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Jacobs MR, Zhou B, Tayal A, Maitta RW. Bacterial Contamination of Platelet Products. Microorganisms 2024; 12:258. [PMID: 38399662 PMCID: PMC10891786 DOI: 10.3390/microorganisms12020258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/18/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
Transfusion of bacterially contaminated platelets, although rare, is still a major cause of mortality and morbidity despite the introduction of many methods to limit this over the past 20 years. The methods used include improved donor skin disinfection, diversion of the first part of donations, use of apheresis platelet units rather than whole-blood derived pools, primary and secondary testing by culture or rapid test, and use of pathogen reduction. Primary culture has been in use the US since 2004, using culture 24 h after collection of volumes of 4-8 mL from apheresis collections and whole-blood derived pools inoculated into aerobic culture bottles, with limited use of secondary testing by culture or rapid test to extend shelf-life from 5 to 7 days. Primary culture was introduced in the UK in 2011 using a "large-volume, delayed sampling" (LVDS) protocol requiring culture 36-48 h after collection of volumes of 16 mL from split apheresis units and whole-blood derived pools, inoculated into aerobic and anaerobic culture bottles (8 mL each), with a shelf-life of 7 days. Pathogen reduction using amotosalen has been in use in Europe since 2002, and was approved for use in the US in 2014. In the US, recent FDA guidance, effective October 2021, recommended several strategies to limit bacterial contamination of platelet products, including pathogen reduction, variants of the UK LVDS method and several two-step strategies, with shelf-life ranging from 3 to 7 days. The issues associated with bacterial contamination and these strategies are discussed in this review.
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Affiliation(s)
- Michael R. Jacobs
- Department of Pathology, Case Western Reserve University and University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA; (B.Z.); (A.T.); (R.W.M.)
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Rios J, Webb J, Dy B, Young PP. The operational and financial impact of adding anaerobic screening of platelets. Transfusion 2024; 64:104-115. [PMID: 38098310 DOI: 10.1111/trf.17611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/20/2023] [Accepted: 10/22/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND AND OBJECTIVES We evaluated the operational and safety impact of implementing anaerobic culture screening of apheresis and pooled platelets at the American Red Cross on the already established use of the aerobic culture screening of each donation performed no sooner than 24 h following collection. MATERIALS AND METHODS Platelets were screened for bacterial contamination with the BACT/ALERT 3D® (bioMérieux, Durham, NC) microbial detection testing system. The addition of anaerobic culture to the already existing aerobic culture resulted in sampling an additional 8-10 mL from each donation. RESULTS Implementation of anaerobic testing resulted in an approximate 3.5-fold increased rate of False Positive BACT/ALERT alarms. There was a modest increase in the rate of True Positive alarms of 1.4-fold with increased detection of Klebsiella and Propionibacterium species, including Cutibacterium acnes. In addition, there was an approximate 3.5-fold increase rate of False Positives and a 13.5-fold increase rate of Indeterminates, the majority (~57%) were due to Cutibacterium acnes. The combined costs and lost revenue associated with adding anaerobic screening increased by ~$1,000,000/year due to testing cost and product discards. CONCLUSION The addition of anaerobic culture to aerobic culture to the original donation (without the introduction of sampling delay) resulted in a significant increase in the rate of alerts. The 40% increased rate of True Positive alarms may have modestly improved platelet safety. However, there was a disproportionate increase in the rate of False Positive and Indeterminate bacterial culture alarms, which added substantial cost and overall loss of platelet products.
