INFECTIOUS-DISEASE TESTING FOR BLOOD-TRANSFUSIONS

Objective.-To provide physicians and other transfusion medicine profes sionals with a current consensus on infectious disease testing for blo od transfusions.Participants.-A nonfederal, nonadvocate, 12-member con sensus panel representing the fields of hematology, infectious disease , transfusion medicine, epidemiology, and biostatistics and a public r epresentative. In addition, 23 experts in hematology, cardiology, tran sfusion 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. E xperts prepared abstracts with relevant citations from the literature, Scientific evidence was given precedence over clinical anecdotal expe rience. Consensus.-The panel, answering predefined consensus questions , developed their conclusions based on the scientific evidence present ed in open forum and the scientific literature. Consensus Statement.-T he panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, th e panel resolved conflicting recommendations and released a revised st atement at the end of the conference. The panel finalized the revision s within a few weeks after the conference. Conclusions.-The serum alan ine aminotransferase test should be discontinued as a surrogate marker for blood donors likely to transmit posttransfusion non-A, non-B hepa titis infection since specific hepatitis C antibody testing has elimin ated more than 85% of these cases. Antibody to hepatitis B core antige n testing should continue as it may prevent some cases of posttransfus ion hepatitis B; it may also act as a surrogate marker for human immun odeficiency virus (HIV) infection in donors and may prevent a small nu mber of cases of transfusion-transmitted HIV infection, Syphilis testi ng should continue until adequate data can determine its effect on the rarity of transfusion-transmitted syphilis. Vigilant public health su rveillance is critical in responding to emerging infectious disease th reats to the blood supply.