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Semin Thromb Hemost 2013; 39(07): 779-793
DOI: 10.1055/s-0033-1354420
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pathogen Safety of Long-Term Treatments for Bleeding Disorders: (Un)Predictable Risks and Evolving Threats

Giovanni Di Minno
1   Department of Clinical Medicine and Surgery, Regional Reference Centre for Coagulation Disorders, Napoli, Italy
,
Mariana Canaro
2   Department of Hemostasis and Thrombosis, Son Espases Universitary Hospital, Palma de Mallorca, Spain
,
James W. Ironside
3   National Creutzfeldt-Jakob Disease Surveillance Unit, School of Molecular and Clinical Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
,
David Navarro
4   Department of Microbiology, Microbiology Service, Hospital Clínico Universitario, School of Medicine, University of Valencia, Valencia, Spain
,
Carlo F. Perno
5   Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
,
Andreas Tiede
6   Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
,
Lutz Guertler
7   Max von Pettenkofer Institute for Hygiene and Medical Microbiology, University of München, Munich, Germany
› Institutsangaben
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Publikationsdatum:
12. September 2013 (online)

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Erratum zu diesem Artikel:

Pathogen Safety of Long-Term Treatments for Bleeding Disorders: (Un)Predictable Risks and Evolving ThreatsSemin Thromb Hemost 2013; 39(08): 973-973
DOI: 10.1055/s-0033-1358798

Abstract

Substantial improvements in the safety of blood and plasma products for the management of bleeding disorders have been achieved in recent decades. This has led some clinicians to believe that the infectious threat is over and that inhibitor formation is the foremost complication of hemophilia therapy. On the contrary, elimination of all microbes from blood is difficult, potentially impossible, and there are always threats from emerging pathogens. The risk of infection transmission is also increasing due to greater exposure to products, increasing prophylaxis and high-dose regimens for immune tolerance, and longevity of hemophilia patients. Current products can be considered “reasonably safe,” but pathogen testing is not all-inclusive, and manufacturing and purification techniques are often not standardized. Although safer nonplasma-derived products are widely used, they are not available for all bleeding disorders, and so there is an ongoing need for plasma-derived products. This review will discuss the evolving risk from emerging pathogens in the context of the issues described. Reducing the risk from emerging infections requires global collaboration to devise ways to monitor and continue to improve blood safety.

Keywords

bleeding disorders - blood safety - emerging infectious agent(s)
 

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