From donor to recipient: transfusion chain specificities in the French ultra-marine areas
Autor(es): Richard P, Ould Amar K
Resumo: Besides specific organisational requirements, the transfusional chain in French ultra-marine areas has specificities related to the epidemiology of infectious diseases - to population characteristics. We focus on some of these sociodemographic - medical peculiarities: the challenge of autosufficiency in relation to demographic trends; epidemiologic risks associated to emergent viruses such as dengue - Chikungunya, - the strategies that had been implemented to face last outbreaks; inappropriate selection criteria for eligibility to blood donation (biologic characteristics of Afro-Caribbeans not taken into account for the low hemoglobin deferral threshold; absence of guidelines for the screening of hemoglobinopathies AS/AC, present in 8% of the target population); specific indications for transfusion, such as platelet use in dengue fever or RBC transfusion in sickle cell disease. Due to the high polymorphism of erythrocyte antigens in Afro-Caribbeans, intra-ethnic transfusion facilitates compatibility for common antigens, but is responsible for the emergence of allo-antibodies difficult to identify in the absence of specific antisera or panels; molecular typing of erythrocyte antigens would allow detection of those patients at risk for immunization, expressing variant antigens or lacking high frequency antigens, as well as the characterization of RBC expressing immunogenic so called low frequency antigens. In an era of periodic emergence of new viruses in Europe (dengue, Chikungunya, West Nile virus...) - with the spreading of diseases with high transfusional requirements, such as sickle cell disease, ultra-marine services represent laboratories for the study of future trends - problems in transfusion medicine.
Palavras-Chave: Blood donation; Dengue; Chikungunya; Hemoglobin screening; Sickle cell trait; Sickle cell disease; Afro-Caribbeans; Intra-ethnic transfusion; RH polymorphism; Rare phenotypes
Imprenta: Transfusion Clinique et Biologique, v. 20, n. 2, p. 59-67, 2013
Identificador do objeto digital: 10.1016/j.tracli.2013.02.027
Descritores: Chikungunya virus - Biosynthesis; Chikungunya virus - Cell; Chikungunya virus - Pathogenesis; Chikungunya virus - Antibodies; Chikungunya virus - Infectious diseases; Chikungunya virus - Viral infections; Chikungunya Virus - Virus; Chikungunya virus - Molecular screening; Chikungunya virus - Transmission; Chikungunya virus - Chikungunya fever; Chikungunya virus - Dengue; Chikungunya virus - Epidemiology; Chikungunya virus - Public health
Data de publicação: 2013
