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At least 271 records · Page 15Linked to original sources
PubMed2002

Simian foamy virus infection in a blood donor.

BACKGROUND: Infections with simian foamy virus (SFV) are widely prevalent in nonhuman primates. SFV infection was confirmed in a worker, occupationally exposed to nonhuman primates, who donated blood after the retrospectively documented date of infection. Human-to-human transmission of SFV through transfusion and its pathogenicity have not been studied. STUDY DESIGN AND METHODS: Recipients of blood from this donor were identified and blood samples from such recipients were tested for SFV infection by Western blot and PCR assay. RESULTS: One recipient of RBCs and another recipient of FFP had died; retroviral infections were not implicated. One platelet recipient could not be tested. Recipients of RBCs (two), a WBC-reduced RBC unit (one), and a platelet unit (one) tested SFV-negative 19 months to 7 years after transfusion. Tested recipients had transfusions 3 to 35 days after blood donation. Samples of one lot of albumin and three lots of plasma protein fraction (manufactured from recovered plasma from two donations) tested negative both for antibodies and for viral RNA. CONCLUSION: SFV transmission through transfusion was not identified among four recipients of cellular blood components from one SFV-infected donor. Derivatives containing plasma from that donor tested negative for SFV.

Adult↗
PubMed2004

Leukocyte antibodies and biologically active mediators in the pathogenesis of transfusion-related acute lung injury.

Transfusion-related acute lung injury (TRALI) is a clinical constellation of signs and symptoms associated with transfusion. In severe cases, the most prominent feature is acute onset of pulmonary edema. Two mechanisms have been advanced to explain pulmonary injury in this syndrome. One mechanism involves the presence of antibodies to white blood cells, usually in a transfused blood component. Interaction of antibodies, with white blood cells in the transfusion recipient, is hypothesized to cause cellular activation with release of cytokines resulting in pulmonary vascular endothelial damage and exudation of fluid across the pulmonary basement membrane. In the biologically active mediator mechanism, two events are hypothesized to cause TRALI. In the first event, polymorphonuclear cells become primed and pulmonary vascular endothelium becomes activated secondary to the production of biologically active mediators, as a result of physiologic stress. The second event is the infusion of biologically active mediators in a stored cellular blood product. The second event causes release of cellular activators with subsequent endothelial damage and exudation of fluid into the pulmonary alveoli.

Acute Disease↗
PubMed1996

Medicare and Medicaid programs; hospital standard for potentially HIV infectious blood and blood products--HCFA. Final rule.

This final rule requires hospitals participating in the Medicare and Medicaid programs to take appropriate action when the hospitals learn that they have received whole blood, blood components (including recovered plasma), source plasma, and source leukocytes (hereafter referred to as blood or blood products) that are at increased risk of transmitting Human Immunodeficiency Virus (HIV) infection. If the hospital learns that it has received blood or blood products collected from a donor recently exposed to HIV, before the donor has a sufficient level of antibody to be detected by the screening test for antibody to HIV, the hospital must quarantine any blood or blood products remaining in inventory pending confirmation testing. If the presence of HIV is confirmed by more specific testing, the hospital must notify patients who received the blood or blood product. This final rule is intended to ensure that proper health and safety steps are taken to minimize further spread of HIV infection. A final rule published elsewhere in this Federal Register by the Food and Drug Administration applies the same requirements to entities furnishing transfusion services that do not participate in the Medicare and Medicaid programs and clarifies the responsibilities of blood establishments to identify and notify the transfusion service that received affected blood and blood products.

Blood Component Transfusion↗
PubMed2005

[Guidelines for safer and more appropriate use of blood transfusion systems in Japan].

The Blood Transfusion Law has been newly established in Japan since 2003. Under the new law, physicians and co-medical staff have to work hard to establish safer blood transfusion systems and more appropriate transfusion of blood components for the patients in their hospitals. Guide lines for transfusion of blood components made by the Ministry of Health, Welfare, and Labor in Japan are useful tools to accomplish the aims shown above. When they would transfuse blood components appropriately to the patients according to the guidelines, more fresh frozen plasma could be available for the raw materials to produce albumin components and immunoglobulin components those are now partially imported from the foreign countries. Eventually, blood components consumed in Japan for transfusion will be supplied by 100% inland donors blood.

Blood Component Transfusion↗
PubMed2003

Allergic transfusion reactions: an evaluation of 273 consecutive reactions.

