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Human T‐lymphotropic virus lookback in NHS B lood and T ransplant ( E ngland) reveals the efficacy of leukoreduction
Author(s) -
Hewitt Patricia E.,
Davison Katy,
Howell David R.,
Taylor Graham P.
Publication year - 2013
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12105
Subject(s) - leukoreduction , blood donations , medicine , immunology , blood component , blood transfusion , virology , emergency medicine
Background Leukoreduction of blood components was introduced in the U nited K ingdom during 1998. Human T ‐lymphotropic virus ( HTLV ) screening of blood donations was introduced in 2002. NHS B lood and T ransplant conducted an HTLV lookback on blood components issued before 2002. A proportion of included components were nonleukoreduced, although the majority were subject to white blood cell reduction measures. Study Design and Methods A standard lookback was conducted on untested cellular blood components from donors later confirmed to be HTLV positive, for the 4 to 5 years before 2002, and on the last tested negative donation from donors who had seroconverted. Results A total of 437 red blood cell and platelet components were included and an outcome was reported for 84% of these. Just over half of identified recipients were dead at the time of lookback; blood samples for testing were obtained from 77% of identified living recipients. HTLV infection was confirmed in seven recipients, but one was discounted as not transfusion transmitted. Conclusion Although numbers are small, our results provide evidence of the efficacy of leukoreduction in reducing the likelihood of HTLV transmission through transfusion of cellular blood components. The HTLV ‐positive rate in recipients of leukoreduced components was 3.7%, a reduction of 93% compared with nonleukoreduced components. Importantly, the one infected recipient of a leukoreduced component had existing risk factors for HTLV infection. HTLV lookback was much less efficient in identifying infected recipients than was hepatitis virus C lookback.