Blajchman M A
Department of Pathology, McMaster University, Hamilton, Ontario, Canada.
Dev Biol (Basel). 2002;108:59-67.
A septic reaction occurring during or following the transfusion of cellular blood components was one of the earliest recognized complications of allogeneic blood transfusions. The presence of bacteria in blood products has been a problem for many decades and currently it is probably the most common microbiological cause of transfusion-associated morbidity and mortality. Transfusion-associated sepsis due to contaminated platelet concentrates appears to be much more common than those due to red cells. The overall prevalence of contaminated cellular blood products (red cells and platelets) is approximately one in 3000; however, the transfusion to a recipient of a contaminated blood product may not necessarily be associated with clinically evident morbidity. This is because the majority of contaminated blood product units contain only few bacteria. In other instances, contaminated units may contain large numbers of virulent bacteria as well as endotoxins, and their transfusion may be associated with significant morbidity and even be lethal to the recipient. The prevalence of severe episodes of transfusion-associated sepsis has not been clearly established, but is probably of the order of one in 50,000 per platelet unit and one in 500,000 per red cell unit transfused. As a result of the increased recognition that such transfusion-associated episodes can occur, a variety of measures have been proposed to try to prevent and/or control the risk of transfusion-associated septic reactions.
在输注细胞血液成分期间或之后发生的败血症反应是同种异体输血最早被认识到的并发症之一。血液制品中存在细菌数十年来一直是个问题，目前它可能是输血相关发病和死亡最常见的微生物学原因。因血小板浓缩物污染导致的输血相关败血症似乎比因红细胞污染导致的更为常见。受污染的细胞血液制品（红细胞和血小板）的总体发生率约为三千分之一；然而，向受血者输注受污染的血液制品不一定会伴有临床明显的发病情况。这是因为大多数受污染的血液制品单位仅含有少量细菌。在其他情况下，受污染的单位可能含有大量致病细菌以及内毒素，输注这些制品可能会伴有严重发病情况，甚至对受血者致命。输血相关败血症严重发作的发生率尚未明确确定，但可能约为每输注一个血小板单位五万分之一，每输注一个红细胞单位五十万分之一。由于越来越认识到可能发生此类输血相关事件，已提出了多种措施来试图预防和/或控制输血相关败血症反应的风险。
