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Dodd RY. Emerging pathogens and their implications for the blood supply and transfusion transmitted infections. Br J Haematol 2012; 159:135-42. [PMID: 22924410 PMCID: PMC7161751 DOI: 10.1111/bjh.12031] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The threat of infection by conventional transfusion-transmitted agents has been essentially eliminated from the blood supply in developed countries, thus focusing attention on the potential risk from emerging infections. Over recent years, actions have been taken to manage a number of such risks to blood safety. These illustrate the inherent variability of the agents concerned and of the measures needed to define and control the risk.
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Affiliation(s)
- Roger Y Dodd
- Research and Development, American Red Cross, Holland Laboratory, 15601 Crabbs Branch Way, Rockville, MD 20855, USA.
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202
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Laughlin CA, Morens DM, Cassetti MC, Costero-Saint Denis A, San Martin JL, Whitehead SS, Fauci AS. Dengue research opportunities in the Americas. J Infect Dis 2012; 206:1121-7. [PMID: 22782946 PMCID: PMC3499110 DOI: 10.1093/infdis/jis351] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 01/18/2012] [Indexed: 11/13/2022] Open
Abstract
Dengue is a systemic arthropod-borne viral disease of major global public health importance. At least 2.5 billion people who live in areas of the world where dengue occurs are at risk of developing dengue fever (DF) and its severe complications, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Repeated reemergences of dengue in sudden explosive epidemics often cause public alarm and seriously stress healthcare systems. The control of dengue is further challenged by the lack of effective therapies, vaccines, and point-of-care diagnostics. Despite years of study, even its pathogenic mechanisms are poorly understood. This article discusses recent advances in dengue research and identifies challenging gaps in research on dengue clinical evaluation, diagnostics, epidemiology, immunology, therapeutics, vaccinology/clinical trials research, vector biology, and vector ecology. Although dengue is a major global tropical pathogen, epidemiologic and disease control considerations in this article emphasize dengue in the Americas.
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Affiliation(s)
- Catherine A Laughlin
- Virology Branch, Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892-6603, USA.
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203
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Delwart E. Human parvovirus 4 in the blood supply and transmission by pooled plasma-derived clotting factors: does it matter? Transfusion 2012; 52:1398-403. [PMID: 22780892 DOI: 10.1111/j.1537-2995.2012.03721.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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204
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Aapro M, Cornes P, Sun D, Abraham I. Comparative cost efficiency across the European G5 countries of originators and a biosimilar erythropoiesis-stimulating agent to manage chemotherapy-induced anemia in patients with cancer. Ther Adv Med Oncol 2012; 4:95-105. [PMID: 22590483 DOI: 10.1177/1758834012444499] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES To evaluate the comparative cost efficiency across the European Union G5 countries of the erythropoiesis-stimulating agents (ESAs) epoetin α (originator [Eprex®] and biosimilar [Binocrit®]; once weekly), epoetin β (NeoRecormon®; once weekly), and darbepoetin α (Aranesp®; once weekly or once every 3 weeks) under different scenarios of fixed and weight-based dosing in the management of chemotherapy-induced anemia. METHODS Direct costs of ESA treatment were calculated for one patient with cancer undergoing chemotherapy (six cycles at 3-week intervals) with ESA initiated at week 4 and continued for 15 weeks. Five scenarios were developed under fixed and weight-based dosing: continuous standard dose for 15 weeks; sustained dose escalation to 1.5× or double the standard dose at week 7, continued for 12 weeks; and discontinued dose escalation to 1.5× or double the standard dose at week 7 for a 3-week period, then 9 weeks of standard dose. RESULTS Under fixed dosing, the average cost of biosimilar epoetin α treatment across scenarios was €4643 (30,000 IU) or €6178 (40,000 IU). Corresponding estimates were €7168 for originator epoetin α, €7389 for epoetin β, €8299 for darbepoetin α once weekly, and €9221 for darbepoetin α once every 3 weeks. Under weight-based dosing, the average cost of biosimilar epoetin α treatment across scenarios was €4726. Corresponding estimates were €5484 for originator epoetin α, €5652 for epoetin β, and €8465 for both darbepoetin α once weekly and once every three weeks. CONCLUSION Managing chemotherapy-induced anemia with biosimilar epoetin α is consistently cost efficient over treatment with originator epoetin α, epoetin β, and darbepoetin α under both fixed and weight-based dosing scenarios.
