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Title: Strategies for reducing the risk of transfusion-transmitted leishmaniasis in an area endemic for Leishmania infantum: a patient- and donor-targeted approach
Author: Jimenez-Marco, Teresa
Riera Lizandra, Ma. Cristina
Girona-Llobera, Enrique
Guillen, Carmen
Iniesta González, Laura
Alcover Amengual, Maria Magdalena
Berenguer, Diana
Pujol Brugués, Alba
Tomás Pérez, Míriam
Cancino Faure, María Beatriz
Serra, Teresa
Mascaró, Martín
Gascó, Joan
Fisa Saladrigas, Roser
Keywords: Leishmania infantum
Donants de sang
Transfusió de sang
Illes Balears
Leishmania infantum
Blood donors
Blood transfusion
Balearic Islands
Issue Date: 15-Mar-2017
Publisher: Edizioni SIMTI
Abstract: Background. In the Balearic Islands, as in other areas of the Mediterranean basin, there is a significant proportion of asymptomatic Leishmania (L.) infantum-infected blood donors, who may represent an important threat to transfusion safety. The Balearic Islands blood bank, located in an area endemic for L. infantum, carried out a study of donors and patients to investigate the impact of this infectious disease on blood safety in the region. Materials and methods. Twenty asymptomatic Leishmania-infected blood donors were followed-up between 2008 and 2011 to investigate the evolution of Leishmania infection in asymptomatic carriers. Their blood was periodically tested for anti-Leishmania antibodies by western blot and for Leishmania DNA by quantitative polymerase chain reaction (qPCR). Additionally, the prevalence of L. infantum infection was investigated in a group of 68 multiply transfused patients to ascertain the risk of transfusion-transmitted leishmaniasis (TTL) in the region, taking into account regular blood component production practices such as pre-storage leucodepletion and pathogen reduction technology. Results. All 20 donors remained asymptomatic over the study period (2008-2011). Most donors had repeatedly positive qPCR results, either persistently or intermittently, but showed no symptoms of Leishmaniasis. Levels of parasitaemia were remarkably low in asymptomatic donors, with values ≤1 parasite/mL. Despite multiple transfusions received over 15 years, no transfused patient studied was infected with L. infantum. Discussion. L. infantum-infected donors can remain asymptomatic for at least 3 years. In our region, no cases of TTL were detected, despite an active search in multiply transfused patients. This seems to be related to two independent variables: (i) a low concentration of the parasite in the peripheral blood of asymptomatic carriers and (ii) the application of methods with proven efficacy against TTL, such as leucodepletion and pathogen reduction technology.
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It is part of: Blood Transfusion, 2017
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ISSN: 1723-2007
Appears in Collections:Articles publicats en revistes (Biologia, Sanitat i Medi Ambient)

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