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Pathogens
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Pathogen Reduction of Blood Bank Components
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Pathogen Reduction of Blood Bank Components

A special issue of Pathogens (ISSN 2076-0817).

Deadline for manuscript submissions: closed (31 May 2022) | Viewed by 28141

Special Issue Editors

Dr. Vincenzo De Angelis

E-Mail Website
Guest Editor
National Blood Centre, Italian National Institute of Health, 00161 Rome, Italy
Interests: immunohaematology; quality systems in laboratory and clinical transfusion; haemostaseology
Special Issues, Collections and Topics in MDPI journals
Dr. Ilaria Pati

E-Mail Website
Guest Editor
National Blood Centre, Italian National Institute of Health, 00161 Rome, Italy
Interests: transfusion risk; transfusion transmitted infection (TTI), pathogen reduction; neuroinflammation; neurological infection diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The pathogen reduction technologies (PRTs) were introduced with the aim of reducing the risk of infection transmission through blood and blood-component transfusion because of their ability to inactivate nucleic acids and prevent pathogen replication.

The introduction of PRTs into transfusion practice can contribute to reducing the risk of post-transfusion infections and, therefore, to achieving higher safety standards.

Although the blood donor selection procedures, deferral and serological and molecular tests for infection markers have drastically reduced the incidence of transfusion-transmitted diseases, the threat of new or re-emerging pathogens remains.

The blood component qualification involves screening, through highly sensitive and specific tests, for known pathogens that are transmissible through transfusion, such as hepatitis C virus (HCV), human immunodeficiency virus (HIV), hepatitis B virus (HBV) and Treponema pallidum. This made it possible to significantly reduce the risk of transfusion and to ensure the safety of blood components.

However, there remains a residual risk of transfusion transmission, not only from known pathogens, but also from emerging pathogens, which represent a problem for transfusion safety because of their rapid spread. Among these are viruses transmitted by vectors (e.g., Dengue, Chikungunya and Zika), parasites and new emerging viruses responsible for serious epidemics, for which blood donations are not commonly tested.

PRTs are also an effective tool in reducing the bacterial contamination of blood components. Transfusion-associated bacterial sepsis (TABS) is an undesirable effect that can cause severe, sometimes fatal, outcomes in recipients. Blood components are most frequently contaminated during the collection phase, and are also rarely contaminated by asymptomatic bacteraemia of the donor or during the blood processing.

The currently available PRTs that are validated for pathogen inactivation are exclusively intended for use on plasma and platelets, while the PRTs for whole blood are still in the clinical trial phase.

However, PRTs also have limitations related to their demonstrated ineffectiveness against some pathogens and the increase in storage lesions. We must also be cautious in considering the possibly deleterious effect of pathogen reduction on the quality of blood components frequently reported by scientists. Hence, a careful risk–benefit analysis is still awaited, also balancing the possibility that PRTs may lead to the administration of blood components altered by these technologies, in the extremely safe environment of blood transfusion we have now reached. To date, there is no validated system that can universally inactivate pathogens in all blood components.

The ultimate goal of PRTs should be to reduce the transmission of potential pathogens without significantly compromising the therapeutic efficacy of cellular and protein constituents of the blood. PRTs must not cause toxicity of the product or induce the formation of neoantigens and the subsequent production of antibodies; in addition, they must be easy to use.

As Guest Editors, we are excited to start a new challenge with this Special Issue. We hope that the document collection in this Issue will provide insights into the technological evolution of PRTs in terms of effectiveness, product safety and impact, both economic and in terms of the improvement of the quality and safety of the transfusion system, resulting from their introduction.

The information can come from clinical practice and experimental research, but also from the accurate evaluation of the data published in the literature.

We would like to invite our colleagues in science to submit original research and review articles that provide interesting insights and news.

