Infection Risk Poses Blood Transfusion Dilemma

2008 ◽  
Vol 1 (9) ◽  
pp. 10-11
Author(s):  
MITCHEL L. ZOLER
Keyword(s):  
Blood Transfusion ◽  
Infection Risk

Since blood transfusion is linked to the magnitude of the surgical procedure, comparing transfused patients to untransfused patients will always be confounded by infection risks due to factors related to the procedure. To control for these factors one must compare patients transfused with red cells from different sources or prepared in a manner which minimize infection risk. Patients transfused with homologous blood have infection rates several fold higher than recipients of equal values of autologous blood undergoing the same operative procedure (20-23). Homologous blood recipients have significantly longer hospital stays attributed to treating infections. The cost of a blood transfusion exceeds the cost of collection, storage and administration because of transfusion's association with length of stay. In this era of cost-containment the association with prolonged stay may ultimately curtail the use of blood. Homologous blood can be filtered to remove donor leukocytes which may be contributing to immune suppression and infection risk. A prospective randomized trial comparing the infection rates among colorectal cancer patients receiving filtered and unfiltered blood has been conducted (9). There were 17 infectious complications among the 56 recipients of whole blood and one infectious complication among the 48 recipients of filtered blood. Infections were prevented by the seemingly simplistic addition of a $25/filter to every bag of blood transfused. These clinical studies are very convincing: homologous blood transfusion is associated with increased risk of infection in every clinical situation examined. In multivariate analyses transfusion was a significant predictor of infection after consideration of other variables measured and in the majority of those studies transfusion was the single most significant factor. Patients receiving homologous blood exhibited an incidence of infectious complications that was approximately four times higher than patients receiving autologous blood. The association of transfusion with infection is found among patients undergoing surgery for cardiac, orthopedic and gastrointestinal disorders and for trauma as well as among unoperated patients transfused for bums and gastrointestinal bleeding. The observation that nosocomial infections are increased in these studies argues strongly that the association of transfusion with infection is not simply a reflection of transfusion as a marker of tissue destruction and contamination. Infections that develop in transfused patients away from the site of trauma or in the absence of trauma, cannot be attributed to the quantity of tissue destroyed or to the degree of bacterial contamination. Filtered blood can remove leukocytes and prevent postoperative infections. Since filtering blood can significantly reduce the incidence of infection among transfused patients, all transfused blood will be passing through filters in the very near future. EXPERIMENTAL STUDIES RELATING BLOOD TRANSFUSION TO INCREASED RISK OF INFECTION Patients are extremely heterogeneous and even in prospective randomized trials, factors which influence patients' participation affect the outcome despite double-blinding and randomization. In animal studies using syngeneic strains with identical housing, lighting, access to food and water, control over the extent of injury, use of antibiotics and exposure to other variables the influence of a single variable such as blood transfusion can be measured. Dr. Waymack's laboratory has intensively studied parameters which interact with transfusion in

1995 ◽  
pp. 296-296
Keyword(s):  
Blood Transfusion ◽  
Autologous Blood ◽  
Experimental Studies ◽  
Infection Risk ◽  
Infectious Complications ◽  
Risk Of Infection ◽  
Infection Rates ◽  
Homologous Blood ◽  
Increased Risk ◽  
The Cost

Blood transfusion from another person doubles infection risk after CABG surgery

BMJ ◽  
2009 ◽  
Vol 339 (aug04 1) ◽  
pp. b3147-b3147
Author(s):  
S. Mayor
Keyword(s):  
Blood Transfusion ◽  
Infection Risk ◽  
Cabg Surgery

Mechanism of Injury May Influence Infection Risk from Early Blood Transfusion

2017 ◽  
Vol 18 (2) ◽  
pp. 83-88 ◽  
Author(s):  
Charles A. Karcutskie ◽  
Jonathan P. Meizoso ◽  
Juliet J. Ray ◽  
Davis B. Horkan ◽  
Xiomara D. Ruiz ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Infection Risk ◽  
Mechanism Of Injury

THE EFFECTS OF LEUKOREDUCED BLOOD TRANSFUSION ON INFECTION RISK FOLLOWING INJURY

Shock ◽  
2006 ◽  
Vol 26 (4) ◽  
pp. 342-347 ◽  
Author(s):  
Avery B. Nathens ◽  
Theresa A. Nester ◽  
Gordon D. Rubenfeld ◽  
Raminder Nirula ◽  
Terry B. Gernsheimer
Keyword(s):  
Blood Transfusion ◽  
Infection Risk

scholarly journals Risk of HCV infection associated with hospital-based invasive procedures: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Paul Henriot ◽  
Mathieu Castry ◽  
Liem Binh Luong Nguyen ◽  
Yusuke Shimakawa ◽  
Kevin Jean ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Transfusion ◽  
Infection Control ◽  
Meta Analysis ◽  
Infection Risk ◽  
Hcv Infection ◽  
Control Measures ◽  
Invasive Procedures ◽  
Country Level ◽  
Hcv Prevalence

Background: Healthcare settings, where invasive procedures are frequently performed, may play an important role in the transmission dynamics of blood-borne pathogens when compliance with infection control precautions remains suboptimal. This study aims at better understanding and quantifying the role of hospital-based invasive procedures on hepatitis C virus (HCV) transmission. Methods: We conducted a systematic review and meta-analysis to identify recent studies reporting association measures of HCV infection risk that are linked to iatrogenic procedures performed in hospital settings. Based on expert opinion, invasive procedures were categorized into 10 groups for which pooled measures were calculated. Finally, the relationship between pooled measures and the country-level HCV prevalence or the Healthcare Access and Quality (HAQ) index was assessed in meta-regressions. Findings: A total of 71 studies were included in the analysis. The most evaluated procedures were blood transfusion and surgery (60 and 37 studies, respectively). The pooled odds ratio (OR) of HCV infection varied widely, ranging from 1.46 (95%CI: 1.14-1.88) for dental procedures to 5.86 (1.26-27.24) for haemodialysis. The OR for blood transfusion was higher for transfusions performed before 1998 (3.77, 2.42-5.88) than for those without a specified date (2.26, 1.81-2.81). Finally, the country-level overall risk for all procedures was significantly associated with HCV prevalence, but not with the HAQ index. In procedure-specific analyses, the HCV infection risk was significantly negatively associated with the HAQ for endoscopy and positively associated with HCV prevalence for endoscopy and surgery. Interpretation: Various invasive procedures were documented to be significantly associated with HCV infection. Our results provide a ranking of procedures in terms of HCV risk that may be used for prioritization of infection control measures, especially in high HCV prevalence settings. Funding: INSERM-ANRS (France Recherche Nord and Sud Sida-HIV Hepatites)

Hyperkalaemia and rapid blood transfusion

Anaesthesia ◽  
2000 ◽  
Vol 55 (9) ◽  
pp. 928-929 ◽  
Author(s):  
J. R. Davies
Keyword(s):  
Blood Transfusion
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