Blood transfusion safety has progressed significantly in modern times. However, infectious complications of blood transfusions can still be encountered from time to time. Although any intravenously administered fluid can transmit infection, blood is a unique medium and is an exceptional mode for transmitting infection. Only through modern blood banking procedures have infectious complications associated with transfusions been reduced to their current rates.
As early as the 1930s, syphilis was the only recognized transfusion-transmitted infection (TTI). This list was expanded by the AABB (formerly the American Association of Blood Banks) until, by 2009, it included 77 organisms. Numerous important viral infections were identified—first, hepatitis B virus (HBV), followed by human immunodeficiency virus (HIV). Additionally, there has always been a background transmission of bacteria and parasites causing TTIs, and prion transmission through transfusion was first recognized in the 1990s.
Reduction in TTIs has been brought about by donor selection and exclusion and donation testing. For example, the estimated risk of transmission of hepatitis C virus (HCV), HIV, or HBV from a blood transfusion is less than <1:1,000,000. That said, emerging infections and their associated risks emphasize the ongoing need for constant horizon scanning, rapid worldwide information exchange, risk-reduction initiatives, methodical surveillance, and collection of epidemiological data to continue to keep TTIs at an all-time low.
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