Dr. Vincenzo De Angelis
Dr. Ilaria Pati

Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pathogens is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • blood and transfusion safety
  • pathogen inactivation
  • pathogen reduction
  • pathogen reduction technology
  • blood components

Published Papers (11 papers)

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Research

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10 pages, 807 KiB  
Article
Preparation and Storage of Cryoprecipitate Derived from Amotosalen and UVA-Treated Apheresis Plasma and Assessment of In Vitro Quality Parameters
by Katarina Kovacic Krizanic, Florian Prüller, Konrad Rosskopf, Jean-Marc Payrat, Silke Andresen and Peter Schlenke
Pathogens 2022, 11(7), 805; https://doi.org/10.3390/pathogens11070805 - 18 Jul 2022
Cited by 3 | Viewed by 2273
Abstract
Cryoprecipitate is a plasma-derived blood product, enriched for fibrinogen, factor VIII, factor XIII, and von Willebrand factor. Due to infectious risk, the use of cryoprecipitate in Central Europe diminished over the last decades. However, after the introduction of various pathogen-reduction technologies for plasma, [...] Read more.
Cryoprecipitate is a plasma-derived blood product, enriched for fibrinogen, factor VIII, factor XIII, and von Willebrand factor. Due to infectious risk, the use of cryoprecipitate in Central Europe diminished over the last decades. However, after the introduction of various pathogen-reduction technologies for plasma, cryoprecipitate production in blood centers is a feasible alternative to pharmaceutical fibrinogen concentrate with a high safety profile. In our study, we evaluated the feasibility of the production of twenty-four cryoprecipitate units from pools of two units of apheresis plasma pathogen reduced using amotosalen and ultraviolet light A (UVA) (INTERCEPT® Blood System). The aim was to assess the compliance of the pathogen-reduced cryoprecipitate with the European Directorate for the Quality of Medicines (EDQM) guidelines and the stability of coagulation factors after frozen (≤−25 °C) storage and five-day liquid storage at ambient temperature post-thawing. All pathogen-reduced cryoprecipitate units fulfilled the European requirements for fibrinogen, factor VIII and von Willebrand factor content post-preparation. After five days of liquid storage, content of these factors exceeded the minimum values in the European requirements and the content of other factors was sufficient. Our method of production of cryoprecipitate using pathogen-reduced apheresis plasma in a jumbo bag is feasible and efficient. Full article
(This article belongs to the Special Issue Pathogen Reduction of Blood Bank Components)
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9 pages, 1161 KiB  
Article
Visible 405 nm Violet-Blue Light Successfully Inactivates HIV-1 in Human Plasma
by Viswanath Ragupathy, Mohan Haleyurgirisetty, Neetu Dahiya, Caitlin Stewart, John Anderson, Scott MacGregor, Michelle Maclean, Indira Hewlett and Chintamani Atreya
Pathogens 2022, 11(7), 778; https://doi.org/10.3390/pathogens11070778 - 08 Jul 2022
Cited by 4 | Viewed by 1742
Abstract
Despite significant advances in ensuring the safety of the blood supply, there is continued risk of transfusion transmitted infections (TTIs) from newly emerging or re-emerging infections. Globally, several pathogen reduction technologies (PRTs) for blood safety have been in development as an alternative to [...] Read more.
Despite significant advances in ensuring the safety of the blood supply, there is continued risk of transfusion transmitted infections (TTIs) from newly emerging or re-emerging infections. Globally, several pathogen reduction technologies (PRTs) for blood safety have been in development as an alternative to traditional treatment methods. Despite broad spectrum antimicrobial efficacy, some of the approved ultraviolet (UV) light-based PRTs, understandably due to UV light-associated toxicities, fall short in preserving the full functional spectrum of the treated blood components. As a safer alternative to the UV-based microbicidal technologies, investigations into the use of violet-blue light in the region of 405 nm have been on the rise as these wavelengths do not impair the treated product at doses that demonstrate microbicidal activity. Recently, we have demonstrated that a 405 nm violet-blue light dose of 270 J/cm2 was sufficient for reducing bacteria and the parasite in plasma and platelets suspended in plasma while preserving the quality of the treated blood product stored for transfusion. Drawn from the previous experience, here we evaluated the virucidal potential of 405 nm violet-blue light dose of 270 J/cm2 on an important blood-borne enveloped virus, the human immunodeficiency virus 1 (HIV-1), in human plasma. Both test plasma (HIV-1 spiked and treated with various doses of 405 nm light) and control plasma (HIV-1 spiked, but not treated with the light) samples were cultured with HIV-1 permissive H9 cell line for up to 21 days to estimate the viral titers. Quantitative HIV-1 p24 antigen (HIV-1 p24) levels reflective of HIV-1 titers were measured for each light dose to assess virus infectivity. Our results demonstrate that a 405 nm light dose of 270 J/cm2 is also capable of 4–5 log HIV-1 reduction in plasma under the conditions tested. Overall, this study provides the first proof-of-concept that 405 nm violet-blue light successfully inactivates HIV-1 present in human plasma, thereby demonstrating its potential towards being an effective PRT for this blood component safety. Full article