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Affiliation(s)
- Jorge Rios
- American Red Cross Biomedical, Dedham, Massachusetts, USA
| | - Jonathan Webb
- American Red Cross Biomedical, Product and Process Management, Washington, District of Columbia, USA
| | - Beth Dy
- American Red Cross Biomedical, Product and Process Management, Washington, District of Columbia, USA
| | - Pampee P Young
- American Red Cross Biomedical, Product and Process Management, Washington, District of Columbia, USA
- Vanderbilt University Medical Center, Department of Pathology, Microbiology, and Immunology, Nashville, Tennessee, USA
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Alabdullatif MI. Hemovigilance data: An effective approach for evaluating bacterial protection systems for platelet transfusions. Asian J Transfus Sci 2024; 18:91-96. [PMID: 39036690 PMCID: PMC11259335 DOI: 10.4103/ajts.ajts_157_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 05/23/2021] [Accepted: 05/29/2022] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Septic transfusion reactions due to bacterial contamination in platelet concentrates (PCs) are continually reported to hemovigilance (HV) programs. Worldwide, blood centers use different systems to avoid transfusion-associated bacterial sepsis in PCs. Herein, national HV data were gathered to compare bacterial protection systems and to assess the risk of bacterial contamination. MATERIALS AND METHODS HV data with definite transfusion-associated bacterial sepsis in PCs were obtained from Australia, Canada, the United Kingdom (U. K.), and Switzerland between 2006 and 2016. These data were reviewed to evaluate bacterial protection systems including early small-volume (ESV), early large-volume (ELV), and delayed large-volume (DLV) bacterial culture screening and pathogen inactivation (PI) treatment. RESULTS Implementation of DLV bacterial culture screening in the U. K. and PI treatment in Switzerland resulted in significant reductions (P < 0.05) in transfusion-associated bacterial sepsis for the period of 2011-2016 compared to the prior 4 years (2006-2010). Approximately 1.86 million DLV bacterial culture-screened PCs and 0.21 million PI-treated PCs were issued with no reported septic fatalities nor cases of life-threatening sepsis. In Australia, two life-threatening septic transfusion reactions (1.923 per million) were reported out of almost 1.04 million ELV bacterial culture-screened PCs, and no septic fatalities were reported. Meanwhile, in Canada, four life-threatening septic transfusion reactions (3.6/million) and one fatality (0.9/million) were observed in about 1.11 million ESV bacterial culture-screened PCs. CONCLUSION DLV bacterial culture and PI treatment significantly reduced the incidence of septic reactions. The advantages and disadvantages of both systems merit further investigation before implementation.
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Affiliation(s)
- Meshari I. Alabdullatif
- Department of Pathology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
- Department of Pathology, SmartLab, Riyadh, Saudi Arabia
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Boyd FA, O’Leary MF, Benson K, Baluch A. A Case of Fatal Clostridium perfringens Sepsis with Massive Hemolysis in the Setting of a Coincidental Platelet Transfusion. Lab Med 2022:6758539. [DOI: 10.1093/labmed/lmac135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Abstract
A 62-year-old woman with acute myeloid leukemia (AML) died of shock and massive hemolysis shortly after receiving two platelet transfusions at a routine clinic visit. Subsequent investigation into what was initially believed to be an acute hemolytic transfusion reaction secondary to platelet transfusions revealed that the patient died of Clostridium perfringens sepsis leading to massive hemolysis. Further investigation ruled out bacterially-contaminated platelets since a patient blood sample from 2 days prior had Clostridium species. The unusual findings and management considerations for this oncology patient are reviewed and compared with previously reported cases of C. perfringens transfusion-transmitted infections. Oncology patients may be especially susceptible to unusual presentations involving unusual pathogens.
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Affiliation(s)
- Frank A Boyd
- Department of Pathology & Cell Biology, University of South Florida Morsani College of Medicine , Tampa, FL , USA
| | - Mandy F O’Leary
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute , Tampa, FL , USA
| | - Kaaron Benson
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute , Tampa, FL , USA
| | - Aliyah Baluch
- Division of Infectious Diseases, H. Lee Moffitt Cancer Center and Research Institute , Tampa, FL , USA
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Wagner SJ, Snyder EL. Identification and management of bacterially contaminated platelets-Back to the future. Transfusion 2022; 62:1948-1960. [PMID: 36059246 DOI: 10.1111/trf.17088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | - Edward L Snyder
- Transfusion Medicine Service, Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
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6
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Cloutier M, De Korte D. Residual risks of bacterial contamination for
pathogen‐reduced
platelet components. Vox Sang 2022; 117:879-886. [DOI: 10.1111/vox.13272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/22/2021] [Accepted: 02/10/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Marc Cloutier
- Medical Affairs and Innovation Héma‐Québec Québec Canada
- Biochemistry, Microbiology and Bio‐informatics Université Laval Québec Canada
| | - Dirk De Korte
- Blood Cell Research Sanquin Research Amsterdam The Netherlands
