Laperche Syria, Lefrère Jean-Jacques, Morel Pascal, Pouchol Elodie, Pozzetto Bruno
Centre national de référence des hépatites B et C et du VIH en transfusion, Institut national de la transfusion sanguine, 75015 Paris, France.
Institut national de la transfusion sanguine, 75015 Paris, France; Université Paris 5 (Paris Descartes), 75005 Paris, France.
Presse Med. 2015 Feb;44(2):189-99. doi: 10.1016/j.lpm.2014.06.034. Epub 2014 Dec 26.
From blood donor collection to transfusion of the recipient, there are several layers of protection of the blood supply. These measures combined with huge progresses over the three past decades in pathogen discovery and blood testing for specific pathogens (human immunodeficiency virus (HIV), hepatitis B (HBV) and C (HCV) viruses, Human T-cell leukemia virus (HTLV)), provide the greatest safety. With the implementation of serological and molecular testing, at least in high-income countries, transfusion-transmitted infections have become extremely rare. However, for pathogen agents, which are not tested and especially those which are responsible for emerging infectious disease, it became apparent that full control of infectious disease had not been achieved. In addition, the immune status of the recipient has also an impact in the outcome of infectious diseases transmitted by transfusion. Blood safety is based on several measures: education and deferral of donors with risk factors for transmissible disease, blood testing, pathogen reduction interventions, and patient blood management. This paper proposes a review of the residual risk of transmission of infectious diseases by transfusion and of the additional interventions able to further reduce it.
从献血采集到受血者输血，血液供应有多层保护措施。这些措施，再加上过去三十年在病原体发现和特定病原体（人类免疫缺陷病毒（HIV）、乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）、人类T细胞白血病病毒（HTLV））血液检测方面取得的巨大进展，提供了最大程度的安全性。随着血清学和分子检测的实施，至少在高收入国家，输血传播感染已变得极为罕见。然而，对于未进行检测的病原体，尤其是那些导致新发传染病的病原体，显然尚未实现对传染病的完全控制。此外，受血者的免疫状态也会对输血传播传染病的结果产生影响。血液安全基于多项措施：对有传染病传播风险因素的献血者进行教育和延期献血、血液检测、病原体灭活干预以及患者血液管理。本文对输血传播传染病的残余风险以及能够进一步降低该风险的额外干预措施进行综述。
