避免輸血感染之策略

The Strategies to Prevent Transfusion-Transmitted Infections

輸血治療對於有血液和其他疾病的患者是必須的，因此預防因輸血而造成傳染性病原體（transfusion-transmitted infections , TTIs）感染的風險，是輸血安全的重要議題。台灣血液基金會在作業程序對於有潛在TTIs發生（例如：捐血前暫緩捐血及血液常規檢測等），已逐年有效性地執行各種措施，使得病患輸血安全更加有所保障。目前雖未有數據或病例證明，COVID-19會經由輸血感染的風險，針對疑似病例確診或接觸者仍暫緩捐血以預防感染。從2013年2月開始，除了血清學檢查外另增加對HIV'HCV和HBV的核酸擴大檢驗（nucleic acid amplification test , NAT），其可降低因檢驗空窗期的殘留風險。從NAT執行檢驗至2021年止，共篩檢出21,689人次為陽性，該檢驗陽性之血品銷毀，不供應至醫院給病患使用；且為減少血小板製品可能因細菌污染，而造成輸血反應所執行血小板製品細菌檢驗，在2013至2021年，血小板製品執行細菌檢驗共有389人次檢驗結果為陽性，亦不供應醫療使用。台灣血液基金會所屬之捐血中心努力應用新技術以降低TTIs的機率，確保患者輸用血液安全。

Blood-transfusion therapy is necessary for hematological and other diseases. To prevent the risks of transfusion-transmitted infectious agents (transfusion-transmitted infections: TTIs) remains the key issue for blood-transfusion safety. The responses to prevent potential TTIs (ex, donor deferral and laboratory screening testing) had been introduced to blood centers in Taiwan to safeguard the patients for blood transfusion. Although there is no evidence to indicate that COVID-19 can be transmitted through blood transfusion currently, it is still recommended to defer blood donation if blood donors have closed contact with suspected COVID-19 or confirmed COVID-19 and COVID- infected. In addition to serological assays, NAT (nucleic acid amplification test: NAT) technology had been implemented as the routine work since February 2013. During the period of implementation NAT testing to 2021, a total of 21,689 donations were screened as positive results and these blood products were discarded. To reduce the risks of transfusion adverse reaction caused by bacterial contamination of platelet products, total of 389 donations for apheresisplatelets (leukocyte-reduced) were not used for medical purposes from 2013 to 2021 according to the result of bacterial screening test. The blood centers must take all the effort to apply new technology to reduce TTIs prevalence rate and guard the blood safety for patients.