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Transfusionsmedizin 2017; 7(01): 18-29
DOI: 10.1055/s-0043-100280
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Sicherheit von Blutprodukten – ein Update 2016

Blood Safety – Update 2016
Michael Schmidt
DRK-Blutspendedienst, Frankfurt am Main
,
Erhard Seifried
DRK-Blutspendedienst, Frankfurt am Main
› Author Affiliations
Further Information

Publication History

Publication Date:
13 March 2017 (online)

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Zusammenfassung

Die Vermeidung transfusionsbedingter Virusinfektionen ist ein wesentliches Ziel der Transfusionsmedizin. Neben einer sorgfältigen Spenderbefragung nach möglichen Infektionsrisiken hat gerade die Entwicklung von kombinierten diagnostischen Antigen-/Antikörper-Assays (Assays der 4. Generation) sowie die Einführung der Polymerase-Kettenreaktion-(PCR-)Untersuchungen in das Spenderscreening, mit dazu beigetragen, das diagnostische Fenster insbesondere für Hepatitis A, Hepatitis B, Hepatitis C, HIV und Parvovirus B19 auf ein Minimum zu reduzieren. Dabei liegt der Schwerpunkt sowohl auf der Vermeidung von Virusübertragungen durch klassische Pathogene, wie Hepatitis-B-Viren (HBV), Hepatitis-C-Viren (HCV) oder Humane Immundefizienz-Viren (HIV), als auch auf neuen Pathogenen wie Hepatitis-E-Viren, West-Nil-Viren oder Dengue-Viren. Aufgrund der starken Reiseaktivitäten können sich Pathogene innerhalb von 48 h weltweit verbreiten, sodass auf der einen Seite flexible modifizierbare Screeningsysteme erforderlich sind und auf der anderen Seite eine generelle Pathogeninaktivierung mehr und mehr an Bedeutung gewinnt. Aufgrund der Fortschritte in den letzten Jahren sind die Blutprodukte gegenwärtig auf dem höchsten Sicherheitsstand der Medizingeschichte, sodass Übertragungen von HCV oder HIV-1 kein medizinisch reales Risiko bei der Anwendung von Blutprodukten mehr darstellen. Neben der Erhöhung der Sicherheit gegenüber viralen Pathogenen konnte in den letzten Jahren auch die Sicherheit gegenüber bakteriellen Kontaminationen, durch die Einführung von Schnelltestmethoden zur Testung bakterieller Kontaminationen von Thrombozytenkonzentraten, und auch die Einführung der Pathogeninaktivierung einen wesentlichen Beitrag leisten, auch diese Risiken weiter zu reduzieren.

Abstract

The prevention of transfusion-induced viral infections is a major goal of transfusion medicine. In addition to a donor questionnaire on possible infection risks, the development of combined diagnostic antigen/antibody assays (fourth generation assays) as well as the introduction of polymerase chain reaction (PCR) investigations into donor screening reduced the residual diagnostic window period especially for hepatitis A virus, for hepatitis B virus, for hepatitis C virus, for HIV and for parvovirus B19 to a minimum. The focus is not only on the prevention of viral transmissions by classical pathogens such as hepatitis B viruses, hepatitis C viruses or human immunodeficiency viruses, but also on new pathogens such as hepatitis E viruses, West Nile viruses or dengue viruses. Due to extended travel activities of human people, pathogens can spread rapidly within 48 hours around the world, so that, on the one hand, flexible modifiable screening systems are necessary or, on the other hand, a general pathogen inactivation becomes more and more important. Due to progress in recent years, blood products are currently at the highest level of safety, so that transfusion-related transmissions of HCV or HIV-1 are not any longer a real medical risk in transfusion medicine. In addition to the improved blood safety against viral pathogens, the residual risk against bacterial contaminations especially in platelets was reduced by the introduction of rapid bacterial detection tests as well as by pathogen inactivation methods.

Schlüsselwörter

Infektionsrisiko - transfusionsassoziierte Infektionen - Spenderscreening - Pathogeninaktivierung

Key words

HBV - HCV - HIV - Sicherheit der Blutprodukte - Restinfektionsrisiken
 

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