Infectious disease testing for blood transfusions. NIH Consensus Development Panel on Infectious Disease Testing for Blood Transfusions
OBJECTIVE--To provide physicians and other transfusion medicine
professionals with a current consensus on infectious disease testing for
blood transfusions. PARTICIPANTS--A nonfederal, nonadvocate, 12-member
consensus panel representing the fields of hematology, infectious disease,
transfusion medicine, epidemiology, and biostatistics and a public
representative. In addition, 23 experts in hematology, cardiology,
transfusion medicine, infectious disease, and epidemiology presented data
to the consensus panel and a conference audience of 450. EVIDENCE--The
literature was searched through MEDLINE and an extensive bibliography of
references was provided to the panel and the conference audience. Experts
prepared abstracts with relevant citations from the literature. Scientific
evidence was given precedence over clinical anecdotal experience.
CONSENSUS--The panel, answering predefined consensus questions, developed
their conclusions based on the scientific evidence presented in open forum
and the scientific literature. CONSENSUS STATEMENT--The panel composed a
draft statement that was read in its entirety and circulated to the experts
and the audience for comment. Thereafter, the panel resolved conflicting
recommendations and released a revised statement at the end of the
conference. The panel finalized the revisions within a few weeks after the
conference. CONCLUSIONS--The serum alanine aminotransferase test should be
discontinued as a surrogate marker for blood donors likely to transmit
posttransfusion non-A, non-B hepatitis infection since specific hepatitis C
antibody testing has eliminated more than 85% of these cases. Antibody to
hepatitis B core antigen testing should continue as it may prevent some
cases of posttransfusion hepatitis B; it may also act as a surrogate marker
for human immunodeficiency virus (HIV) infection in donors and may prevent
a small number of cases of transfusion-transmitted HIV infection. Syphilis
testing should continue until adequate data can determine its effect on the
rarity of transfusion-transmitted syphilis. Vigilant public health
surveillance is critical in responding to emerging infectious disease
threats to the blood supply.