- Product and Process Development Sanquin Blood Bank Amsterdam The Netherlands
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McDonald CP, Bearne J, Aplin K, Sawicka D. Assessing the inactivation capabilities of two commercially available platelet component pathogen inactivation systems: effectiveness at end of shelf life. Vox Sang 2021; 116:416-424. [PMID: 33616238 DOI: 10.1111/vox.13040] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/06/2020] [Accepted: 11/08/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND OBJECTIVES The inactivation capabilities of the two current commercially available pathogen inactivation (PI) systems for platelet components (PC), Mirasol and Intercept, were investigated by determination of the absence of viable bacteria at the end of shelf life by testing the entire contents of the PC by enrichment culture (terminal sterility). METHODS A pool-and-split method was used, with two treated units and one untreated control per inoculum concentration. Pairs of PC bags were inoculated with a single bacterial species. Three concentrations (n = 2 per concentration), which incremented tenfold, were tested initially based on published data from the manufacturer. Dependent on these results, the concentrations subsequently tested were either increased or decreased until the inactivation capability of the system was derived. Bacterial count was determined post-spiking, immediately prior to treatment (2 h from spiking), immediately after treatment and at the end of shelf life (day seven). Enrichment culture was performed immediately prior to treatment, after treatment and at the end of shelf life. RESULTS The inactivation capabilities, in CFU/ml, of Intercept and Mirasol, respectively, at the end of PC shelf life were as follows: Staphylococcus aureus ≥ 107 , <101 ; Staphylococcus epidermidis ≥106 , <102 ; Klebsiella pneumoniae 105 , <101 ; Streptococcus bovis ≥107 , 101 , Escherichia coli ≥106 , <101 ; Streptococcus pneumoniae ≥106 , 103 ; Streptococcus mitis ≥107 , 101 ; Listeria monocytogenes ≥107 , 101 ; Streptococcus dysgalactiae ≥107 , <101 ; Serratia marcescens 103 , <101 ; Pseudomonas aeruginosa 103 , Mirasol not tested; and Bacillus cereus < 102 , Mirasol not tested. CONCLUSION The inactivation capability of Intercept was greater than that of Mirasol. Inactivation capability (by terminal sterility) is the most meaningful measure to evaluate a PI system for bacteria, rather than logarithmic reduction assessed immediately after treatment by plate count. PI offers a possible alternative to bacterial screening if treatment is performed at an appropriate time dependent on the inactivation capabilities of the system.
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Affiliation(s)
- Carl P McDonald
- Microbiology Services Laboratory - Bacteriology, NHS Blood and Transplant, London, UK
| | - Jennifer Bearne
- Microbiology Services Laboratory - Bacteriology, NHS Blood and Transplant, London, UK
| | - Kate Aplin
- Microbiology Services Laboratory - Bacteriology, NHS Blood and Transplant, London, UK
| | - Danuta Sawicka
- Microbiology Services Laboratory - Bacteriology, NHS Blood and Transplant, London, UK
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Ramirez‐Arcos S, Evans S, McIntyre T, Pang C, Yi Q, DiFranco C, Goldman M. Extension of platelet shelf life with an improved bacterial testing algorithm. Transfusion 2020; 60:2918-2928. [DOI: 10.1111/trf.16112] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/14/2020] [Accepted: 08/18/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Sandra Ramirez‐Arcos
- Canadian Blood Services Ottawa Ontario Canada
- Department of Biochemistry, Microbiology and Immunology University of Ottawa Ottawa Ontario Canada
| | | | | | | | - Qi‐Long Yi
- Canadian Blood Services Ottawa Ontario Canada
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Bordetella holmesii Contamination of Platelet Concentrates: Revisiting the Definition of a Positive Culture. J Clin Microbiol 2018; 56:JCM.01105-18. [PMID: 30158191 DOI: 10.1128/jcm.01105-18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 08/16/2018] [Indexed: 11/20/2022] Open
Abstract
Bacterial contamination remains the most important infectious risk of platelet transfusion. After an initially positive result, a second test is performed on the blood products and the initial culture bottle to confirm the contamination. Based on the blood center's decision algorithm used, results can be either confirmed negative, positive, or indeterminate, or be unconfirmed or discordant. Here, we report the first cases of platelet concentrates contaminated with Bordetella holmesii The in vitro growth characteristics of this unusual contaminant in platelet concentrate were investigated. Two B. holmesii strains isolated from platelet concentrates, as well as a control strain (Serratia marcescens), were spiked into platelet concentrates (PCs) at 1 and 10 CFU/ml. PCs were stored at 20 to 24°C under agitation. Samples were collected on days 2, 3, 4, and 7 for colony count and for bacterial screening using the BacT/Alert 3D system. Two PCs were detected as being positive for B. holmesii However, recultures were negative. In vitro, B. holmesii did not grow but remained detectable in PCs. Its viability diminished rapidly in contact with human plasma. Upon screening using the BacT/Alert 3D system, the majority of products spiked with B. holmesii were negative. This is the first description of PCs contaminated with B. holmesii This bacterium survives in blood products and remains dormant at low concentrations in blood products stored at room temperature, thus making difficult its detection with the BacT/Alert 3D system. The present definition of a true-positive culture of PCs may be overly restrictive for certain bacterial strains.