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Affiliation(s)
- Matti Aapro
- Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland
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205
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206
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Lanteri MC, Busch MP. Dengue in the context of "safe blood" and global epidemiology: to screen or not to screen? Transfusion 2012; 52:1634-9. [PMID: 22882092 PMCID: PMC3509801 DOI: 10.1111/j.1537-2995.2012.03747.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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207
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Gallagher LM, Ganz PR, Yang H, Kessler DA, O'Brien SF, Custer BS, Busch MP, Dodd RY, Stramer SL, Walderhaug MO, Forshee RA, Williams AE, Epstein JS, Anderson SA. Advancing risk assessment for emerging infectious diseases for blood and blood products: proceedings of a public workshop. Transfusion 2012; 53:455-63. [PMID: 22845334 DOI: 10.1111/j.1537-2995.2012.03808.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Lou M Gallagher
- Center for Biologics Evaluation and Research, US FDA, Rockville, Maryland, USA.
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208
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Spahn DR, Theusinger OM, Hofmann A. Patient blood management is a win-win: a wake-up call. Br J Anaesth 2012; 108:889-92. [PMID: 22593125 DOI: 10.1093/bja/aes166] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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209
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Tsen SWD, Wu TC, Kiang JG, Tsen KT. Prospects for a novel ultrashort pulsed laser technology for pathogen inactivation. J Biomed Sci 2012; 19:62. [PMID: 22768792 PMCID: PMC3495397 DOI: 10.1186/1423-0127-19-62] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 06/13/2012] [Indexed: 12/28/2022] Open
Abstract
The threat of emerging pathogens and microbial drug resistance has spurred tremendous efforts to develop new and more effective antimicrobial strategies. Recently, a novel ultrashort pulsed (USP) laser technology has been developed that enables efficient and chemical-free inactivation of a wide spectrum of viral and bacterial pathogens. Such a technology circumvents the need to introduce potentially toxic chemicals and could permit safe and environmentally friendly pathogen reduction, with a multitude of possible applications including the sterilization of pharmaceuticals and blood products, and the generation of attenuated or inactivated vaccines.
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Affiliation(s)
- Shaw-Wei D Tsen
- Department of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA
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210
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Anez G, Chancey C, Grinev A, Rios M. Dengue virus and other arboviruses: a global view of risks. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/j.1751-2824.2012.01602.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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211
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Vanlandingham DL, Keil SD, Horne KM, Pyles R, Goodrich RP, Higgs S. Photochemical inactivation of chikungunya virus in plasma and platelets using the Mirasol pathogen reduction technology system. Transfusion 2012; 53:284-90. [PMID: 22626525 DOI: 10.1111/j.1537-2995.2012.03717.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Chikungunya virus (CHIKV) is a reemerging mosquito-borne virus that has been responsible for a number of large-scale epidemics as well as imported cases covering a wide geographical range. As a blood-borne virus capable of mounting a high-titer viremia in infected humans, CHIKV was included on a list of risk agents for transfusion and organ transplant by the AABB Transfusion-Transmitted Diseases Committee. Therefore, we evaluated the ability of the Mirasol pathogen reduction technology (PRT) system (CaridianBCT Biotechnologies) to inactivate live virus in contaminated plasma and platelet (PLT) samples. STUDY DESIGN AND METHODS Plasma, PLTs, and phosphate-buffered saline controls were spiked with CHIKV and treated with riboflavin and varying doses of ultraviolet (UV) light using the Mirasol PRT system. Samples were tested before and after treatment for cytotoxicity, interference, and virus titer by titration and quantitative real-time reverse transcription-polymerase chain reaction. RESULTS A significant reduction in CHIKV titer of greater than 99% was recorded after treatment of plasma or PLTs with the Mirasol PRT system, and the titer reduction was directly proportional to the UV dose delivered to the samples. No cytotoxicity of interference was observed in any sample at any treatment dose. CONCLUSION These data indicate that the Mirasol PRT system efficiently inactivated live CHIKV in plasma and PLTs and could therefore potentially be used to prevent CHIKV transmission through the blood supply.
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Affiliation(s)
- Dana L Vanlandingham
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, USA
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212
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Alhumaidan H, Westley B, Esteva C, Berardi V, Young C, Sweeney J. Transfusion-transmitted anaplasmosis from leukoreduced red blood cells. Transfusion 2012; 53:181-6. [DOI: 10.1111/j.1537-2995.2012.03685.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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213
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Lozano ML, Rivera J, Vicente V. Concentrados de plaquetas procedentes de sangre total (buffy coat) u obtenidos por aféresis; ¿qué producto emplear? Med Clin (Barc) 2012; 138:528-33. [DOI: 10.1016/j.medcli.2011.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Revised: 05/30/2011] [Accepted: 05/31/2011] [Indexed: 10/28/2022]
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Alternative blood products and clinical needs in transfusion medicine. Stem Cells Int 2012; 2012:639561. [PMID: 22567025 PMCID: PMC3337502 DOI: 10.1155/2012/639561] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Accepted: 12/30/2011] [Indexed: 01/19/2023] Open
Abstract
The primary focus of national blood programs is the provision of a safe and adequate blood supply. This goal is dependent on regular voluntary donations and a regulatory infrastructure that establishes and enforces standards for blood safety. Progress in ex vivo expansion of blood cells from cell sources including peripheral blood, cord blood, induced pluripotent stem cells, and human embryonic stem cell lines will likely make alternative transfusion products available for clinical use in the near future. Initially, alloimmunized patients and individuals with rare blood types are most likely to benefit from alternative products. However, in developed nations voluntary blood donations are projected to be inadequate in the future as blood usage by individuals 60 years and older increases. In developing nations economic and political challenges may impede progress in attaining self-sufficiency. Under these circumstances, ex vivo generated red cells may be needed to supplement the general blood supply.
