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transfusion-associated infection
Pathology:
1) viral transmission
a) etiology: failure to recognize asymptomatic donors infected with HIV-1, HIV-2, HTLV-1, HTLV-2, hepatitis viruses, CMV, & others
b) clinical manifestations: related to transmitted virus
c) incidence: (risk per unit of component transfused)
- HIV: < 1 in 200,000
- hepatitis B: < 1 in 200,000
- hepatitis C: < 1 in 3000
- HTLV: < 1 in 60,000
- CMV: 50-100% of donors are infected
d) prevention:
1] careful donor screening
2] serologic testing
3] leukocyte filters to remove strictly leukocyte- associated viruses (HTLV)
4] donors negative for antibodies to CMV less likely to transmit CMV
2) transmission of bacteria & bacterial endotoxins
a) etiology:
1] unrecognized bacteremia in donor
2] contamination during processing
3] bacterial contamination of donor platelets is the most common cause
4] E. coli & Pseudomonas are associated with refrigerated components
5] Yersinia, Serratia & Salmonella are associated with platelets
b) clinical manifestations:
1] shock & disseminated intravascular coagulation (DIC)
2] high mortality
c) incidence: < 1 in 500,000 as cause of death
d) prevention:
1] proper skin preparation with blood donation
2] good blood banking practices
3] deferring donors with febrile illnesses
4] use of leukocyte-depleted blood components
3) transmission of parasites
a) etiology: donors infected with parasites, i.e. Plasmodium (malaria), Trypanosomes (Chagas' disease)
b) clinical manifestations: related to transmitted parasite
c) incidence: rare in the USA
d) prevention:
1] donor screening
2] development of serologic tests
Specific
transfusion-associated bacterial infection
transfusion-associated viral infection
General
complication
infection (infectious disease)