Laboratory detection of donors implicated in transfusion-transmitted malaria.

Autor: Galel SA; Medical Affairs - Donor Screening, Roche Diagnostics Solutions, Pleasanton, California, USA.; Department of Pathology, Stanford University School of Medicine, Stanford, California, USA.
Jazyk: angličtina
Zdroj: Transfusion [Transfusion] 2024 Dec; Vol. 64 (12), pp. 2325-2331. Date of Electronic Publication: 2024 Nov 06.
DOI: 10.1111/trf.18061
Abstrakt: Background: Transfusion-transmitted malaria (TTM) is rare in non-endemic areas (non-EAs) but can potentially be fatal. This review analyzes the laboratory results of donors causing TTM in non-EAs, to assess the detectability of their Plasmodium infection by molecular or antibody tests.
Study Design and Methods: TTM cases in the United States, Canada, and Europe since 2010 were identified through a literature review. Authors and laboratories were contacted for missing details about sample types and laboratory methods. Results of Plasmodium polymerase chain reaction (PCR) and antibody tests were summarized.
Results: Twelve cases of TTM and one bone marrow transplant transmission were identified. Of the 13 source donors, 12 were tested by PCR, 10 were positive on at least one sample; the 2 negative donors were tested only on retained segments of blood refrigerated for several weeks. All donors were PCR positive on a fresh sample except one who was positive on a retained but not a fresh sample. These PCRs targeted Plasmodium DNA with sensitivities in the range of 1000-10,000 parasites/mL. Antibody EIA was positive in only three of seven donors tested.
Discussion: This review found that antibody EIAs failed to detect four of the seven TTM donors tested. DNA-based PCRs were able to detect Plasmodium infection in all donors tested except for two tested only on samples likely to have deteriorated from prolonged storage. Recently developed ribosomal RNA-based molecular donor screening assays are approximately 1000 fold more sensitive than these DNA-based PCRs, holding promise as a potential method to further reduce TTM.
(© 2024 The Author(s). Transfusion published by Wiley Periodicals LLC on behalf of AABB.)
Databáze: MEDLINE
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