Klein H G
Department of Transfusion Medicine, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland 20892, USA.
Am J Surg. 1995 Dec;170(6A Suppl):21S-26S. doi: 10.1016/s0002-9610(99)80054-3.
The risk of blood transfusion-associated complications has been reduced in the past 10 years through technical advances in testing of blood, viral inactivation of noncellular blood components, enforcement of stringent donor selection criteria, and the use of alternatives to allogeneic transfusion. Even so, a zero-risk blood supply is unfeasible. The general public perceives infectious complications to be the most significant risk: although the greatest fear is associated with transmission of human immunodeficiency virus (HIV), at least three hepatitis viruses are transmissible by all blood components. Human immunodeficiency virus accounts for < 20 cases per year of transfusion-related acquired immunodeficiency syndrome in the United States. The three important noninfectious complications are alloimmunization, which is common but clinically insignificant; immunosuppression, the clinical significance of which is controversial; and graft-versus-host disease, a lethal complication most likely to affect patients who are immunosuppressed, have cancer, or are recipients of bone marrow transplants.
在过去10年里，通过血液检测技术的进步、非细胞血液成分的病毒灭活、严格执行献血者选择标准以及使用异体输血替代方法，输血相关并发症的风险已有所降低。即便如此，实现零风险血液供应仍不可行。公众认为感染性并发症是最重大的风险：尽管最大的担忧与人类免疫缺陷病毒（HIV）传播相关，但至少三种肝炎病毒可通过所有血液成分传播。在美国，每年因输血相关获得性免疫缺陷综合征而感染人类免疫缺陷病毒的病例少于20例。三种重要的非感染性并发症是同种免疫，这种情况很常见但临床意义不大；免疫抑制，其临床意义存在争议；以及移植物抗宿主病，这是一种致命并发症，最有可能影响免疫抑制患者、癌症患者或骨髓移植受者。