(This article belongs to the Special Issue Pathogen Reduction of Blood Bank Components)
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9 pages, 309 KiB  
Article
Comparison of Bacterial Risk in Cryo AHF and Pathogen Reduced Cryoprecipitated Fibrinogen Complex
by Thea Lu, Pallavi Nahata, Aja Johnson, Nadia Keltner, Lindsay Peters, Melissa McCormack, Bianca Muñoz, Mary Krath, Elan Weiner and Peter Bringmann
Pathogens 2022, 11(7), 744; https://doi.org/10.3390/pathogens11070744 - 30 Jun 2022
Viewed by 1591
Abstract
Until November 2020, cryoprecipitated antihaemophilic factor (cryo AHF) was the only United States Food and Drug Administration (FDA)-approved fibrinogen source to treat acquired bleeding. The post-thaw shelf life of cryo AHF is limited, in part, by infectious disease risk. Concerns over product wastage [...] Read more.
Until November 2020, cryoprecipitated antihaemophilic factor (cryo AHF) was the only United States Food and Drug Administration (FDA)-approved fibrinogen source to treat acquired bleeding. The post-thaw shelf life of cryo AHF is limited, in part, by infectious disease risk. Concerns over product wastage demand that cryo AHF is thawed as needed, with thawing times delaying the treatment of coagulopathic patients. In November 2020, the FDA approved Pathogen Reduced Cryoprecipitated Fibrinogen Complex for the treatment and control of bleeding, including massive hemorrhage, associated with fibrinogen deficiency. Pathogen Reduced Cryoprecipitated Fibrinogen Complex (also known as INTERCEPT® Fibrinogen Complex, IFC) has a five-day post-thaw room-temperature shelf life. Unlike cryo AHF, manufacturing of IFC includes broad spectrum pathogen reduction (Amotosalen + UVA), enabling this extended post-thaw shelf life. In this study, we investigated the risk of bacterial contamination persisting through the cryoprecipitation manufacturing process of cryo AHF and IFC. Experiments were performed which included spiking plasma with bacteria prior to cryoprecipitation, and bacterial survival was analyzed at each step of the manufacturing process. The results show that while bacteria survive cryo AHF manufacturing, IFC remains sterile through to the end of shelf life and beyond. IFC, with a five-day post-thaw shelf life, allows the product to be sustainably thawed in advance, facilitating immediate access to concentrated fibrinogen and other key clotting factors for the treatment of bleeding patients. Full article
(This article belongs to the Special Issue Pathogen Reduction of Blood Bank Components)
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13 pages, 1125 KiB  
Article
Inactivation of SARS-CoV-2 in All Blood Components Using Amotosalen/Ultraviolet A Light and Amustaline/Glutathione Pathogen Reduction Technologies
by Felicia Santa Maria, Yan-Jang S. Huang, Dana L. Vanlandingham and Peter Bringmann
Pathogens 2022, 11(5), 521; https://doi.org/10.3390/pathogens11050521 - 28 Apr 2022
Cited by 3 | Viewed by 1829
Abstract
No cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transfusion-transmitted infections (TTI) have been reported. The detection of viral RNA in peripheral blood from infected patients and blood components from infected asymptomatic blood donors is, however, concerning. This study investigated the efficacy [...] Read more.
No cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transfusion-transmitted infections (TTI) have been reported. The detection of viral RNA in peripheral blood from infected patients and blood components from infected asymptomatic blood donors is, however, concerning. This study investigated the efficacy of the amotosalen/UVA light (A/UVA) and amustaline (S-303)/glutathione (GSH) pathogen reduction technologies (PRT) to inactivate SARS-CoV-2 in plasma and platelet concentrates (PC), or red blood cells (RBC), respectively. Plasma, PC prepared in platelet additive solution (PC-PAS) or 100% plasma (PC-100), and RBC prepared in AS-1 additive solution were spiked with SARS-CoV-2 and PR treated. Infectious viral titers were determined by plaque assay and log reduction factors (LRF) were determined by comparing titers before and after treatment. PR treatment of SARS-CoV-2-contaminated blood components resulted in inactivation of the infectious virus to the limit of detection with A/UVA LRF of >3.3 for plasma, >3.2 for PC-PAS-plasma, and >3.5 for PC-plasma and S-303/GSH LRF > 4.2 for RBC. These data confirm the susceptibility of coronaviruses, including SARS-CoV-2 to A/UVA treatment. This study demonstrates the effectiveness of the S-303/GSH treatment to inactivate SARS-CoV-2, and that PRT can reduce the risk of SARS-CoV-2 TTI in all blood components. Full article
(This article belongs to the Special Issue Pathogen Reduction of Blood Bank Components)
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13 pages, 1881 KiB  
Article
Protein Concentrations in Stored Pooled Platelet Concentrates Treated with Pathogen Inactivation by Amotosalen Plus Ultraviolet a Illumination
by Niels Arni Arnason, Freyr Johannsson, Ragna Landrö, Björn Hardarsson, Sveinn Gudmundsson, Aina-Mari Lian, Janne Reseland, Ottar Rolfsson and Olafur E. Sigurjonsson
Pathogens 2022, 11(3), 350; https://doi.org/10.3390/pathogens11030350 - 14 Mar 2022
Viewed by 2161
Abstract
