Transmission of disease by transfusion of blood and plasma

1. 1. The possibility of transmission of disease through transfusion has increased in proportion to the increase in transfusion therapy. The diseases which must be considered most seriously are homologous serum hepatitis, syphilis and malaria. 2. 2. The incidence of homologous serum hepatitis has been greatly increased by the use of pooled plasma. Reducing the size of plasma pools will limit the incidence of the disease. Fractionation of plasma is one avenue of approach to the problem. Physical methods may inactivate the virus without injuring the plasma. 3. 3. In spite of careful selection of donors a low but definite incidence of transfusion syphilis may be expected. Blood containing active treponemes may be rendered safe for use either by adding an arsenical in a dilute concentration or by storage at 4 °c. for ninety-six hours. Infected blood may also be utilized by converting it to plasma and storing it at −20 °c. for forty-eight hours. Recipients of such plasma will develop positive serologic tests for syphilis for from one to two weeks. Such a program would prevent the waste of large quantities of blood now discarded because of positive serologic tests for syphilis. 4. 4. No method has been found which will allow blood banks to utilize safely whole blood infected with malaria. If under some circumstances it should be necessary to employ actually or potentially infected blood, transmission can be prevented by the concurrent institution of antimalarial therapy. Plasma made from infected blood and stored at −20 °c. for five days can be used without danger. Persons with a past history of malaria or of exposure to malaria may, therefore, be accepted as donors.