#blooducation December gift from @bloodbankguy about transfusion-transmitted infection. In this thread, let's reflect & contrast the controversial points nationally in & internationally. https://twitter.com/bloodbankguy/status/1339261441665236992

Keep in mind, mitigation of TTI starts from the donor selection to include:
Donor screening questions (DHQ)
Donor testing
Direct treatment of blood products
to prevent known & emerging infections.

For HBV, a different combo of screening markers is used. In contrast to donor screening in the US, which utilizes Hbs antigen and Anti-Hbsc along with NAT. SA, UK & JapanHbsAg, anti-Hbc & anti-Hbs in addition to NAT.

The difference is donors with immuned status defined by neg HbsAg, pos anti-HbS & high titer anti-Hbc are NOT deferred in the UK (anti-Hbc >100) and Japan ( anti-Hbc>200). The practice is variable in Saudi Arabia.

For HTLV, Blood services in the UK are not required to test all donations for anti-HTLV antibodies. Some centres test high risk donors, others test first time donations only.

In Saudi, several retrospective studies showed a low risk of TT HTLV, especially after introducing universal leucodepletion & suggested that testing might be reconsidered.
https://pubmed.ncbi.nlm.nih.gov/?term=HTLV+donor+testing+in+saudi+Arabia

MALARIA, a big hurdle in our area. How to test is highly debatable. The deferral practice in Saudi is variable;
-Considering donor history only.
- Considering donor history only, which leads to a which high deferral rate.
- Based on PBS, which poses a huge load on BC.

Highlighting the recent Leishmania outbreak in Riyadh. Persons affected with Leishmaniasis are subjected to permanent deferral in Saudi Arabia. In other areas as in US donors with a history of leishmaniasis are deferred for 1-2 years. So, Shall we reconsider?

Happy to know your perspective
@omarsuhaibani @sharkj2000 @almohammadi77 @iBB_2020 @aalmashi @KreuterMD @blood_academy @bloodbankguy @HermelinMD @TZThompsonMD @TeamCaptainJohn @AABB @SaudiBlood1 @DrRiyamia @mahabadawi @ISBTCO @TransfusionNews @SueTJohnson @ChrisTormey3