Blood transfusion and its risk assessment: are we safe?

This post originally appeared on our partner blog Pharma Sastra at http://pharmasastra.blogspot.in/2016/06/blood-transfusion-and-its-risk.html

14^th June, WORLD BLOOD DONOR DAY, a campaign marked by WHO (World Health Organization), established in 2004 in order to raise awareness of the need for safe blood and blood products, and to thank blood donors for their voluntary, life-saving gifts of blood.

World Blood Donor Day celebration brings a precious opportunity to all donors for celebrating it on national and global level as to commemorate the birthday anniversary of KARL LANDSTEINER (a great scientist who won the Nobel Prize for his great discovery of the ABO blood group system).

This year the theme of the day was “Blood connects us all”. And we should not forget that blood can also connect to us via a disease as well.

This week itself, lots of blood donation program has been conducted by various organizations. But very less such organization take care about the risk of disease transmission via such large mass blood donation program. Here we tried to elaborate some risk which can occur via blood donation programs. Being a health professional its our duty to present a real picture and risk of blood transfusion.

Transfusion-Transmitted Infection (TTI):

Blood transfusion has been and continues to be a possible source of disease transmission. A myriad of agents can potentially be transmitted through blood transfusions, including bacteria, viruses and parasites. Of these, bacteria are the most commonly transmitted. Some of the enlisted exogenous substances which may come during blood transfusion and infect the healthy human:

·        Prions : These can cause Creutzfeldt-Jakob disease, are also transmissible through transfusion; they cannot be destroyed using current techniques for inactivating pathogens in the blood supply.

·       Viral: Nowadays viral transmission is a greatest chanllenge for the health professionals. Dieases like hepatitis C and HIV has high risk of transmission by blood transfusion. Some other like, cytomegalovirus (CMV), Human T-cell lymphotrophic viruses (HTLVs), West Nile Virus 9 (WNV).

·         Parasites: Some parasites like malaria also transmit via blood transfusion.

·         Bacteria:- Some of the bacterias like Pseudomonas, Staphylococci, Treponema Pallidum, a spirochete bacterium(Syphilis).

Any infective agent that potentially evades the sterility of the transfusion loop can come from the donor's blood or skin or from a contaminated environment. It has been proposed that the higher incidence of bacterial transmission via platelets is due to the difference in storage temperatures. Also important is the duration of storage, which has a direct correlation with the likelihood of bacterial contamination. An important concept in the evaluation of data regarding transfusion-transmitted bacterial infections (TTBIs) is the definition of a case.

Such infected blood transfusion can cause mild to serious damage till death. So to prevent such ill effect any organization can take various measures which are enlisted below:

*Donor selection

*Processing, Quality control

*Screening Tests

*Storage , Pathogen inactivation

*Better blood transfusion

*Tracing surveillance

We recommend any organization to follow following measures or visit red cross for the proper guidance and training.

·     Assure the donor safe from any diseases by taking his/her history.

·     Repeat the type and cross-match, and also collect blood for a Coombs test and bacterial culture from the recipient

·     In order to prevent an infective incident, strict sterile precautions and donor screening are required 

·     Donors who are febrile and likely infected should be deferred

·     Chlorhexidine or iodine should be used to properly disinfect the venipuncture site.

·     The initial aliquot of donor blood should be discarded to prevent contamination with the skin flora.

·     Identify bacterial contamination by laboratory methods

·     Bactericidally treat the donated blood

Despite the potential for disease transmission through transfused blood, the safety of the blood supply should be continued to improve blood donation and transfusion.

Ms. Sandhaya D.