Clinical Use of Plasma and Plasma Fractions Chapter: Viral Inactivation Techniques
Abstract
Even though the blood supply is very safe, concerns regarding transmission of transfusion-related pathogens exist. Risks are reduced by donor screening, arm-preparation techniques, first aliquant diversion, screening for pathogens and, in many countries, pathogen reduction/eradication technology. The risk for viral infection from transfusion is now reported at 1:2,135,000 for HIV, 1:138,700-233,000 for HBV, 1:1935,000 for HCV, 1:250,000 for HTLV 1 and 2 (after screening peripherally), 1:1,000,000 HAV, 1:10,000 for parvovirus B19, and 1:250 unfiltered blood CMV. Prior to NAT testing, risk for WNV is 1:833 (risk is suspected to decrease with NAT testing). Risk for bacterial infection is 1:500,000 RBC units or 1:13,500 random or apheresis platelet units. Two technologies are FDA approved for screening of platelet units, though not all bacterial contamination is thought to be eliminated by such screening. Seroprevalence of parasite Trypanosome cruzi 1:7,500 to 33,000, Babesia microti up to 1:100 levels vary depending on donor population. Also, risks are unknown for Leishmaniasis and Toxoplasma. Other viruses known to be transmitted by transfusion but with less or unknown clinical significance include: Transfusion-Transmitted Virus (TTV), a non-enveloped single strand DNA virus, SEN -V (a non-enveloped single strand DNA virus) which is involved in 83% of non A-E Hepatitis, and Hepatitis 0 virus (single strand RNA enveloped virus). Wide prevalence has been demonstrated in donor populations. Though the risk is low, significant risk for transfusion- transmitted infections remains. Emerging pathogens and unknown future pathogens are not screened for or may contaminate blood components. A new tier of protection-pathogen reduction technology- is being developed to further decrease risks. Various additives are added to blood products to inactivate viruses, bacteria, fungi, protozoa, and other know/unknown transfusion- transmitted pathogens.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 26, 2005
- Accession Number
- ADA429793
Entities
People
- Joesph P. Pelletier
Organizations
- Yale University