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215
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Zou S, Stramer SL, Dodd RY. Donor Testing and Risk: Current Prevalence, Incidence, and Residual Risk of Transfusion-Transmissible Agents in US Allogeneic Donations. Transfus Med Rev 2012; 26:119-28. [DOI: 10.1016/j.tmrv.2011.07.007] [Citation(s) in RCA: 148] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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216
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Meier J, Müller MM, Lauscher P, Sireis W, Seifried E, Zacharowski K. Perioperative Red Blood Cell Transfusion: Harmful or Beneficial to the Patient? ACTA ACUST UNITED AC 2012; 39:98-103. [PMID: 22670127 DOI: 10.1159/000337187] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 08/02/2011] [Indexed: 11/19/2022]
Abstract
Although the transfusion of red blood cells (RBCs) is safer than ever regarding infections, it is still associated with several adverse reactions and therefore should only be used on the basis of evidence-based triggers. However, prevention of RBC transfusion and subsequent substitution of blood losses with acellular solutions will inevitably result in dilutional anemia. Acute dilutional anemia can be compensated by the body over a wide range of hemoglobin concentrations without a critical restriction of tissue oxygenation. On the other hand, chronic anemia is known to be a potent cause of morbidity and mortality. As a consequence, the impact of perioperative anemia on mortality is difficult to describe, because anemia, as well as the transfusion of RBCs, can influence the clinical outcome. The resulting 'Gordian knot' cannot be cut easily, and this circumstance forces clinical physicians to make a daily trade-off between transfusion-associated and anemia-associated risks. This review focuses on the physiology of oxygen transport, the hazards of acute anemia, the hazards of RBC transfusion, and the literature putting these problems into perspective.
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Affiliation(s)
- Jens Meier
- Department of Anesthesiology and Intensive Care Medicine, Eberhard Karls University, Tübingen, Germany
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217
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Stramer SL, Linnen JM, Carrick JM, Foster GA, Krysztof DE, Zou S, Dodd RY, Tirado-Marrero LM, Hunsperger E, Santiago GA, Muñoz-Jordan JL, Tomashek KM. Dengue viremia in blood donors identified by RNA and detection of dengue transfusion transmission during the 2007 dengue outbreak in Puerto Rico. Transfusion 2012; 52:1657-66. [PMID: 22339201 DOI: 10.1111/j.1537-2995.2012.03566.x] [Citation(s) in RCA: 142] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND In 2007, a total of 10,508 suspected dengue cases were reported in Puerto Rico. Blood donations were tested for dengue virus (DENV) RNA and recipients of RNA-positive donations traced to assess transfusion transmission. STUDY DESIGN AND METHODS Blood donation samples from 2007 were maintained in a repository and tested individually for DENV RNA by transcription-mediated amplification (TMA); a subset was further tested by an enhanced TMA (eTMA) assay. TMA-reactive samples were considered confirmed if TMA (including eTMA) was repeat reactive (RR). All TMA-RR samples were tested by quantitative, DENV type-specific reverse transcriptase-polymerase chain reaction (RT-PCR) and for anti-DENV immunoglobulin (Ig)M by enzyme-linked immunosorbent assay. Samples positive by RT-PCR were further tested for infectivity in mosquito cell culture. Patients receiving components from TMA-RR donations were followed. RESULTS Of 15,350 donation samples tested, 29 were TMA-RR for a prevalence of 1 per 529 (0.19%). DENV Types 1, 2, and 3 with viral titers of 10(5) to 10(9) copies/mL were detected by RT-PCR in 12 samples of which all were infectious in mosquito culture. Six TMA-RR samples were IgM positive. Three of the 29 recipients receiving TMA-RR donations were tested. One recipient in Puerto Rico transfused with red blood cells containing 10(8) copies/mL DENV-2 became febrile 3 days posttransfusion and developed dengue hemorrhagic fever. The recipient was DENV-2 RNA positive by RT-PCR; both the donor and the recipient viruses had identical envelope sequences. CONCLUSIONS High rates of viremia were detected in blood donors in Puerto Rico coupled with the first documented transfusion transmission of severe dengue disease, suggesting that further research on interventions is needed.
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Affiliation(s)
- Susan L Stramer
- Scientific Support Office, American Red Cross, Gaithersburg, Maryland 20877, USA.
