Catherine E. Chapman

Ten years of hemovigilance reports of transfusion‐related acute lung injury in the United Kingdom and the impact of preferential use of male donor plasma

BACKGROUND AND METHODS: From 1996 through 2006, 195 cases were reported as transfusion‐related acute lung injury (TRALI) to the Serious Hazards of Transfusion scheme and from 1999 onward classified by probability, using clinical features and HLA and/or HNA typing. From late 2003, the National Blood Service provided 80 to 90 percent of fresh‐frozen plasma (FFP) and plasma for platelet (PLT) pools from male donors.

Effect of WBC reduction of transfused RBCs on postoperative infection rates in cardiac surgery

BACKGROUND : WBC‐replete blood transfusion has been suggested as an independent cause of increased postoperative infection.

The impact of universal leukodepletion of the blood supply on hemovigilance reports of posttransfusion purpura and transfusion‐associated graft‐versus‐host disease

BACKGROUND: The pathogenesis of posttransfusion purpura (PTP) and transfusion‐associated graft‐versus‐host disease (TA‐GVHD) involves patient exposure to donor platelets (PLTs) and T lymphocytes, respectively, which are removed during blood component leukodepletion (LD).

Long‐term survival after blood transfusion: a population based study in the North of England

BACKGROUND:  Blood transfusion may transmit infec‐tious diseases with long incubation periods. Estimation of the risks of transmission of such disease requires know‐ledge of long‐term survival of transfused patients. No such information is available in the UK, where there is particular concern about possible transmission by trans‐fusion of variant CJD.

National Blood Service TRALI Reduction Policies: Implementation and Effect

This article describes the TRALI reduction policies which were introduced by the National Blood Service in late 2003. Consideration was given to the reasons for their introduction and how the changes were implemented. The observed effects which followed the introduction of these policies were examined by analysis of reports to the Serious Hazards of Transfusion (SHOT) Scheme.

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Haemovigilance reports of post-transfusion purpura and transfusion-associated graft-versus-host disease before and after implementation of universal leucocyte depletion in the UK

There is now hard evidence that vCJD can be transmitted from personto-person by blood transfusion. Fortunately the vCJD outbreak in the UK appears to be in decline although there remain concerns about the extent of sub-clinical infection. As with any transfusion-associated disease there are a number of ways whereby spread of disease can be controlled: Removing the source of infection Deferring at risk donors Removal of infectivity from donations Testing of donations Implementing measures to reduce secondary spread For vCJD in the UK and elsewhere all these steps have been used. Thus removal of high risk tissues from the food chain has reduced the numbers of BSE and hence vCJD primary infections. Many countries have put in place deferral of donors from the UK, and in some cases other European, countries. For those of us in the UK the equivalent is to import donations from low-risk cites and to some extent this has been done, particularly for fractionation plasma. Leucodepletion as a route top reducing individual donation infectivity was introduced soon after the discovery of vCJD in a number of countries, but recent animal data suggests that this may be of limited value. Two companies have been developing filters to remove soluble infectivity that is not removed by leucofilters. The development of tests for donation screening has challenged the available technologies for large scale screening, but is now seems likely that a number of companies are approaching the market with usable technologies. The setting of acceptable specifications and validation approaches for TSE screening tests and prion removal filters should be priority area for international groups, along with associated ethical issues. One area of ignorance that requires elucidation is the biochemical nature of the form of TSE infectivity that is found in infected blood. Lastly a number of measures have been introduced to prevent secondary spread in some countries, including implementing measures such that transfusions are only given when necessary, deferral of previously transfused donors and the identification of at risk individuals as part of look back exercises. Monday: Parallel Sessions: S1: Quality Management in Blood Transfusion Regulatory Aspects