Abstract
The prevention of infectious disease transmission requires additional, complementary approaches to remove or inactivate viral contaminants in blood components prior to transfusion. Filtration of blood components prior to transfusion is currently used clinically to decrease the incidence of cytomegalovirus (CMV) transmission. The chapter discusses the role of leukofiltration as well as several methodologies in preventing infectious disease transmission and maintaining the safety of the blood supply. The blood components have undergone additional screening or processing steps to reduce the risk of viral transmission. Many transfusion services employ CMV serology to maintain an inventory of CMV-seronegative components, which historically have been regarded as the gold standard for reducing the incidence of transfusion-transmitted CMV infections in selected patient populations. Leukoreduction of packed red blood cell and platelet units, usually accomplished by filtration, decreases the incidence of adverse transfusion outcomes, including alloimmunization to human leukocyte antigens, febrile nonhemolytic transfusion reactions, transfusion-mediated immunosuppression, and transmission of leukocyte-associated infectious agents. Solvent/detergent plasma is prepared for treating the pool with the solvent tri(n-butyl)phosphate and detergent Triton X-100 to inactivate any contaminating lipid-enveloped viruses, including human immunodeficiency virus (HIV) and hepatitis C virus. Advances in molecular biological techniques over the past decades allow coagulation factors—such as factor VIII—to be expressed and purified in vitro, virtually eliminating concerns of infectious disease transmission that still plague factor VIII concentrates prepared from human plasma.
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