transfusion utilization

ABC Newsletter -9- July 26, 2013
REGULATORY NEWS
AABB recently published a “Summary of Significant Changes to the Standards for Immunohematology
Reference Laboratories, 8 th edition.” This summary details edits made to AABB’s 8 th edition of
the Standards. The summary of changes can be downloaded at
www.aabb.org/sa/standards/Pages/sigchngirlstds8.aspx
INFECTIOUS DISEASE UPDATES
HEPATITIS E VIRUS
A study in Transfusion on July 7 provides an assessment of hepatitis E virus (HEV) in a small group of
US blood donors and recipients. The researchers, led by Harvey Alter, MD, of the National Institutes of
Health, tested for immunoglobulin (Ig)G and IgM antibodies to HEV and for HEV RNA in 1,939 unselected
NIH volunteer blood donors. They also tested the same variables in pre- and serial post-transfusion
samples from 362 prospectively followed blood recipients to assess transfusion risk. I(g)G anti-HEV
seroprevalence in the total 1,939 donations was 18.8 percent. A significant stepwise increase in anti-HEV
seroprevalence was seen with increasing age. Eight of 1,939 donations tested anti-HEV IgM positive; no
donation was HEV RNA positive. Two transfusion recipients had an apparent anti-HEV seroconversion,
but temporal relationships and linked donor testing showed that these were not transfusion-transmitted
infections. No transfusion-transmitted HEV infections were observed in 362 prospectively followed blood
recipients, despite an anti-HEV seroprevalence among donations exceeding 16 percent. “Overall, this
study concludes that past exposure to HEV is common in the US donor population, that a small proportion
of such donors have IgM antibody suggestive of recent exposure, and that a very small proportion
harbor HEV RNA. Thus, the potential for HEV infection clearly exists and indeed has been confirmed in
several case reports,” write the authors. They add that further studies are necessary to determine whether
donor screening for HEV is appropriate. Specifically, the authors suggest that “the most immediate need
for the study of HEV and blood transfusion is to test tens of thousands of donors for HEV RNA and then
to follow those found positive to determine the duration of viremia.”
Citation: Xu C, et al. An assessment of hepatitis E virus (HEV) in US blood donors and recipients: no
detectable HEV RNA in 1,939 donors tested and no evidence for HEV transmission to 362 prospectively
followed recipients. Transfusion. 2013 July 7. [Epub ahead of print]
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