CONTEXT: Allergic reaction to transfusion is common. However, the review of a large series of allergic transfusion reactions has not been performed. OBJECTIVE: To review a large series of allergic transfusion reactions. DESIGN: A retrospective review of all reported and evaluated transfusion reactions during a 9-year period at 1 institution was performed. Associated clinical signs and symptoms were evaluated. SETTING: Large, tertiary-care teaching hospital. RESULTS: A total of 1613 adverse reactions to transfusion were evaluated. Allergic transfusion reactions accounted for 17% (273 of 1613) of the transfusion reactions. Severe allergic reactions (anaphylaxis, anaphylactoid signs and symptoms, and/or hypotension) were observed in 21 patients (7.7% of allergic reactions, or 1.3% of all transfusion reactions). Serum tryptase, a marker for anaphylaxis, was measured in 1 patient and determined to be borderline elevated. Five patients experienced allergic transfusion reactions to autologous red cell transfusions. One patient experienced hives during the transfusion of a major ABO mismatched red blood cell. A wide variety of skin manifestations were observed, but 26 (9.5%) patients did not have skin manifestations. Allergic transfusion reactions were estimated to occur in approximately 1 in 4124 blood components transfused, or 1 in 2338 transfusion episodes. Severe allergic reactions occurred in approximately 1 in 30,281 transfusions. No deaths directly attributable to transfusion were observed in this patient group. CONCLUSIONS: The clinical presentation of allergic transfusion reactions was quite variable, and the pathophysiology remains unclear. Recommendations for clinical evaluation and therapy remain problematic and often empirical.

Acute Disease↗
PubMed2004

Current status of transfusion triggers for red blood cell concentrates.

Clinical practice guidelines on red blood cell transfusion (RBC) are based on expert opinion, animal studies and the few human trials available. Twelve randomized controlled trials on the benefits of RBC transfusions in humans have been published. In the absence of definitive outcome studies, numerous theoretical arguments have been put forward in favor or against the classic transfusion threshold of 100 g/l. However, data from randomized controlled trials suggest that overall morbidity (including cardiac) and mortality, hemodynamic, pulmonary and oxygen transport variables are not different between restrictive (transfusion threshold between 70 and 80 g/l) and liberal transfusion strategies and that a restrictive transfusion strategy is not associated with increased adverse outcomes. In fact, a restrictive strategy may be associated with decreased adverse outcomes in younger and less sick critical care patients. The majority of existing guidelines conclude that transfusion is rarely indicated when the hemoglobin concentration is greater than 100 g/l and is almost always indicated when it falls below a threshold of 60 g/l in healthy, stable patients or more in older, sicker patients. In anesthetized patients, this threshold should be modulated by factors related to the dynamic nature of surgery such as uncontrolled hemorrhage, microvascular bleeding, etc. Another important role of RBC relates to primary hemostasis and higher triggers may be appropriate in coagulopathic patients. RBC concentrates are administered to correct inadequate oxygen delivery and/or to sustain primary hemostasis. Reliable monitors of tissue oxygenation and hemostasis will be required to study the benefits (or lack thereof) of RBC transfusions. The quest for a universal transfusion trigger, i.e., one that would be applicable to patients of all ages under all circumstances, must be abandoned. All RBC transfusions must be tailored to the patient's needs, at the moment the need arises. In conclusion published recommendations are commensurate with existing knowledge and, unfortunately, their conclusions are limited. Future research and development should focus on the determination of optimal transfusion strategies in various patient populations and on reliable monitors to guide transfusion therapy.

Blood Component Transfusion↗
PubMed1992

Guidelines for transfusion of erythrocytes to neonates and premature infants. Fetus and Newborn Committee, Canadian Paediatric Society.

The transfusion of erythrocytes to neonates and premature infants is common and should be minimized through a reduction in the number of blood samples taken for laboratory tests. The risks to patients have been minimized with current blood-banking techniques, although neonates and premature infants may require special consideration. The indications for transfusion of erythrocytes to neonates include the presence of shock, a loss of 10% or more of the blood volume within 72 hours when further blood sampling is expected, a hemoglobin level of less than 130 g/L in neonates with cardio-respiratory disease who require increased oxygen-carrying capacity, and a hemoglobin level of less than 80 to 100 g/L in neonates with tachypnea, tachycardia, recurrent apnea, poor feeding or failure to gain weight. The attending physician should consider these indications along with clinical judgement to ensure safe and effective erythrocyte transfusion.

Blood Component Transfusion↗