Platelet granules contain a diverse group of proteins. Upon activation and during storage, platelets release a number of proteins into the circulation or supernatant of stored platelet concentrate (PC). The aim of this work was to investigate the effect of pathogen inactivation (PI) [...] Read more.
Platelet granules contain a diverse group of proteins. Upon activation and during storage, platelets release a number of proteins into the circulation or supernatant of stored platelet concentrate (PC). The aim of this work was to investigate the effect of pathogen inactivation (PI) on a selection of proteins released in stored platelets. Materials and Methods: PCs in platelet additive solution (PAS) were produced from whole blood donations using the buffy coat (BC) method. PCs in the treatment arm were pathogen inactivated with amotosalen and UVA, while PCs in the second arm were used as an untreated platelet control. Concentrations of 36 proteins were monitored in the PCs during storage. Results: The majority of proteins increased in concentration over the storage period. In addition, 10 of the 29 proteins that showed change had significantly different concentrations between the PI treatment and the control at one or more timepoints. A subset of six proteins displayed a PI-related drop in concentration. Conclusions: PI has limited effect on protein concentration stored PC supernatant. The protein’s changes related to PI treatment with elevated concentration implicate accelerated Platelet storage lesion (PSL); in contrast, there are potential novel benefits to PI related decrease in protein concentration that need further investigation. Full article
(This article belongs to the Special Issue Pathogen Reduction of Blood Bank Components)
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11 pages, 1012 KiB  
Article
In Vitro Comparative Study of Platelets Treated with Two Pathogen-Inactivation Methods to Extend Shelf Life to 7 Days
by Nicolas Malvaux, Fanette Defraigne, Styliani Bartziali, Camille Bellora, Kathleen Mommaerts, Fay Betsou and Anne Schuhmacher
Pathogens 2022, 11(3), 343; https://doi.org/10.3390/pathogens11030343 - 11 Mar 2022
Cited by 4 | Viewed by 2295
Abstract
Background and Objectives: Since 2015, platelet products have been pathogen-inactivated (PI) at the Luxemburgish Red Cross (LRC) using Riboflavin and UV light (RF-PI). As the LRC should respond to hospital needs at any time, platelet production exceeds the demand, generating a discard rate [...] Read more.
Background and Objectives: Since 2015, platelet products have been pathogen-inactivated (PI) at the Luxemburgish Red Cross (LRC) using Riboflavin and UV light (RF-PI). As the LRC should respond to hospital needs at any time, platelet production exceeds the demand, generating a discard rate of 18%. To reduce this, we consider the extension of storage time from 5 to 7 days. This study’s objective was to evaluate the in vitro 7-day platelet-storage quality, comparing two PI technologies, RF-PI and amotosalen/UVA light (AM-PI), for platelet pools from whole-blood donations (PPCs) and apheresis platelets collected from single apheresis donation (APCs). Materials and Methods: For each product type, 6 double-platelet concentrates were prepared and divided into 2 units; one was treated with RF-PI and the other by AM-PI. In vitro platelet-quality parameters were tested pre- and post-PI, at days 5 and 7. Results: Treatment and storage lesions were observed in PPCs and APCs with both PI methods. We found a higher rate of lactate increase and glucose depletion, suggesting a stronger stimulation of the glycolytic pathway, a higher Annexin V binding, and a loss of swirling in the RF-PI-treated units from day 5. The platelet loss was significantly higher in the AM-PI compared with the RF-PI units. Conclusions: Results suggest that RF-PI treatment has a higher deleterious impact on in vitro platelet quality compared to AM-PI, but we observed higher loss of platelets with AM-PI due to the post-illumination amotosalen adsorption step. If 7-day storage is needed, it can only be achieved with AM-PI, based on our quality criteria. Full article
(This article belongs to the Special Issue Pathogen Reduction of Blood Bank Components)
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17 pages, 1561 KiB  
Article
Transfusion Transmissible Infections in Blood Donors in the Province of Bié, Angola, during a 15-Year Follow-Up, Imply the Need for Pathogen Reduction Technologies
by Luis Baião Peliganga, Vinicius Motta Mello, Paulo Sergio Fonseca de Sousa, Marco Aurelio Pereira Horta, Álvaro Domingos Soares, João Pedro da Silva Nunes, Miguel Nobrega and Lia Laura Lewis-Ximenez
Pathogens 2021, 10(12), 1633; https://doi.org/10.3390/pathogens10121633 - 17 Dec 2021
Cited by 12 | Viewed by 4023
Abstract
Transfusion transmissible infections (TTIs), caused by hepatitis B virus (HBV), human immunode-ficiency virus (HIV), hepatitis C virus (HCV), and syphilis, have a high global impact, especially in sub-Saharan Africa. We evaluated the trend of these infections over time in blood donors in Angola. [...] Read more.
