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2023年输血传播疾病,特别关注骨髓移植患者。

Transfusion-Transmitted Disorders 2023 with Special Attention to Bone Marrow Transplant Patients.

作者信息

Udvardy Miklós, Illés Árpád, Gergely Lajos, Pinczés László Imre, Magyari Ferenc, Simon Zsófia

机构信息

Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary.

出版信息

Pathogens. 2023 Jul 1;12(7):901. doi: 10.3390/pathogens12070901.

Abstract

Transfusion medicine is traditionally a strong/fundamental part of clinical practice, saving hundreds of millions of lives. However, blood-borne or transmitted infections are a well-known and feared possibility, a risk we relentlessly mitigate. Pathogens are continuously and rather quickly changing, so during the last decade, many, sometimes exotic, new pathogens and diseases were recorded and analyzed, and some of them were proved to be transmitted with transfusions. Blood or blood component transfusions are carried out after cautious preparative screening and inactivation maneuvers, but in some instances, newly recognized agents might escape from standard screening and inactivation procedures. Here, we try to focus on some of these proven or potentially pathogenic transfusion-transmitted agents, especially in immunocompromised patients or bone marrow transplantation settings. These pathogens are sometimes new challenges for preparative procedures, and there is a need for more recent, occasionally advanced, screening and inactivation methods to recognize and eliminate the threat a new or well-known pathogen can pose. Pathogen transmission is probably even more critical in hemophiliacs or bone marrow transplant recipients, who receive plasma-derived factor preparations or blood component transfusions regularly and in large quantities, sometimes in severely immunosuppressed conditions. Moreover, it may not be emphasized enough that transfusions and plasma-derived product administrations are essential to medical care. Therefore, blood-borne transmission needs continued alertness and efforts to attain optimal benefits with minimized hazards.

摘要

传统上,输血医学是临床实践的重要/基础组成部分,挽救了数亿人的生命。然而,血源性或输血传播感染是一种众所周知且令人恐惧的可能性,我们一直在不懈地降低这种风险。病原体在持续且相当迅速地发生变化,因此在过去十年中,记录并分析了许多新的病原体和疾病,其中一些有时很罕见,并且已被证明可通过输血传播。血液或血液成分输血是在经过谨慎的预处理筛查和灭活操作后进行的,但在某些情况下,新发现的病原体可能会逃过标准的筛查和灭活程序。在此,我们试图聚焦于一些已证实或潜在致病的输血传播病原体,尤其是在免疫功能低下的患者或骨髓移植环境中。这些病原体有时对预处理程序构成新的挑战,因此需要更新的、有时甚至是先进的筛查和灭活方法,以识别并消除新出现或已知病原体可能带来的威胁。病原体传播在血友病患者或骨髓移植受者中可能更为关键,他们经常大量接受血浆源性因子制剂或血液成分输血,有时处于严重免疫抑制状态。此外,输血和血浆源性产品的使用对医疗至关重要,这一点怎么强调都不为过。因此,对于血源性传播需要持续保持警惕,并努力在将危害降至最低的同时实现最佳效益。

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