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218
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Ettinger A, Miklauz MM, Hendrix BK, Bihm DJ, Maldonado-Codina G, Goodrich RP. Quality of proteins in riboflavin and UV light-treated FFP during 1year of storage at −18°C. Transfus Apher Sci 2012; 46:15-8. [DOI: 10.1016/j.transci.2011.10.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Revised: 08/11/2011] [Accepted: 10/13/2011] [Indexed: 10/15/2022]
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Abstract
Each year, more than 4 million patients receive a blood transfusion in the United States to control symptoms associated with anemia, coagulopathy, thrombocytopenia, or some combination thereof. In each of these cases, the physician and the patient must weigh the potential benefits of the transfusion along with the associated risks. To assess accurately the risk:benefit ratio and to discuss this with the patient, the physician must be familiar with the range of adverse transfusion outcomes and the current estimates of their frequency. Most important, during the past decade the risk profile of transfusion has changed significantly. Transfusion-transmitted disease, although still a rare outcome of transfusion, is no longer an overriding concern in transfusion safety considerations; however, risks such as hemolysis, transfusion-related lung injury, and anaphylaxis continue to represent significant concerns and are relatively more common than the transmission of infectious diseases after transfusion. Against this background, the development of a national hemovigilance system, designed to evaluate more accurately transfusion adverse outcomes in the United States, will require greater precision and reliability in the assessment of adverse transfusion outcomes by clinicians if the proposed benefits of this system are to be realized.
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223
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Arinsburg SA, Skerrett DL, Friedman MT, Cushing MM. A survey to assess transfusion medicine education needs for clinicians. Transfus Med 2011; 22:44-9; quiz 49-51. [DOI: 10.1111/j.1365-3148.2011.01118.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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224
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Abstract
West Nile virus first arrived in North America in the late summer of 1999. Since then it has established itself in Canada and the USA, causing outbreaks every summer since then. The emergence of a new virus prompted a great deal of public health activity and posed a new challenge to the organizations that collect, test, process and supply blood products, in terms of the prevention of transfusion transmission. The rapid development and implementation of effective and innovative donor testing strategies highlights the importance of collaboration, both national and international, and creative thinking as we prepare for the future and the microbial challenges we will certainly face.
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Affiliation(s)
- Margaret Fearon
- Medical Microbiology, Canadian Blood Services, 87 College St, Toronto, ON M5G 2M1, Canada
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225
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Shander A, Javidroozi M, Ozawa S, Hare G. What is really dangerous: anaemia or transfusion? Br J Anaesth 2011; 107 Suppl 1:i41-59. [DOI: 10.1093/bja/aer350] [Citation(s) in RCA: 350] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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226
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Pogłód R, Lętowska M. Plasma in Poland: Production, use and safety. Transfus Apher Sci 2011; 45:227-8. [PMID: 22071226 DOI: 10.1016/j.transci.2011.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ryszard Pogłód
- Department of Transfusion Medicine, Institute of Hematology and Transfusion Medicine, 14 I. Gandhi Str., 02-776 Warsaw, Poland.
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227
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Kishore J, Srivastava M, Choudhury N. Serological study on parvovirus B19 infection in multitransfused thalassemia major patients and its transmission through donor units. Asian J Transfus Sci 2011; 5:140-3. [PMID: 21897592 PMCID: PMC3159243 DOI: 10.4103/0973-6247.83239] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Human parvovirus B19 (B19) virus is a newly recognized agent for transfusion transmitted diseases. Beta-thalassemia major patients receive a hypertransfusion regimen, hence, are prone to acquire B19 infection; moreover, B19 escapes viral inactivation methods and donor units are not tested for B19, but there are just a couple of studies globally and none from the Asian continent. Hence, a study was designed to find the frequency of B19 infection and its transmission in multitransfused thalassemia patients. Materials and Methods: Ninety multitransfused beta-thalassemia major (thalassemia) patients, 32 controls (age, sex matched) without any history of transfusion were enrolled. Besides the donor units were tested in B19 un-infected patients. B19 specific IgG and IgM antibodies in the sera were analyzed by ELISA (in-house), using B19 VPI and VP2 recombinant and purified antigens; additionally HBsAg and anti-HIV and anti-HCV antibodies were tested for coexisting infections. Results: Seventy-three (81%) thalassemia patients tested positive for anti-B19 IgG antibodies as compared to seven (21%) in the controls group (P < 0.01), while anti-B19 IgM antibodies were detected in 37 (41.1%) compared to two (6.2%) in the controls (P < 0.01). Mean age of the thalassemia patient was eight years (range 2 – 18 years) and B19 infection was highest in the six-to-ten year range. Seropositivity increased with the number of transfusions. Two of the four HBsAg positive and five of the seven anti-HCV IgM antibody-positive patients also had anti-B19 IgM. After a six-month follow-up, four (25%) of the 16 seronegative patients seroconverted and anti-B19 IgM antibodies were detected in their donor units. Conclusions: Most of multitransfused thalassemics were B19 seropositive or had anti-B19 IgM; in the remaining uninfected group, B19 got transmitted through infected / IgM-positive donor units.
