Transfusion refers to the process of transferring blood or blood products from one individual (donor) to another (recipient). This procedure is commonly used in medical practice to replace lost blood, improve blood component levels (such as red blood cells, platelets, or plasma), or provide specific components like clotting factors or antibodies. Transfusions are often necessary in various medical conditions, including: Hemorrhage: Severe bleeding due to trauma, surgery, or medical conditions like gastrointestinal bleeding may require blood transfusions to restore lost blood volume and maintain adequate circulation. Anemia: Blood transfusions are used to treat anemia caused by factors such as blood loss, insufficient production of red blood cells, or destruction of red blood cells. Transfusions can increase the oxygen-carrying capacity of the blood and alleviate symptoms of anemia, such as fatigue and shortness of breath. Hematologic Disorders: Certain hematologic disorders, such as sickle cell disease, thalassemia, and aplastic anemia, may require regular blood transfusions to manage complications and improve quality of life. Cancer Treatment: Patients undergoing chemotherapy or radiation therapy for cancer may experience low blood counts (cytopenias) and may need blood transfusions to support their blood cell levels. Surgical Procedures: Some surgeries, particularly those involving major blood loss or complex procedures, may necessitate blood transfusions to maintain hemostasis and ensure adequate tissue perfusion. The process of blood transfusion involves several steps: Donor Screening: Donors are screened for eligibility based on health criteria to ensure safe blood collection. Blood Collection: Blood is collected from donors using sterile techniques and stored appropriately to maintain its integrity. Compatibility Testing: Before transfusion, the recipient's blood type and Rh factor are determined, and compatibility testing (crossmatching) is performed to match the donor blood with the recipient's blood to minimize the risk of transfusion reactions. Transfusion: The blood or blood component is administered to the recipient intravenously at a controlled rate, typically in a clinical setting such as a hospital or blood transfusion center. Monitoring: During and after the transfusion, the recipient is monitored for any signs of adverse reactions or complications, such as transfusion reactions, hemolysis, or fluid overload

1. Transplant and Transfusion
Associated Infections

2. Transplant Associated Infections

3. Problem of infections in transplantations

4. Infections after solid organ transplantation
• Background
Immunosuppressed patient

5. Biologic Preparations
Used to
Prevent or Treat
Rejection

6. Infections after solid organ transplantation
• Background
Immunosuppressed patient
Diagnosis is a challenge
Host factors :
Blunt or minimize CFs
of inflammation
Medication toxicities
May present with
more than one infection

7. Factors that contribute to infection after
transplantation

8. Post transplant infection classification
• According to time scale
Day 0–30
Day 30–180
Day 180 and beyond

9. DAY 0–30
• Major predisposing factors
Surgical complications
Nosocomial infections
Pretransplant colonizers
Donor-derived infections

10. Day 0–30
• Pathogens
Bacteria
Gram-ve & Gram-positive bacteria
(including MDROs)
Clostridioides difficile
Pretransplant colonizers (e.g., B. cepacia)

11. Day 30–180
• Predisposing factors
Effects of iatrogenic immunosuppression
High risk of opportunistic pathogens
Residual postsurgical sequelae

12. Day 0–30
• Pathogens
Fungi
Candida spp
Aspergillus (uncommon, except for
patients with cystic fibrosis)
Viruses
Respiratory viruses
herpesviruses: uncommon in the current
era of routine antiviral prophylaxis

13. Day 30–180
• Pathogens
Bacteria
Nocardia
MTB and nontuberculous mycobacteria
Nosocomial Gram- / Gram positive bacteria

14. Day 30–180
• Pathogens
Fungi
Molds
Aspergillus
mucormycosis
Candida and Pneumocystis (less common)

15. Day 30–180
• Pathogens
Viruses
Herpesviruses (cytomegalovirus )
BK virus
Respiratory viruses

16. Day 180 and beyond
• Predisposing factors
Community acquired pathogens
State of immunosuppression such as treatment
of rejection, intensity of maintenance
regimen

17. Day 180 and beyond
• Pathogens
Bacteria
Streptococci
Legionella
Listeria
Nosocomial bacteria if hospitalized

18. Day 180 and beyond
• Pathogens
Fungi
Cryptococcus
Pneumocystis
Toxoplasmosis

19. Day 180 and beyond
• Pathogens
Reactivation of chronic viral infections
HSV, CMV, EBV
Respiratory viruses
norovirus
JC virus

20. Unique characteristics of infections in different
types of transplants

21. Infections in kidney transplant recipients
• Most infections arise from the urinary tract
Uncomplicated cystitis
Graft pyelonephritis
Associated with worse long-term graft
function and survival.

