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Is an endoscopic examination associated with transfusion‐transmissible infections? A systematic review and meta‐analysis
Author(s) -
Van Remoortel Hans,
Borra Vere,
De Buck Emmy,
Compernolle Veerle,
Vandekerckhove Philippe
Publication year - 2018
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.14416
Subject(s) - medicine , odds ratio , meta analysis , confidence interval , observational study , blood transfusion , hepatitis b , hepatitis , physical examination , immunology
BACKGROUND The purpose of a donor medical questionnaire is to identify the blood donor's history relative to the current known blood‐safety risks. A temporary deferral from blood donation after an endoscopic examination is enforced because of the reusable nature of the endoscope and close contact with the inner body. The objective of this systematic review was to find the best available evidence on the association between an endoscopic examination and the risk of transfusion‐transmissible infections. METHODS Studies from five databases investigating the link between an endoscopic examination and transfusion‐transmissible infections (hepatitis B virus, hepatitis C virus, human immunodeficiency virus infection, Treponema pallidum ) were retained and assessed independently by two reviewers. The association between endoscopy and transfusion‐transmissible infections was identified by conducting meta‐analyses and calculating pooled effect measures (odds ratios and 95% confidence intervals). The Grading of Recommendations, Assessment, Development, and Evaluation methodology was used to assess the quality of evidence. RESULTS We identified 7571 references and finally included 29 observational studies. A significant association between an endoscopic examination and hepatitis B virus infection (pooled odds ratio [OR], 2.21; 95% confidence interval [CI], 1.26‐3.86; p = 0.005) or hepatitis C virus infection (pooled OR 1.76, 95% CI, 1.45‐2.14; p < 0.00001) was found. The level of evidence was considered as “very low” due to the type of study design (i.e., observational) and indirect study populations (i.e., no blood donor populations). CONCLUSION An endoscopic examination is associated with an increased hepatitis B virus or hepatitis C virus infection risk. Further high‐quality trials are required to formulate stronger evidence‐based recommendations on endoscopic examination as a blood donor deferral criterion.