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Affiliation(s)
- Janak Kishore
- Departments of Microbiology and Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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228
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Whyte R, Kirpalani H. Low versus high haemoglobin concentration threshold for blood transfusion for preventing morbidity and mortality in very low birth weight infants. Cochrane Database Syst Rev 2011:CD000512. [PMID: 22071798 DOI: 10.1002/14651858.cd000512.pub2] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Infants of very low birth weight often receive multiple transfusions of red blood cells, usually in response to predetermined haemoglobin or haematocrit thresholds. In the absence of better indices, haemoglobin levels are imperfect but necessary guides to the need for transfusion. Chronic anaemia in premature infants may, if severe, cause apnoea, poor neurodevelopmental outcomes or poor weight gain.On the other hand, red blood cell transfusion may result in transmission of infections, circulatory or iron overload, or dysfunctional oxygen carriage and delivery. OBJECTIVES To determine if erythrocyte transfusion administered to maintain low as compared to high haemoglobin thresholds reduces mortality or morbidity in very low birth weight infants enrolled within three days of birth. SEARCH METHODS Two review authors independently searched the Cochrane Central Register of Controlled Trials (The Cochrane Library) , MEDLINE,EMBASE, and conference proceedings through June 2010. SELECTION CRITERIA We selected randomised controlled trials (RCTs) comparing the effects of early versus late, or restrictive versus liberal erythrocyte transfusion regimes in low birth weight infants applied within three days of birth, with mortality or major morbidity as outcomes.
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MESH Headings
- Anemia, Neonatal/blood
- Anemia, Neonatal/prevention & control
- Biomarkers/blood
- Blood Transfusion/standards
- Erythrocyte Transfusion/standards
- Hematocrit/standards
- Hemoglobin A/analysis
- Humans
- Infant, Newborn
- Infant, Premature
- Infant, Premature, Diseases/blood
- Infant, Premature, Diseases/mortality
- Infant, Premature, Diseases/prevention & control
- Infant, Very Low Birth Weight/blood
- Morbidity
- Randomized Controlled Trials as Topic
- Reference Values
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Affiliation(s)
- Robin Whyte
- Department of Neonatal Pediatrics, IWK Health Centre - G2216, Halifax, Canada.
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229
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Bornard L, Blay M, Roger PM, Raucoules-Aimé M, Carles M. [Anaesthesia for HIV-infected patients]. ACTA ACUST UNITED AC 2011; 30:501-11. [PMID: 21684100 DOI: 10.1016/j.annfar.2011.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Accepted: 03/24/2011] [Indexed: 10/18/2022]
Abstract
France is one of main countries affected by the HIV-outbreak in Europe with more than 120,000 cases, among which 34,600 patients having developed an AIDS. The antiretroviral combination therapies (combined antiretroviral therapy [cART]) reduced by half the mortality. A low compliance to cART alters the virologic control and increases the morbimortality. If required, the therapeutic break should be the shortest possible, including the whole treatment (to limit the risk of viral resistance). The perioperative care should take into account the underlying conditions. During the preoperative period, the clinical picture could combine various complications: 1: respiratory impairment; 2: impairment of neuronal functions (related to viral factors, host response and environmental factors such as alcohol, drug addiction, HCV co-infection) inducing a cognitive dysfunction or a peripheral neuropathy; 3: lipodystrophy, dyslipidemia and insulin resistance are the main metabolic cART-related side effects, responsible for atherosclerosis and coronaropathy; 4: major nutritional impairment. Anesthesia for HIV patients is almost the same than usual, without HIV-related contraindication to regional anesthesia. Anesthetic drugs can be associated to cART. The main restriction belongs to the protease inhibitors, which could affect the metabolic pathways of opioids, NSAIDs and benzodiazepines (over dosage risks). During the postoperative period, the follow-up should include the thromboembolism prevention (increased risk compared to main people), the cardiovascular side effects, the nutritional status and the continuation of the treatment. Moreover, the psychological status related and a close collaboration with the corresponding physician is critical.
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Affiliation(s)
- L Bornard
- Pôle d'anesthésie réanimation chirurgicale, hôpital Archet 2, CHU de Nice, université de Nice-Sophia-Antipolis, 151 route de Saint-Antoine-Ginestière, Nice cedex, France
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Abstract
In the past few months, there has been public discussion relating to a new perspective on blood safety and specifically upon measures to prevent or discourage donation by individuals with a diagnosis of myalgic encephalopathy-chronic fatigue syndrome. This reflects an intriguing interplay between science, public health and public concern and illustrates some of the difficulties of making decisions in the face of uncertainty and inadequate information.
