title: Current concepts in the prevention of pathogen transmission via blood/plasma-derived products for bleeding disorders.
abstract: The pathogen safety of blood/plasma-derived products has historically been a subject of significant concern to the medical community. Measures such as donor selection and blood screening have contributed to increase the safety of these products, but pathogen transmission does still occur. Reasons for this include lack of sensitivity/specificity of current screening methods, lack of reliable screening tests for some pathogens (e.g. prions) and the fact that many potentially harmful infectious agents are not routinely screened for. Methods for the purification/inactivation of blood/plasma-derived products have been developed in order to further reduce the residual risk, but low concentrations of pathogens do not necessarily imply a low level of risk for the patient and so the overall challenge of minimising risk remains. This review aims to discuss the variable level of pathogenic risk and describes the current screening methods used to prevent/detect the presence of pathogens in blood/plasma-derived products.
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Regional Reference Centre for Coagulation Disorders, Federico II University, Via S. Pansini 5, 80131 Naples, Italy. Electronic address: diminno@unina.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Minno
authors.affiliation: Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy.
authors.forename: Carlo Federico
authors.initials: CF
authors.lastname: Perno
authors.affiliation: Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Tiede
authors.affiliation: Department of Microbiology, Microbiology Service, Hospital Clínico Universitario, School of Medicine, University of Valencia, Av Blasco Ibáñez 17, 46010 Valencia, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Navarro
authors.affiliation: Department of Hemostasis and Thrombosis, Son Espases University Hospital, Carretera de Valdemossa, 79, 07120 Palma de Mallorca, Spain.
authors.forename: Mariana
authors.initials: M
authors.lastname: Canaro
authors.affiliation: Max von Pettenkofer Institute for Hygiene and Medical Microbiology, University of München, Pettenkofer Str 9A, 80336 Munich, Germany.
authors.forename: Lutz
authors.initials: L
authors.lastname: Güertler
authors.affiliation: National Creutzfeldt-Jakob Disease Research and Surveillance Unit, School of Clinical Sciences, University of Edinburgh, Western General Hospital, Edinburgh EH4 2XU, UK.
authors.forename: James W
authors.initials: JW
authors.lastname: Ironside
mesh_terms: D016470:Bacteremia / Q000209:etiology / Q000517:prevention & control* / Q000635:transmission; D001778:Blood Coagulation Disorders / Q000628:therapy; D016913:Blood Component Transfusion / Q000009:adverse effects; D001782:Blood Donors / Q000941:ethics; D017848:Blood-Borne Pathogens / Q000302:isolation & purification*; D002852:Chromatography, Ion Exchange / Q000295:instrumentation / Q000379:methods; D016469:Fungemia / Q000209:etiology / Q000517:prevention & control* / Q000635:transmission; D015497:HIV-1 / Q000302:isolation & purification; D016174:Hepacivirus / Q000302:isolation & purification; D006515:Hepatitis B virus / Q000302:isolation & purification; D006801:Humans; D018512:Parasitemia / Q000209:etiology / Q000517:prevention & control* / Q000635:transmission; D012306:Risk; D014462:Ultrafiltration / Q000295:instrumentation; D014766:Viremia / Q000209:etiology / Q000517:prevention & control* / Q000635:transmission
keywords: Blood safety; Clotting; Haemophilia; Pathogen; Transfusion