Principle:

Using the Medinfo Hematos IIG program, it is easy to perform look-back for patients who have developed an infectious disease that might have been transmitted by a blood component.  Likewise, if a donor develops an infectious disease that is transmissible to patients, we can check which patient(s) received blood components from the incriminated donor.  The time interval for checking will vary according to local regulations.

Policy:

1. If a patient is reported to have developed an infectious disease which might have been transmitted by a blood component transfusion:
   1. Review the patient’s infectious marker testing data.
   2. Review the patient’s transfusion history, especially for any transfusions at outside institutions or any other body fluid exposures.
   3. Look up the transfusion history in Medinfo HIIG.
   4. Determine which transfusions occurred during the deferral period for that disease.  Examples:
      1. HBV—6 months
      2. HCV—6 months
      3. HIV—2 months
      4. Malaria—6 months
      5. HTLV—6 months
      6. Syphilis—12 months
   5. Look up the donors for each donation during the specified interval.
   6. Check each donor’s donation records for:
      1. Infectious disease marker testing
      2. Questionnaires—any irregularities noted?
   7. Call donors back for repeat testing (only on advice of the investigating transfusion medicine physician)
   8. Collate all results and prepare an interpretative report.
   9. Interpretative report must be reviewed/released by the Head, Transfusion Medicine.
   10. Submit the report to Infectious Disease and the patient’s most responsible physician
   11. If any irregularities are found, assess processes to make any improvements in an attempt to minimize future risk.
   12. Prepare an OVA according to HMC procedures.
2. If donor develops an infectious disease:
   1. Review the donor’s infectious marker testing results.
   2. Check if the donor had any body fluid exposures.
   3. Obtain new specimen from the donor.
   4. Look up all components made from that donor.
   5. Determine which transfusions occurred during the incubation period for that disease.  Examples:
      1. HBV—6 months
      2. HCV—6 months
      3. HIV—2 months
      4. Malaria—6 months
      5. HTLV—6 months
      6. Syphilis—12 months
   6. Recheck the complete donor history including infectious disease marker testing and questionnaire
   7. If samples are available from the interval, repeat donor marker testing on it.
   8. Look up the patient/recipients for each donation during the specified interval
   9. Check each patient’s records for infectious disease marker testing results
   10. Call patients back for repeat testing (only on advice of the investigating transfusion medicine physician in conjunction with the Infectious Disease department.)
   11. Collate all results and prepare an interpretative report.
   12. Interpretative report must be reviewed/released by the Head, Transfusion Medicine.
   13. Submit the report to Infectious Disease and the patient’s most responsible physician
   14. If any irregularities are found, assess processes to make any improvements in an attempt to minimize future risk.
   15. Prepare an OVA according to HMC procedures.

Reference:

Standards for Blood Banks and Transfusion Services, Current Edition, Bethesda, MD, USA