Can Blood Tranfusion Transmit Cancer? A Literature Review

How do I think about blood donor eligibility criteria for medical conditions?

Every blood center must determine blood donor eligibility criteria for donors with medical conditions, often based on very limited published data and variable practice. This manuscript briefly outlines possible impacts of donor medical conditions on donor and recipient safety and product quality, and describes the multidisciplinary approach used in Canada to think about donor criteria issues. Many years of experience are distilled into practical considerations in determining criteria, possible sources of information, and factors for successful change implementation, to hopefully assist medical and technical staff engaged in decision-making around donor eligibility.

How donor selection criteria can be evaluated with limited scientific evidence: lessons learned from the TRANSPOSE project

BACKGROUND AND OBJECTIVE

Donor selection criteria (DSC) are a vital link in the chain of supply of Substances of Human Origin (SoHO) but are also subject to controversy and differences of opinion. Traditionally, DSC have been based on application of the precautionary principle.

MATERIALS AND METHODS

From 2017 to 2020, TRANSPOSE (TRANSfusion and transplantation PrOtection and SElection of donors), a European research project, aimed to identify discrepancies between current DSC by proposing a standardized risk assessment method for all SoHO (solid organs excluded) and all levels of evidence.

RESULTS

The current DSC were assessed using a modified risk assessment method based on the Alliance of Blood Operators' Risk-based decision-making framework for blood safety. It was found that with limited or diverging scientific evidence, it was difficult to reach consensus and an international standardized method for decision-making was lacking. Furthermore, participants found it hard to disregard their local guidelines when providing expert opinion, which resulted in substantial influence on the consensus-based decision-making process.

CONCLUSIONS

While the field of donation-safety research is expanding rapidly, there is an urgent need to formalize the decision-making process regarding DSC. This includes the need for standardized methods to increase transparency in the international decision-making process and to ensure that this is performed consistently. Our framework provides an easy-to-implement approach for standardizing risk assessments, especially in the context of limited scientific evidence.

Management of blood donors and blood donations from individuals found to have a positive direct antiglobulin test

The medical literature is replete with articles addressing the diagnosis and management of patients with a positive direct antiglobulin test (DAT). However, there is scant information addressing the management of blood donors and blood donations found to have a positive DAT. Practices vary considerably between countries and blood suppliers within countries, and there is no standardized approach to the management of these blood donors or the blood products prepared from their donations. Recent evidence from Israel suggests that the finding of a positive DAT in a blood donor may not be as benign as previously thought. Therefore, it may be prudent for blood collection agencies to periodically reexamine their approach to the management of blood donors with a positive DAT and their donations. This article reviews the available literature and explores options for the management of DAT-positive blood donors and their blood donations.

[Pathogen reduction of blood components: from financial issues to possible long-term consequences]

Pathogen inactivation of blood products represents a global and major paradigm shift in transfusion medicine. In the next near future, it is likely that most blood products will be inactivated by various physicochemical approaches. The concept of blood safety will be challenged as well as transfusion medicine practice, notably for donor selection or biological qualification. In this context, it seems mandatory to develop analytical economic approaches by assessing costs-benefits ratio of blood transfusion as well as to set up cohorts of patients based on hemovigilance networks allowing rigorous scientific analysis of the benefits and the risks of blood transfusion at short- and long-term.