Jf. Desforges et al., INFECTIOUS-DISEASE TESTING FOR BLOOD-TRANSFUSIONS, JAMA, the journal of the American Medical Association, 274(17), 1995, pp. 1374-1379
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.