Septic Transfusion Reactions
PREVENTION: Prevention of septic reactions is a frustrating topic for many Blood Bankers.
In particular, those who do not have a hand in running the Collection facility that supplies them with blood.
The reason is simple: The majority of septic reactions are the result of contamination that either happens at the time of donation or was already existent in the donor. Clearly, careful attention by donor personnel to proper collection site preparation and technique is crucial. Donor Center medical directors should have a very clear understanding of all .aspects of their facility's collection policies to make sure that no local "customs" are in place that would endanger the integrity of the collection. In addition, a very high index of suspicion for blood donors with questionable histories of recent illness or gastrointestinal complaints is crucial for preventing donors with subclinical bacteremia from donating is also key. Let me say more about that.
The worst case of bacterial contamination I personally have ever seen was the result of Yersinia contamination of a whole blood collection. After the reaction and contamination was diagnosed, the donor was interviewed by several people, and was emphatic and credible about the fact that he was virtually asymptomatic, having had only a single loose stool between one and two weeks prior to collection! Despite that, he had given a unit that was loaded with Yersinia, and he himself was still blood culture positive for Yersinia two weeks after his blood donation! The take-home message is this: Don't hesitate to defer people with even slightly questionable histories, especially regarding gastrointestinal complaints (even mild ones) from blood donation.
Hey, another section down! Congratulations! If you can stand the thought, we can move on to a discussion of the delayed transfusion reaction.
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