Új korszak és új szempontok a transzfúziós kórokozó-átvitel kockázatában, különös tekintettel a rendszeres plazmaeredetű készítményre szoruló haemophiliás betegekre

Abstract

Abstract: Preparative and clinical transfusiology and transfusion, a majestic part of clinical medicine saved the life of hundred millions. However, bloodborne or transmitted infections became a serious issue in France in the 1980s, when many haemophiliacs were infected by HIV or hepatitis C virus by receiving plazma FactorVIII concentrates. This resulted in a quick and powerful development of screening as well as pathogen-inactivating methods, which reduced pathogen contamination and transmission to minimal levels. Times and pathogens are continously and rather quickly changing, so during the last decade many – not only egzotic – new pathogens and diseases were recognised, and some of them (e.g., Zyka virus, Ebola, hepatitis E virus, etc.) can also be transmitted by blood or blood-component transfusions, and in some instances they escape from standard screening and inactivation procedures. Hereby we try to focus and draw attention to some of these potentially pathogenic new bloodborne microbiological agents, and along with this we try to emphasize the significance of application of updated next generation screening and inactivation procedures. Interestingly a recent British trial, based on large population data, showed some evidence of a slight increase of non-Hodgkin lymphoma incidence in patients with multiple previous transfusions. Probably these facts are even more important in haemophiliacs, who receive prophylactic treatment 3 times weekly either by plasma factor concentrates derived from multiple donors or by gene synthetic factor sources. It is important that haemophiliac patient and family should receive the necessary information, and go for a fully informed consent based on the potential advantages and hazards of a particular treatment modality, the same way as in the chronic treatment of other diseases. Orv Hetil. 2018; 159(37): 1495–1500.