Transfusion transmissible infections (TTIs), caused by hepatitis B virus (HBV), human immunode-ficiency virus (HIV), hepatitis C virus (HCV), and syphilis, have a high global impact, especially in sub-Saharan Africa. We evaluated the trend of these infections over time in blood donors in Angola. A retrospective cross-sectional study was conducted among blood donors in Angola from 2005 to 2020. Additionally, frozen samples obtained from blood donors in 2007 were investigated to identify chronic HCV carriers and possible occult HBV infection (OBI). The overall prevalence of HBV, HCV, HIV, and syphilis was 8.5, 3, 2.1, and 4.4%, respectively, among 57,979 blood donors. HBV was predominant among male donors, while the remaining TTIs were predominant among women. Donors >50 years had a significantly high prevalence for all TTIs. Chronic HCV infection was ab-sent in 500 samples tested and OBI was present in 3%. Our results show the continued high prev-alence of TTIs among blood donors in Angola. Most infections showed a significantly low preva-lence in years with campaigns seeking voluntary blood donors, thus, reinforcing the importance of this type of donor to ensure safe blood. Africa, with a high prevalence of diverse pathogens, should consider cost-effective pathogen reduction technologies, once they are commercially accessible, to increase the availability of safe blood. Full article
(This article belongs to the Special Issue Pathogen Reduction of Blood Bank Components)
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14 pages, 470 KiB  
Article
The 4-Year Experience with Implementation and Routine Use of Pathogen Reduction in a Brazilian Hospital
by Roberta Maria Fachini, Rita Fontão-Wendel, Ruth Achkar, Patrícia Scuracchio, Mayra Brito, Marcelo Amaral and Silvano Wendel
Pathogens 2021, 10(11), 1499; https://doi.org/10.3390/pathogens10111499 - 18 Nov 2021
Cited by 5 | Viewed by 2235
Abstract
(1) Background: We reviewed the logistics of the implementation of pathogen reduction (PR) using the INTERCEPT Blood System™ for platelets and the experience with routine use and clinical outcomes in the patient population at the Sírio-Libanês Hospital of São Paulo, Brazil. (2) Methods: [...] Read more.
(1) Background: We reviewed the logistics of the implementation of pathogen reduction (PR) using the INTERCEPT Blood System™ for platelets and the experience with routine use and clinical outcomes in the patient population at the Sírio-Libanês Hospital of São Paulo, Brazil. (2) Methods: Platelet concentrate (PC), including pathogen reduced (PR-PC) production, inventory management, discard rates, blood utilization, and clinical outcomes were analyzed over the 40 months before and after PR implementation. Age distribution and wastage rates were compared over the 10 months before and after approval for PR-PC to be stored for up to seven days. (3) Results: A 100% PR-PC inventory was achieved by increasing double apheresis collections and production of double doses using pools of two single apheresis units. Discard rates decreased from 6% to 3% after PR implementation and further decreased to 1.2% after seven-day storage extension for PR-PCs. The blood utilization remained stable, with no increase in component utilization. A significant decrease in adverse transfusion events was observed after the PR implementation. (4) Conclusion: Our experience demonstrates the feasibility for Brazilian blood centers to achieve a 100% PR-PC inventory. All patients at our hospital received PR-PC and showed no increase in blood component utilization and decreased rates of adverse transfusion reactions. Full article
(This article belongs to the Special Issue Pathogen Reduction of Blood Bank Components)
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11 pages, 616 KiB  
Article
Retrospective Study of the Seroprevalence of HIV, HCV, and HBV in Blood Donors at a Blood Bank of Western Mexico
by José de Jesús Guerrero-García, Alejandra Guadalupe Zúñiga-Magaña, Juan Carlos Barrera-De León, Rafael Magaña-Duarte and Daniel Ortuño-Sahagún
Pathogens 2021, 10(7), 878; https://doi.org/10.3390/pathogens10070878 - 11 Jul 2021
Cited by 4 | Viewed by 3079
Abstract
Obtaining blood which is safe for transfusions is one of the principal challenges in the health systems of developing countries. Supply of contaminated blood increases morbidity, mortality, and the costs of patient care. In Mexico, serological screening is mandatory, but only a few [...] Read more.
Obtaining blood which is safe for transfusions is one of the principal challenges in the health systems of developing countries. Supply of contaminated blood increases morbidity, mortality, and the costs of patient care. In Mexico, serological screening is mandatory, but only a few of the main blood banks routinely perform a nucleic acid test (NAT). Data from 80,391 blood donations processed between August 2018 and December 2019 at the Central Blood Bank of the Western National Medical Center of the Mexican Social Security Institute (IMSS) were analyzed. All donors were screened for serological markers and NAT was performed. Reactive donors were followed-up to confirm their results. The number of reactive donors and seroprevalence rates for HIV, HCV, and HBV were 152 (18.91/10,000), 385 (47.89/10,000), and 181 (22.51/10,000), respectively; however, these rates decreased when NAT-confirmed reactive results were considered. Male donors were found to have a higher seroprevalence than females, and younger donors higher than older donors. The present study shows that HIV, HCV, and HBV seroprevalence in blood donors in Western Mexico is low. We propose that Mexico should establish future strategies, including pathogen reduction technologies (PRTs), in order to improve blood safety and reduce transfusion-transmissible infections (TTIs). Full article
(This article belongs to the Special Issue Pathogen Reduction of Blood Bank Components)
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Review