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11
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Nelson RC, Ivey JR, Eder AF. Delayed presentation of a septic transfusion reaction. Transfusion 2017; 57:2309-2310. [DOI: 10.1111/trf.13983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 11/17/2016] [Accepted: 12/01/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Randin C. Nelson
- Department of Transfusion Medicine, Clinical CenterNational Institutes of HealthBethesda Maryland
| | - Julie R. Ivey
- Department of Transfusion Medicine, Clinical CenterNational Institutes of HealthBethesda Maryland
| | - Anne F. Eder
- Department of Transfusion Medicine, Clinical CenterNational Institutes of HealthBethesda Maryland
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Eder AF, Dy BA, DeMerse B, Wagner SJ, Stramer SL, O'Neill EM, Herron RM. Apheresis technology correlates with bacterial contamination of platelets and reported septic transfusion reactions. Transfusion 2017; 57:2969-2976. [DOI: 10.1111/trf.14308] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/10/2017] [Accepted: 07/24/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Anne F. Eder
- Georgetown University School of Medicine; Washington DC
| | - Beth A. Dy
- National Headquarters, Biomedical Services; Rockville Maryland
| | - Barbara DeMerse
- National Headquarters, Biomedical Services; Rockville Maryland
| | - Stephen J. Wagner
- Holland Laboratory; Biomedical Services, American Red Cross; Rockville Maryland
| | | | - E. Mary O'Neill
- National Headquarters, Biomedical Services; Rockville Maryland
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Ramirez-Arcos S, DiFranco C, McIntyre T, Goldman M. Residual risk of bacterial contamination of platelets: six years of experience with sterility testing. Transfusion 2017; 57:2174-2181. [DOI: 10.1111/trf.14202] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 04/04/2017] [Accepted: 04/30/2017] [Indexed: 01/29/2023]
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Moritz ED, Tonnetti L, Hewins ME, Berardi VP, Dodd RY, Stramer SL. Description of 15 DNA-positive and antibody-negative “window-period” blood donations identified during prospective screening for Babesia microti. Transfusion 2017; 57:1781-1786. [DOI: 10.1111/trf.14103] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 02/08/2017] [Accepted: 02/08/2017] [Indexed: 01/21/2023]
Affiliation(s)
- Erin D. Moritz
- Scientific Affairs Department; American Red Cross; Gaithersburg Maryland
| | - Laura Tonnetti
- Scientific Affairs Department; American Red Cross; Gaithersburg Maryland
| | | | | | - Roger Y. Dodd
- Scientific Affairs Department; American Red Cross; Gaithersburg Maryland
| | - Susan L. Stramer
- Scientific Affairs Department; American Red Cross; Gaithersburg Maryland
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Moritz ED, Winton CS, Tonnetti L, Townsend RL, Berardi VP, Hewins ME, Weeks KE, Dodd RY, Stramer SL. Screening for Babesia microti in the U.S. Blood Supply. N Engl J Med 2016; 375:2236-2245. [PMID: 27959685 DOI: 10.1056/nejmoa1600897] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Babesia microti, a tickborne intraerythrocytic parasite that can be transmitted by means of blood transfusion, is responsible for the majority of cases of transfusion-transmitted babesiosis in the United States. However, no licensed test exists for screening for B. microti in donated blood. We assessed data from a large-scale, investigational product-release screening and donor follow-up program. METHODS From June 2012 through September 2014, we performed arrayed fluorescence immunoassays (AFIAs) for B. microti antibodies and real-time polymerase-chain-reaction (PCR) assays for B. microti DNA on blood-donation samples obtained in Connecticut, Massachusetts, Minnesota, and Wisconsin. We determined parasite loads with the use of quantitative PCR testing and assessed infectivity by means of the