Risks associated with red blood cell transfusions: potential benefits from application of pathogen inactivation

Kleinman, Steve; Stassinopoulos, Adonis

RBC transfusion carries multiple risks, each of which (excepting some infections in highly endemic areas) is relatively small. Because of this, it appears unlikely that a laboratory screening intervention to minimize any one of these risks will be implemented. The chief deterrent is cost, but other factors such as lack of concern by clinicians (due to underrecognition of cases, underappreciation of the potential for severe outcomes, and the availability of treatment) and blood center concerns of unnecessary donor deferrals due to false-positive test results may also influence inaction. PI offers a solution to this dilemma in that multiple risks can be obviated by a single intervention. Since PI will come at additional cost, an economic analysis leading to a decision to implement PI may also need to factor in protection against an EIA that could result in a large number of transfusion transmissions and severe recipient outcomes. 4, 5 In this worstcase scenario, failure to have implemented PI may create lack of trust in the entire blood system. The potential specific benefits of PI-RBC technology include: