Viral infections blood transfusion

Treatment of aplastic crisis is primarily supportive. Blood transfusions may be indicated for severe or symptomatic anemia. Antibiotic therapy is not warranted because the most common etiology is viral, not bacterial, infection. 

Treatment of aplastic crisis is primarily supportive. Blood transfusions may be indicated for severe or symptomatic anemia. Antibiotic therapy is not warranted because the most common etiology is viral, not bacterial, infection. Treatment options for splenic sequestration include observation alone, especially for adults because they tend to have milder episodes chronic transfusion to delay splenectomy and splenectomy after a hfe-threatening crisis, after repetitive episodes, or for chronic hypersplenism. 

Several other viruses have been proposed as causes of liver injury these include hepatitis G yirus (discussed below), transfusion-transmitted virus (TTV), and the closely related SEN-V virus. Although all three are blood borne chronic viral infections and, in the case of TTV and SEN-V, have been known to replicate in the liver, none of these viruses appear to cause acute or chronic liver injuryd " The various hepatitis viruses are outlined in Table 47-2. 

The risk of ABO-incompatible blood transfusion, although completely preventable, is 1000 to 10 000 times higher than the risk of viral infection from blood. However, geographical location is important in evaluation of the risk of transfusion-related infections [3 ]. 

Virases The risk of transfusion-related viral infection is significantly lower than the risk of bacterial infections [3 ]. Of all human herpesviruses, cytomegalovirus (CMV) is the most significant cause of transfusion-related morbidity and mortality. Because CMV may be associated with leukocytes in blood products, the incidence of transfusion-related CMV infection is significantly reduced after the use of leukocyte reduction techniques. The residual risks of transfusion-related infection with hepatitis B virus, hepatitis C virus, and HIV are respectively... 

Adverse events related to transfusion of blood components have been reported, including febrile non-hemolytic transfusion reactions, mild febrile reactions, acute and delayed hemolytic transfusion reactions, transfusion-related acute lung injury (TRALl), anaphylactic and other allergic reactions, graft-versus-host disease (GvHD), transfusion-associated circulatory overload (TACO), viral infections, post-transfusion bacteremia, transfusion-associated sepsis (TAS), hemosiderosis, post-transfusion purpura, and new allo-antibody formation [18 , 19 ]. Whole blood, erythrocytes, leukocytes, platelets, and plasma for transfusion (fresh frozen plasma, FFP) are involved. Quite a number of these adverse effects, such as TRALl, TACO, TAS, and allergic/anaphylactic reactions can be difficult to evaluate. 

Potent antiretroviral activity has been demonstrated for hypericin and pseudohypericin in vivo and in vitro. It is postulated that the compounds interfere with viral infections and/or spread by direct inactivation of the virus or prevent virus shedding, budding, or assembly at the cell membrane. The National Institutes of Health was involved in human clinical trials with oral doses of hypericin in HIV positive subjects. The compound was also being developed as an antiretroviral agent for the transfusion blood supply. Hypericin achieves complete inactivation of more than five logs (more than 100,000 HIV particles/ mL of blood) of infectious HIV The hypericin dose used for inactivation has been shown to be safe to normal blood cells and does not interfere with standard blood tests. Transcription of HIV-1 in different human cells associated with brain HIV-1 infection was suppressed by a novel protein, p27(SJ) isolated from callus cultures of H. perforatum. ... 

Albumin (human) Epoetin alfa contains albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral diseases. No cases of transmission of viral diseases or Creutzfeldt-Jakob disease have ever been identified for albumin. Anemia Not intended for CRF patients who require correction of severe anemia epoetin alfa may obviate the need for maintenance transfusions but is not a substitute for emergency transfusion. Not indicated for treatment of anemia in HIV-infected patients or cancer patients due to other factors such as iron or folate deficiencies, hemolysis, or Gl bleeding, which should be managed appropriately. Hypertension Up to 80% of patients with CRF have a history of hypertension. Do not treat patients with uncontrolled hypertension monitor blood pressure adequately before initiation of therapy. Hypertensive encephalopathy and seizures have occurred in patients with CRF treated with epoetin. 

In acute viral hepatitis C, the HCV RNA usually clears from the serum once the infection is over — although the anti-HCV test remains positive for a long time after this. However, the combination of increased GPT and a positive anti-HCV test of the first generation nearly always points to infectious HCV. Subsequent to the EIA test, 95% of the positive sera demonstrated cRNA by PCR, so that infectivity could be confirmed. Eor this reason, neither anti-HCV-positive blood donors nor blood units can be released for transfusion. As a check for hepatitis B-negative patients with liver cell carcinoma, the EIA test displayed positivity in 83% of cases. In patients with aetiologically unresolved cirrhosis, the EIA test was positive in 62% of cases, i. e. a large number of the cryptogenic chronic cases of hepatitis and cirrhosis were probably caused by HCV infection. 

As outlined earlier, neutrophils and monocytes cannot be replaced effectively by transfusion. Problems with bacterial infection are likely if the neutrophil count drops below 0.5 x 1091-1, and fungal infections are more likely in the presence of neutopenia and monocytopenia. Lymphocytes cannot be replaced effectively by transfusion. Severe lymphopenia may persist for a year or more, long after the rest of the blood count has recovered. This results in a predisposition to viral and other non-bacterial infections. 

The transfusion of blood and blood products carries many risks, some of which are very serious. Haemolytic reactions caused by red cell antibodies, non-haemolytic febrile reactions due to white cell antibodies, urticaria, rare but extremely severe anaphylactic reactions caused by anti-IgA in patients lacking IgA, changes of pH and electrolytes resulting from storage lesions in stored bank blood, bacterial contamination, transmission of disease (in particular hepatitis, cytomegalic inclusion disease, mononucleosis infec-tiosa, syphilis, toxoplasmosis and malaria), circulatory overload and several other complications have been discussed in SED VIII and in many recent review articles. Infection with the virus of cytomegalic inclusion disease (CMV) occurs frequently. In most people it is a benign disease. Like other viral diseases, however, it should be feared in patients with an impaired cellular immunity (1, 2CR). 

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