ABSTRACT
BACKGROUND: In February 2002, a multiorganizational task force investigated blood center reports of unusual particulate matter (PM) visible in packed red blood cells (RBC). A cohort study assessed increase in adverse events (AEs) related to this phenomenon, as well as the effect of post-leukofiltration (LF) on PM. METHODS: Two blood centers assessed AEs in patients transfused with RBCs having visible PM (classified as normal by-products of RBC preparation), PM RBCs subsequently LF, or RBCs without visible PM, and the effect of LF on PM removal. RESULTS: There was no difference in AEs in patients transfused with PM RBCs with or without LF compared to patients transfused with RBCs without visible PM. Subsequently filtered PM RBCs had acceptable residual WBC counts and median platelet removal of 92%. CONCLUSION: Transfusion of RBCs with visible PM or RBCs subsequently LF does not appear to increase the risk of an AE. LF use on PM RBCs results in the PM removal without adversely affecting filter performance. The lack of evidence of an increase in AE reports does not mean that there is no effect, and there may be a baseline AE rate attributable to PM which has not been thoroughly researched.
Subject(s)
Blood Specimen Collection , Erythrocyte Transfusion/adverse effects , Blood Component Removal , Cohort Studies , Filtration , Humans , LeukocytesSubject(s)
Blood Donors , Disasters , HIV Antibodies/blood , Hepatitis B Surface Antigens/blood , Hepatitis C Antibodies/blood , Infection Control , Mass Screening/statistics & numerical data , Terrorism , Adult , Aircraft , Biomarkers , Databases, Factual , Habits , Humans , Motivation , New York City/epidemiology , Risk Factors , Seroepidemiologic Studies , VolunteersABSTRACT
BACKGROUND: Although there have been no well-documented cases of transfusion-transmitted syphilis in more than 30 years, serologic tests for syphilis (STS) continues to be required for donated blood. Previously, the methods for detecting viable spirochetes were dependent on the use of the rabbit infectivity test. DNA PCR and RNA RT-PCR were applied to assess the presence of Treponema pallidum DNA or RNA in blood donors with confirmed-positive results in STS. STUDY DESIGN AND METHODS: This case series describes T. pallidum DNA and RNA testing of platelet concentrates prepared from blood donors with reactive results in an automated treponemal screening test and positive test results in the fluorescent treponomal antibody absorption test. The first DNA test was specific for the T. palladium polA gene. The second DNA test was a multiplex PCR using a T. pallidum 47-kDa gene target. The RT-PCR for RNA used T. pallidum 16S rRNA as a template for production of a cDNA target. RESULTS: One hundred sixty-nine samples (including rapid plasma reagin [RPR]+ and RPR-) tested for T. pallidum DNA and/or RNA were negative. CONCLUSIONS: A lack of demonstrable T. pallidum DNA or RNA suggests that blood donors with confirmed-positive results in STS are unlikely to have circulating T. pallidum in their blood and that that their blood is unlikely to be infectious for syphilis.