22. Infections in kidney transplant recipients
• Uncommon urinary pathogens
TB (Urinary tract)
Mycoplasma hominis
Breakdown of the ureterovesical anastomosis
with subsequent graft loss
Corynebacterium urealyticum
Histoplasmosis
Adenovirus - hemorrhagic cystitis and/or nephritis
BK virus

23. Infections in kidney transplant recipients
• Pneumonia - most common infectious cause of
death (occurred in 25% to 30% of kidney transplant
recipients)

24. Microbial causes of pneumonia in transplant
recipients

25. Infections in liver transplant recipients
• Higher rates of infection than in renal or heart
transplant recipients
• Most deaths are associated with infection
• The most important sites of infection
Abdomen and biliary tract
Surgical wound
Lungs
Bloodstream

26. Infections in liver transplant recipients
• Liver abscesses
Result either from
liver ischemia due to hepatic artery
thrombosis
Obstruction to bile flow due to biliary
strictures
Organisms - Gram-negative enteric bacilli,
enterococci, anaerobes
• Cholangitis

27. Infections in liver transplant recipients
• Peritonitis
Enterococci
Aerobic enteric Gram-negative rods
Staphylococcal and candidal infections
• Abdominal abscesses
Frequently subhepatic
Enteric organisms cause most abscesses
Staphylococci and Candida

28. Infections in liver transplant recipients
• Fungal Infections
High rate of fungal infections (15% to 42%)
Case-fatality (25% to 82%)
Candida – predominant
62% to 88% of the invasive fungal infections
About 1/3 - by non-albicans species
Aspergillus
Cryptococcus
Molds causing mucormycosis

29. Infections in heart transplant recipients
• The most common infections
Bacterial pneumonias
Urinary infections
Herpesvirus infections
Invasive fungal infections

30. Infections in heart transplant recipients
• Postoperative complications
Mediastinitis & sternal wound infections
in ≈2.5% of patients
Staphylococci predominate
Other organisms
M. hominis, Legionella, Aspergillus,
Mucormycetes, and Nocardia

31. Prevention of post-transplant infection
• Screening for transplant recipients and donors
• Immunization of transplant recipients
• Prevention of exposure to pathogens following tx
Hospital exposure
Outpatient exposure
• Pre-emptive approach
• Empirical antibacterial therapy during fever and
neutropenia

32. Suggested screening for transplant recipients
and donors

33. Immunization schedule in transplant recipients

34. Pre-emptive approach
• Monitor patients at predefined intervals to detect
pathogen replication
- Using sensitive assays
eg, Ag detection / molecular assays) -
- Identify infection before progresses to invasive
disease (eg, viremia)
- A positive assay triggers
–the initiation of antimicrobial therapy
–reduction in the intensity of
immunosuppression
–intensified monitoring

35. Empirical antibacterial therapy
during fever and neutropenia
• Broad-spectrum antibiotics such as
– ceftazidime, piperacillin-tazobactam, or cefepime
• Addition of an aminoglycoside possibly required
for institutional antibiotic resistance patterns
• Vancomycin if any cellulitis, dysfunction with an
indwelling catheter, or hemodynamic instability
or colonized with MRSA

36. Transfusion Associated
Infections

37. Organisms that can be transmitted through blood
transfusion

38. Comparison of risk of transmission of HBV, HCV and HIV

39. Transfusion Associated Infections &
Diagnosis

40. Organisms that can be transmitted through blood
transfusion

41. Transfusion Associated Infections &
Diagnosis