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Affiliation(s)
- Roger Y Dodd
- Research & Development, American Red Cross, Holland Laboratory, Rockville, MD 20855, USA.
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233
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Wudhikarn K, Perry EH, Kemperman M, Jensen KA, Kline SE. Transfusion-transmitted babesiosis in an immunocompromised patient: a case report and review. Am J Med 2011; 124:800-5. [PMID: 21683324 DOI: 10.1016/j.amjmed.2011.03.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2010] [Revised: 02/11/2011] [Accepted: 03/08/2011] [Indexed: 11/25/2022]
Abstract
Babesiosis is a tick- and transfusion-borne disease caused by intraerythrocytic Babesia parasites. In 2009, a 61-year-old Minnesota woman with chronic lymphocytic leukemia and a history of recent chemotherapy and numerous blood transfusions for gastrointestinal bleeding became febrile and anemic 12 days postsplenectomy. Babesia were visualized on blood smears, confirmed by polymerase chain reaction as B. microti. She developed respiratory failure despite initiation of clindamycin and quinine, and required 12 weeks of azithromycin and atovaquone before blood smear and polymerase chain reaction findings were negative. Serologic evidence of B. microti infection was identified in 1 associated blood donor and 1 other recipient of that donor's blood. Babesia infection can be asymptomatic or cause mild to fulminant disease resulting in multiorgan failure or death. Patients with advanced age, asplenia, or other immune compromise are at risk for severe babesiosis and may require prolonged treatment to eradicate parasitemia. Incidence of transfusion-transmitted babesiosis has increased over the past decade.
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234
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Borkent-Raven BA, Janssen MP, van der Poel CL, Bonsel GJ, van Hout BA. Cost-effectiveness of additional blood screening tests in the Netherlands. Transfusion 2011; 52:478-88. [DOI: 10.1111/j.1537-2995.2011.03319.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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235
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Levi JE, Nascimento MC, Sumita LM, de Souza VAUF, Freire WS, Mayaud P, Pannuti CS. Non-detection of human herpesvirus 8 (HHV-8) DNA in HHV-8-seropositive blood donors from three Brazilian regions. PLoS One 2011; 6:e23546. [PMID: 21858163 PMCID: PMC3152567 DOI: 10.1371/journal.pone.0023546] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 07/20/2011] [Indexed: 11/19/2022] Open
Abstract
Human herpesvirus 8 (HHV-8), also known as Kaposi's sarcoma-associated herpesvirus (KSHV), is the etiologic agent of all forms of Kaposi's sarcoma, primary effusion lymphoma and the plasmablastic cell variant of multicentric Castleman disease. In endemic areas of sub-Saharan Africa, blood transfusions have been associated with a substantial risk of HHV-8 transmission. By contrast, several studies among healthy blood donors from North America have failed to detect HHV-8 DNA in samples of seropositive individuals. In this study, using a real-time PCR assay, we investigated the presence of HHV-8 DNA in whole-blood samples of 803 HHV-8 blood donors from three Brazilian states (São Paulo, Amazon, Bahia) who tested positive for HHV-8 antibodies, in a previous multicenter study. HHV-8 DNA was not detected in any sample. Our findings do not support the introduction of routine HHV-8 screening among healthy blood donors in Brazil. (WC = 140).
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Affiliation(s)
- José Eduardo Levi
- Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, Brazil
| | - Maria Claudia Nascimento
- Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, Brazil
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Laura Masami Sumita
- Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, Brazil
| | - Vanda Akico Ueda Fick de Souza
- Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Moléstias Infecciosas e Parasitárias (LIM 52 -HC), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Wilton S. Freire
- Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, Brazil
| | - Philippe Mayaud
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Claudio S. Pannuti
- Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Moléstias Infecciosas e Parasitárias (LIM 52 -HC), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- * E-mail:
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236
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Slavov SN, Kashima S, Pinto ACS, Covas DT. Human parvovirus B19: general considerations and impact on patients with sickle-cell disease and thalassemia and on blood transfusions. ACTA ACUST UNITED AC 2011; 62:247-62. [DOI: 10.1111/j.1574-695x.2011.00819.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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237
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Inactivation des pathogènes des concentrés plaquettaires : expérience française. Transfus Clin Biol 2011; 18:478-84. [DOI: 10.1016/j.tracli.2011.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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238
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Seghatchian J, Hervig T, Putter JS. Effect of pathogen inactivation on the storage lesion in red cells and platelet concentrates. Transfus Apher Sci 2011; 45:75-84. [DOI: 10.1016/j.transci.2011.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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239
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Petrik J, Coste J, Fournier-Wirth C. Advances in transfusion medicine in the first decade of the 21st century: Advances in miniaturized technologies. Transfus Apher Sci 2011; 45:45-51. [PMID: 21715229 DOI: 10.1016/j.transci.2011.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Several miniaturized high throughput technologies have been developed in the last decade, primarily to study genomic structures and gene expression patterns under various conditions. At the same time, the microarrays, biosensors, integrated microfluidic lab-on-a-chip devices, next generation sequencing or digital PCR are gradually finding their diagnostic applications, although their suitability for specialised diagnostic fields has still to be assessed. In this review we discuss the potential applications of the new technologies to blood testing.
