(2) Blood donors should be carefully screened and individuals in high-risk
groups should be educated to abstain from donation.
(3) Autologous transfusion should be employed as widely as possible. The
safety of the blood supply is fortified by a 4-point program:
(a) Voluntary blood donation.
(b) Careful medical history and physical examination to eliminate high-
A sensitive test for anti-HIV.
(d) A confidential self-exclusion procedure.
d. Other Diseases. An infectious, mononucleosis-like syndrome characterized
by splenomegaly, atypical lymphocytes, and fever, thought to be caused by
cytomegalovirus infection, is occasionally seen following transfusions of large amounts
of blood. Diseases such as malaria and syphilis can be transmitted by transfusion. The
importance of the medical history in rejecting donors with unapparent malaria cannot be
overestimated as there is no practical laboratory-screening test to detect donors with
malaria. Since the treponemal spirochete does not survive 72-hour refrigeration, fresh
blood or other blood products, such as platelet concentrates that are not stored
refrigerated prior to use, have the greatest risk of syphilis transmission. The use of the
RPR or other syphilis screening test lessens, but does not eliminate, the risk of syphilis
e. Alloimmunization. The transfusion of blood products always entails
exposure to foreign antigens. Immunization to RBC, platelet, Ieukocyte, and protein
antigens may occur to those that the patient lacks. Giblett has estimated the probability
of stimulating one or more antibodies to RBC antigens after one blood transfusion to be
about one percent.
3-11. RECORDS OF TRANSFUSION COMPLICATIONS
Federal regulations require that fatalities attributed to transfusion complications,
for example, hemolytic reactions or viral hepatitis, and transfusion associated AIDS, be
reported to the Bureau of Biologics of the Food and Drug Administration. In addition,
records must be kept of reports of transfusion complications (including those
investigated) and cases of transfusion-associated hepatitis (including those confirmed
as type B) and transfusion associated AIDS for periodic reporting to this Bureau (see
figures 3-1 and 3-2).