title: Transfusion practices and infectious risks.
abstract: Transfusion-transmitted infections remain among the most-feared complications of allogeneic blood transfusion. Thanks to several strategies including donor screening and deferral, blood testing and pathogen inactivation, their risks have reached all-time low levels, particularly in developed nations. Nonetheless, new and emerging infections remain a threat that is likely to exacerbate in the coming years with continued globalization and climate change. More effective strategies of pathogen inactivation and more vigilant horizon screening are hoped to abate the risk. Additionally, allogeneic transfusion has repeatedly been shown to be associated with worsening of outcomes in patients, including the documented increased risk of infections (often nosocomial) in recipients of transfusions. The underlying mechanism is likely to be related to immunosuppressive effects of allogeneic blood, iron content, and bacterial contamination. This issue is best addressed by more judicious and evidence-based use of allogeneic blood components to ensure the potential benefits outweigh the risks.
authors.affiliation: a Department of Anesthesiology and Critical Care Medicine , Englewood Hospital and Medical Center and TeamHealth Research Institute , Englewood , NJ , USA.
authors.forename: Aryeh
authors.initials: A
authors.lastname: Shander
authors.affiliation: a Department of Anesthesiology and Critical Care Medicine , Englewood Hospital and Medical Center and TeamHealth Research Institute , Englewood , NJ , USA.
authors.forename: Gregg P
authors.initials: GP
authors.lastname: Lobel
authors.affiliation: a Department of Anesthesiology and Critical Care Medicine , Englewood Hospital and Medical Center and TeamHealth Research Institute , Englewood , NJ , USA.
authors.forename: Mazyar
authors.initials: M
authors.lastname: Javidroozi
mesh_terms: D001803:Blood Transfusion / Q000379:methods; D003141:Communicable Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000635:transmission; D006801:Humans; D017063:Outcome Assessment, Health Care; D012306:Risk; D065227:Transfusion Reaction
keywords: Transfusion; blood testing; infection; iron; outcomes; patient blood management; transfusion complication; transfusion strategy; transfusion-related immunomodulation; transfusion-transmitted infection