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11 pages, 249 KiB  
Review
Pathogen Reduction for Platelets—A Review of Recent Implementation Strategies
by Paolo Rebulla and Daniele Prati
Pathogens 2022, 11(2), 142; https://doi.org/10.3390/pathogens11020142 - 24 Jan 2022
Cited by 7 | Viewed by 2864
Abstract
The development of pathogen reduction technologies (PRT) for labile blood components is a long-pursued goal in transfusion medicine. While PRT for red blood cells and whole blood are still in an early phase of development, different PRT platforms for plasma and platelets are [...] Read more.
The development of pathogen reduction technologies (PRT) for labile blood components is a long-pursued goal in transfusion medicine. While PRT for red blood cells and whole blood are still in an early phase of development, different PRT platforms for plasma and platelets are commercially available and routinely used in several countries. This review describes complementary strategies recommended by the US FDA to mitigate the risk of septic reactions in platelet recipients, including PRT and large-volume delayed sampling, and summarizes the main findings of recent reports discussing economical and organizational issues of platelet PRT implementation. Sophisticated mathematical analytical models are available to determine the impact of PRT on platelet costs, shortages and outdates in different settings. PRT implementation requires careful planning to ensure the availability of sufficient economical, technological and human resources. A phased approach was used in most PRT implementation programs, starting with adult and pediatric immunocompromised patients at higher risk of developing septic platelet transfusion reactions. Overall, the reviewed studies show that significant progress has been made in this area, although additional efforts will be necessary to reduce the storage lesion of PRT platelets and to expand the sustainable applicability of PRT to all labile blood components. Full article
(This article belongs to the Special Issue Pathogen Reduction of Blood Bank Components)
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Graphical abstract

