reactions may occur in >lo%, urticaria in 1-3%, delayed haemolytic reactions in 0.2%, acute haemolytic reactions in 1 /25 000, anaphylactic shock in 1/20000 (Contreras & Mollison 1992;Nicholls 1993).…”

Section: Discussionmentioning

confidence: 99%

Bone marrow harvesting in children managed without allogenic blood

Sá

Békássy

Schou

et al. 1994

Pediatric Anesthesia

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Eleven children undergoing bone marrow harvesting were studied on 15 occasions to assess whether preoperative haemodilution and the acceptance of a transiently low haemoglobin concentration (5 g·dl−1) during anaesthesia, would obviate the need for giving allogenic blood. Before harvesting, 20 (8–28) ml·kg−1 of blood (median (range)) was collected in citrate‐phosphate‐dextrose (CPD) bags and replaced isovolaemically with dextran‐60 in Ringer's acetate. Replacement of the harvested volume (26 (17–42) ml·kg−1) was done with the same solution. The bag content was reinfused before awakening; red cells recovered during processing of the bone marrow 2–4 h postoperatively. The preoperative haemoglobin concentration (Hb) was 10.3 (8.7–12.3) g·dl−1 and central venous oxygen saturation (Scvo2) 82 (70–94)%. Hb decreased to 5.4 (4.7–8.4) g·dl−1 (P < 0.01) at the end of harvest, and Scvo2 to 76 (60–92)% (P < 0.05). Retransfusion from the CPD bags increased Hb to 6.8 (5.8–9.5) g·dl−1 (P < 0.05). After extubation Scvo2 decreased to 67 (55–79)% (P < 0.05). Reinfusing the harvested red cells increased Hb to 8.6 (6.6–10.5) g·dl−1 and Scvo2 to 74 (59–78)%. Hb one week after the harvest was 11.0 (7.4–12.7) g·dl−1. The authors conclude that the combination of preoperative and intraoperative haemodilution was well tolerated as judged from haemodynamics, Scvo2 and pH and allowed large volumes of bone marrow to be harvested without the need for allogenic blood.

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Transfusion Transmitted Infection: Viral and Exotic Diseases

Cited by 39 publications

References 49 publications

What is the best strategy for the prevention of transfusion-transmitted malaria in sub-Saharan African countries where malaria is endemic?

What is the best strategy for the prevention of transfusion-transmitted malaria in sub-Saharan African countries where malaria is endemic?

Is a Plasmodium lactate dehydrogenase (pLDH) enzyme-linked immunosorbent (ELISA)-based assay a valid tool for detecting risky malaria blood donations in Africa?

Bone marrow harvesting in children managed without allogenic blood

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