What is the role of lookback programs in the prevention of transfusion-transmitted diseases?

Updated: Jan 15, 2017
  • Author: Mudassar Zia, MD; Chief Editor: Emmanuel C Besa, MD  more...
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A very important case scenario in transfusion medicine is lookback. Lookback programs are designed to identify and notify recipients who may have received blood products from a previously negative, screened donor who has now become positive for an infectious agent. (This situation is especially of concern with transfusion-transmitted HCV infections.) Lookback programs represent an attempt to reduce further blood-borne transmission of the infectious agent and to provide a chance for the infected recipients to seek medical attention.

Canada organized a huge lookback program to identify over 100,000 individuals who received blood products in the 1980s. Of the recipients involved in the lookback program, 50,000 tested positive for HCV. It is estimated that about half of these newly diagnosed cases were due to infected blood. [77, 78]

As per FDA guidelines, once a blood bank identifies an HCV-positive donor, it must do the following [79] :

  • Perform a confirmatory test after a positive screen to confirm the diagnosis

  • Quarantine/destroy the blood products, if any, from the newly diagnosed, HCV-positive donor

  • Inform the hospitals where the patient has donated blood previously

The informed hospitals must look up their records and identify the patients who received blood products from that particular donor. Once the recipients are identified, the current attending physician or the physician who initially ordered the blood product must be made aware. The informed physician has the responsibility to follow up with the recipients and notify them.

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