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Affiliation(s)
- J Petrik
- Scottish National Blood Transfusion Service, Edinburgh, UK.
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240
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Singh AE, Plitt SS, Osiowy C, Surynicz K, Kouadjo E, Preiksaitis J, Lee B. Factors associated with vaccine failure and vertical transmission of hepatitis B among a cohort of Canadian mothers and infants. J Viral Hepat 2011; 18:468-73. [PMID: 20546502 DOI: 10.1111/j.1365-2893.2010.01333.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Mother-to-child transmission of hepatitis B virus (HBV) continues to occur despite immunoprophylaxis. We examined maternal factors contributing to transmission in infants receiving adequate immunoprophylaxis in Alberta, Canada. Prenatal specimens from HBsAg-positive women whose babies developed HBV infection despite immunoprophylaxis (cases) and HBsAg-positive mothers whose babies did not (controls) were tested for HBsAg, HBeAg and HBV DNA. Specimens with detectable DNA underwent HBV genotyping. Routinely collected surveillance data and laboratory test results were compared between cases and controls. Twelve cases and 52 controls were selected from a provincial registry from 2000 to 2005. At the time of prenatal screening, median maternal age was 31 years [interquartile range (IQR): 27.5-34.5], and median gestational age was 12 weeks (IQR 10.0-15.5). Cases were more likely than controls to test positive for HBeAg (77.8% vs. 23.1%; P < 0.05). Of all mothers with detectable viral load (n = 51), cases had a significantly higher median viral load than did controls (5.6 × 10(8) IU/mL vs. 1750 IU/mL, P < 0.0001). Of the two cases who were HBeAg negative, one had an undetectable viral load 8 months prior to delivery and a sP120T mutation. The viral load in the other case was 14,000 IU/mL. The majority of isolates were genotype B (31.3%) and C (31.3%) with no significant differences in genotype between cases or controls. In this case-control study, transmission of HBV to infants was more likely to occur in mothers positive for HBeAg and with high HBV DNA.
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Affiliation(s)
- A E Singh
- Department of Medicine, University of Alberta, Edmonton, AB, Canada.
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241
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Spinella PC, Sparrow RL, Hess JR, Norris PJ. Properties of stored red blood cells: understanding immune and vascular reactivity. Transfusion 2011; 51:894-900. [PMID: 21496052 DOI: 10.1111/j.1537-2995.2011.03103.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Philip C Spinella
- Blood Systems Research Institute and University of California, San Francisco, California, USA
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242
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Gregori L, Yang H, Anderson S. Estimation of variant Creutzfeldt-Jakob disease infectivity titers in human blood. Transfusion 2011; 51:2596-602. [DOI: 10.1111/j.1537-2995.2011.03199.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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243
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Hassan N, Halanski M, Wincek J, Reischman D, Sanfilippo D, Rajasekaran S, Wells C, Tabert D, Kurt B, Mitchell D, Huntington J, Cassidy J. Blood management in pediatric spinal deformity surgery: review of a 2-year experience. Transfusion 2011; 51:2133-41. [DOI: 10.1111/j.1537-2995.2011.03175.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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244
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245
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Affiliation(s)
- S Laperche
- Unit of expertise in Virology, National Reference Center for Hepatits B and C and HIV in transfusion, Institut National de la Transfusion Sanguine, Paris, France
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246
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North A, Ciaravino V, Mufti N, Corash L. Preclinical pharmacokinetic and toxicology assessment of red blood cells prepared with S-303 pathogen inactivation treatment. Transfusion 2011; 51:2208-18. [PMID: 21985050 DOI: 10.1111/j.1537-2995.2011.03132.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND A system has been developed to inactivate a wide spectrum of blood-borne pathogens in red blood cells (RBCs) before transfusion. The system utilizes S-303 to target nucleic acids of pathogens and white blood cells. The safety of pathogen inactivated RBC was assessed using S-303-treated RBCs (S-303 RBCs) and S-300, the primary degradation product of S-303. STUDY DESIGN AND METHODS As part of a preclinical safety evaluation program, intravenous toxicity, safety pharmacology, toxicokinetic, and pharmacokinetic studies were conducted in rats and dogs with S-303 RBCs and S-300. RESULTS Single and repeated transfusions of S-303 RBCs were well tolerated in rats and dogs at S-303 concentrations up to five times higher than that used to prepare RBCs for clinical use. For S-300, the doses ranged from the lowest level representative of a clinical exposure from transfusion of 1 unit (0.052 mg/kg/day) to up to the amount of S-300 that would result from exposure to more than 1900 units of RBCs (100 mg/kg/day). There were no related effects of S-303 RBCs or S-300 on mortality, clinical status, body weight, or clinical laboratory assessments and no evidence of organ toxicity. S-300 did not accumulate in the plasma of rats and dogs after repeated transfusions. For all the studies, plasma S-303 was consistently below the limit of quantitation. CONCLUSION The level of residual S-303 and S-300 in the treated blood component is well below that at which no adverse effects were observed. These results support further clinical development of S-303 RBCs for prevention of transfusion-transmitted infections.
