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Durch Blut übertragbare Infektionskrankheiten

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Transfusionsmedizin

Zusammenfassung

Theoretisch sind alle Erreger, die irgendwann während der Infektion im Blut Theoretisch sind alle Erreger, die irgendwann während der Infektion im Blut zirkulieren, durch eine Bluttransfusion von einem Menschen auf einen anderen übertragbar. Der 1. Infektionserreger, für den die Übertragbarkeit durch Blut erkannt wurde, war Treponema pallidum, der Erreger der Syphilis. Seit den 1940er bis in die 80er Jahre stand die Übertragbarkeit von Hepatitiserregern im Mittelpunkt des klinischen und wissenschaftlichen Interesses. In den frühen 80er Jahren hat sich gezeigt, dass ein neu aufgetretenes Retrovirus, HIV, durch Blut und Plasmaprodukte übertragen werden kann. Die Erfahrungen mit diesem Erreger haben dazu geführt, dass man auch anderen Viren, die man wegen ihres extrem seltenen Vorkommens in unseren Breiten (z.B. HTLV-I/II, West-Nil-Virus) oder wegen ihrer geringeren klinischen Bedeutung zunächst nicht beachtet hatte (z.B. Parvovirus B 19), nunmehr erhöhte Aufmerksamkeit schenkt. Überraschend aufgetretene HAV-Infektionen bei Empfängern eines bestimmten Faktor-VIII-Präparates zeigen, dass auch Erreger, die man transfusionsmedizinisch für nicht bedeutsam gehalten hat, Probleme bereiten können. Zudem werden immer wieder neue Erreger wie das GB-C-Virus bzw. das Hepatitis-G-Virus identifiziert, deren Bedeutung für die Transfusionsmedizin aber erst geklärt werden muss.

Trotz steriler Einmalentnahmesysteme bereiten bakterielle Kontaminationen von zellulären Blutprodukten von außen gelegentlich Probleme. Kontaminationen durch eine unerkannte Bakteriämie des Blutspenders und nachfolgendes Keimwachstum im zellulären Blutprodukt können im Einzelfall schwerwiegende Folgen für den Blutempfänger haben.

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  1. G. Caspari
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  2. W. H. Gerlich
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  1. Finkenweg 15, 35440, Linden, Deutschland

    Christian Mueller-Eckhardt

  2. Klinik und Poliklinik für Innere Medizin, Abteilung Transfusionsmedizin, Universitätsklinikum Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland

    Volker Kiefel

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Caspari, G., Gerlich, W.H. (2004). Durch Blut übertragbare Infektionskrankheiten. In: Mueller-Eckhardt, C., Kiefel, V. (eds) Transfusionsmedizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-10597-9_36

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