Other

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22 pages, 5473 KiB  
Systematic Review
Efficacy and Safety of Pathogen-Reduced Platelets Compared with Standard Apheresis Platelets: A Systematic Review of RCTs
by Ilaria Pati, Francesca Masiello, Simonetta Pupella, Mario Cruciani and Vincenzo De Angelis
Pathogens 2022, 11(6), 639; https://doi.org/10.3390/pathogens11060639 - 01 Jun 2022
Cited by 5 | Viewed by 2023
Abstract
In this systematic review, we evaluate the efficacy and safety of blood components treated with pathogen reduction technologies (PRTs). We searched the Medline, Embase, Scopus, Ovid, and Cochrane Library to identify RCTs evaluating PRTs. Risk of bias assessment and the Mantel–Haenszel method for [...] Read more.
In this systematic review, we evaluate the efficacy and safety of blood components treated with pathogen reduction technologies (PRTs). We searched the Medline, Embase, Scopus, Ovid, and Cochrane Library to identify RCTs evaluating PRTs. Risk of bias assessment and the Mantel–Haenszel method for data synthesis were used. We included in this review 19 RCTs evaluating 4332 patients (mostly oncohematological patients) receiving blood components treated with three different PRTs. Compared with standard platelets (St-PLTs), the treatment with pathogen-reduced platelets (PR-PLTs) does not increase the occurrence of bleeding events, although a slight increase in the occurrence of severe bleeding events was observed in the overall comparison. No between-groups difference in the occurrence of serious adverse events was observed. PR-PLT recipients had a lower 1 and 24 h CI and CCI. The number of patients with platelet refractoriness and alloimmunization was significantly higher in PR-PLT recipients compared with St-PLT recipients. PR-PLT recipients had a higher number of platelet and RBC transfusions compared with St-PLT recipients, with a shorter transfusion time interval. The quality of evidence for these outcomes was from moderate to high. Blood components treated with PRTs are not implicated in serious adverse events, and PR-PLTs do not have a major effect on the increase in bleeding events. However, treatment with PRTs may require a greater number of transfusions in shorter time intervals and may be implicated in an increase in platelet refractoriness and alloimmunization. Full article
(This article belongs to the Special Issue Pathogen Reduction of Blood Bank Components)
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