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Affiliation(s)
- Anne North
- Department of Development and Clinical Research and Medical Affairs, Cerus Corp., Concord, California, USA.
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247
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Abstract
Numerous studies have evaluated a wide variety of photosensitizers and alkylating agents as candidates for a pathogen reduction process to be used in RBC suspensions. The methodologies that produce robust inactivation of pathogens with maintenance of RBC properties during storage involve those that specifically target nucleic acids. This has been demonstrated through in vitro studies by flexible photosensitizers, which specifically target nucleic acid but do not engage in photochemistry when free in solution and nucleic acid alkylating agents in conjunction with extracellular quencher(s) to protect against RBC membrane alkylation. The flexible photosensitizer method must be scaled up to entire units, and toxicology studies would need to be performed for further development. Clinical trials will ultimately be necessary to further develop either flexible photosensitizers or nucleic acid alkylating methods with quenchers for use in Transfusion Medicine.
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Affiliation(s)
- S J Wagner
- Blood Components Department, American Red Cross Holland Laboratory, Rockville, MD 20855, USA.
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248
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Cazenave JP. [Photochemical inactivation of pathogens in platelets and plasma: five years of clinical use in routine and hemovigilance. Towards a change of paradigm in transfusion safety]. Transfus Clin Biol 2011; 18:53-61. [PMID: 21474358 PMCID: PMC7110539 DOI: 10.1016/j.tracli.2011.02.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 02/28/2011] [Indexed: 11/15/2022]
Abstract
The transfusion of labile blood products is vital and essential for patients in absence of alternative treatment. Patients and doctors have always feared transfusion-transmitted infections by blood, blood components and blood-derived drugs. Photochemical inactivation of platelet concentrates and plasma, using a technique associating amotosalen and UVA, has been used for five years in a French region for the whole population and a large spectrum of patients, with efficacy and safety. It would seem wise to introduce labile blood products, submitted to pathogen inactivation by a technique already approved by a regulatory agency and not to wait for a perfect system including red blood cells concentrates. Universal implementation of pathogen inactivation in labile blood products is a major and key step to improve safety against infection in transfusion.
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Affiliation(s)
- J-P Cazenave
- Établissement français du sang Alsace, 10, rue Spielmann, BP 36, 67065 Strasbourg cedex, France.
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249
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Abstract
Au cours des 20 dernières années, la sécurité en transfusion sanguine a fait de très grands progrès vis-à-vis du risque infectieux et notamment de celui représenté par les rétrovirus (HIV et HTLV) et les virus des hépatites B et C. L’objet de cette revue est de répertorier les risques viraux résiduels ou émergents qui seraient susceptibles d’entraîner de nouvelles contaminations chez les receveurs. À côté de nombreux autres virus (HHV-8, erythrovirus B19, virus des hépatites A et E…), une place toute particulière est faite aux arboviroses émergentes (infections à West Nile virus, dengue et chikungunya) qui menacent de toucher le territoire métropolitain suite à l’implantation en Europe du moustique Aedes albopictus, principal vecteur de la dengue et du chikungunya dans les régions tempérées. Un autre risque sanguin émergent, particulièrement au Royaume-Uni et en France, est constitué par le prion à l’origine de la forme variante de la maladie de Creutzfeldt-Jakob. La revue se termine par un rapide panorama des mesures qui sont susceptibles de contrôler ces émergences : exclusion des donneurs à risque, tests diagnostiques spécifiques de tel ou tel agent, déleucocytation des produits sanguins labiles et traitements physiques ou chimiques capables d’inactiver de façon non spécifique les agents infectieux potentiellement contaminants sans trop altérer les propriétés des composants sanguins. La capacité à maîtriser de façon prospective les nouveaux risques viraux au niveau transfusionnel représente un vrai défi pour préserver la confiance retrouvée des prescripteurs et des receveurs vis-à-vis des produits sanguins.
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250
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Atreya C, Nakhasi H, Mied P, Epstein J, Hughes J, Gwinn M, Kleinman S, Dodd R, Stramer S, Walderhaug M, Ganz P, Goodrich R, Tibbetts C, Asher D. FDA workshop on emerging infectious diseases: evaluating emerging infectious diseases (EIDs) for transfusion safety. Transfusion 2011; 51:1855-71. [DOI: 10.1111/j.1537-2995.2011.03084.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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