The management of sereconvert donors and recipients is an important obligation of both the blood transfusion service and the clinicians who ordered the transfusion.

 

 

A seroconverted donor is one who is confirmed positive for a particular Transfusion Transmitted Infection in his current donation but was negative in the previous donation.

 

1.1 All donors found to be seroconverted with HIV, Hepatitis B, Hepatitis C or Syphilis shall first be informed and counselled by the doctors at the blood centre, and then referred to the appropriate physician for further management.

 

1.2 Upon confirmation of seroconversion of a donor, the hospital blood bank shall take the following actions concurrently for donor and blood products management:

a. Counsel and permanently defer the donor from donating.

b. Register the donor in SUKUSA.

c. Conduct look back procedure for the last negative donation and donation(s) in the six (6) months period prior to the last negative donation.

d. Recall blood component that has not been used.

e. Inform the hospital(s) supplied with the previous last negative donation of the seroconverted donor.

 

1.3 Upon notification of a seroconverted donor the hospital blood bank shall:-

a. Trace transfusion record of recipient/s of the implicated donation/s and inform treating clinician to contact recipient/s for further counseling

and testing.

b. Trace any blood component that are still in their inventory and return to the blood centre immediately.

 

1.4 The team involved in counselling recipients should include at least the treating specialist/consultant and may include a transfusion medicine specialist.

 

1.5 First counselling session with recipient should be carried out as follows (pre-test counselling):

a. Inform recipient the reason for consultation.

b. Inform and explain that the blood or blood component transfused was from a donor who recently seroconverted. As a precautionary measure, the recipient needs to be tested to ascertain whether he/she is infected following the transfusion of a possible window period donation. Explain that “window period” IS NOT a laboratory error.

c. Assess the risk factors of the recipient with respect to the TTI concerned. Try to identify risk factors other than blood transfusion.

d. Explain about the TTI concerned, including its mode of transmission and potential complications.

e. Explain about tests available and the interpretation of the results.

f. Take samples of blood for the implicated infection, and reassure the recipient that the probability of being infected through transfusion is low.

g. Inform about the precautions to be taken while waiting for the test results. This is to prevent potential transmission from the recipient to

others.

h. Discuss with the recipient the probability of the tests outcome.

 

1.6 Second counselling session should be carried out as follows (post-test counselling):

 

a. If test results is negative

      i. Inform recipient and explain.

     ii. Reassure the recipient.

    iii. If necessary, retest after 6 months or implement any follow-up.

 

b. If test result is positive to the TTI

      i. Inform the recipient and explain.

     ii. Further assess the risk factors other than blood transfusion.

         If none, explain to blood he or she received was tested negative at the time of donation.

    iii. Reassure and discuss about the treatment options.

    iv. Refer the recipient to an infectious disease physician. 

 

 

A seroconverted recipient is one who is confirmed positive for a particular TTI marker(s) after receiving blood transfusion, but who was negative for that infection prior to the transfusion.

 

2.1 Recipients of a transfusion may develop HIV, Hepatitis B, Hepatitis C, Syphilis infection or other possible TTI agent infection resulting from:

a. Transfusion of blood that was donated within the window period of the infection, or

b. other sources not related to the blood transfusion.

 

2.2 However, it is recommended that donors of the blood that has been transfused to the patient in the 12 months period prior to the detection

of the infection be contacted for testing. The hospital blood bank shall be informed to identify the blood donors and their status determined.

 

2.3 If a blood donor is identified as the source of infection, other recipients of his or her blood should be traced and investigated.