inoculation of hamsters and the subsequent examination for parasitemia. Donors with test-reactive samples were followed. Using data on cases of transfusion-transmitted babesiosis, we compared the proportions of screened versus unscreened donations that were infectious. RESULTS Of 89,153 blood-donation samples tested, 335 (0.38%) were confirmed to be positive, of which 67 (20%) were PCR-positive; 9 samples were antibody-negative (i.e., 1 antibody-negative sample per 9906 screened samples), representing 13% of all PCR-positive samples. PCR-positive samples were identified all through the year; antibody-negative infections occurred from June through September. Approximately one third of the red-cell samples from PCR-positive or high-titer AFIA-positive donations infected hamsters. Follow-up showed DNA clearance in 86% of the donors but antibody seroreversion in 8% after 1 year. In Connecticut and Massachusetts, no reported cases of transfusion-transmitted babesiosis were associated with screened donations (i.e., 0 cases per 75,331 screened donations), as compared with 14 cases per 253,031 unscreened donations (i.e., 1 case per 18,074 unscreened donations) (odds ratio, 8.6; 95% confidence interval, 0.51 to 144; P=0.05). Overall, 29 cases of transfusion-transmitted babesiosis were linked to blood from infected donors, including blood obtained from 10 donors whose samples tested positive on the PCR assay 2 to 7 months after the implicated donation. CONCLUSIONS Blood-donation screening for antibodies to and DNA from B. microti was associated with a decrease in the risk of transfusion-transmitted babesiosis. (Funded by the American Red Cross and Imugen; ClinicalTrials.gov number, NCT01528449 .).
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Affiliation(s)
- Erin D Moritz
- From Scientific Affairs, American Red Cross, Gaithersburg, MD (E.D.M., C.S.W., L.T., R.L.T., R.Y.D., S.L.S.); and the Research Division, Imugen, Norwood, MA (V.P.B., M.-E.H., K.E.W.)
| | - Colleen S Winton
- From Scientific Affairs, American Red Cross, Gaithersburg, MD (E.D.M., C.S.W., L.T., R.L.T., R.Y.D., S.L.S.); and the Research Division, Imugen, Norwood, MA (V.P.B., M.-E.H., K.E.W.)
| | - Laura Tonnetti
- From Scientific Affairs, American Red Cross, Gaithersburg, MD (E.D.M., C.S.W., L.T., R.L.T., R.Y.D., S.L.S.); and the Research Division, Imugen, Norwood, MA (V.P.B., M.-E.H., K.E.W.)
| | - Rebecca L Townsend
- From Scientific Affairs, American Red Cross, Gaithersburg, MD (E.D.M., C.S.W., L.T., R.L.T., R.Y.D., S.L.S.); and the Research Division, Imugen, Norwood, MA (V.P.B., M.-E.H., K.E.W.)
| | - Victor P Berardi
- From Scientific Affairs, American Red Cross, Gaithersburg, MD (E.D.M., C.S.W., L.T., R.L.T., R.Y.D., S.L.S.); and the Research Division, Imugen, Norwood, MA (V.P.B., M.-E.H., K.E.W.)
| | - Mary-Ellen Hewins
- From Scientific Affairs, American Red Cross, Gaithersburg, MD (E.D.M., C.S.W., L.T., R.L.T., R.Y.D., S.L.S.); and the Research Division, Imugen, Norwood, MA (V.P.B., M.-E.H., K.E.W.)
| | - Karen E Weeks
- From Scientific Affairs, American Red Cross, Gaithersburg, MD (E.D.M., C.S.W., L.T., R.L.T., R.Y.D., S.L.S.); and the Research Division, Imugen, Norwood, MA (V.P.B., M.-E.H., K.E.W.)
| | - Roger Y Dodd
- From Scientific Affairs, American Red Cross, Gaithersburg, MD (E.D.M., C.S.W., L.T., R.L.T., R.Y.D., S.L.S.); and the Research Division, Imugen, Norwood, MA (V.P.B., M.-E.H., K.E.W.)
| | - Susan L Stramer
- From Scientific Affairs, American Red Cross, Gaithersburg, MD (E.D.M., C.S.W., L.T., R.L.T., R.Y.D., S.L.S.); and the Research Division, Imugen, Norwood, MA (V.P.B., M.-E.H., K.E.W.)
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Menitove JE, Leach Bennett J, Tomasulo P, Katz LM. How safe is safe enough, who decides and how? From a zero-risk paradigm to risk-based decision making. Transfusion 2014; 54:753-7. [DOI: 10.1111/trf.12569] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Accepted: 12/17/2013] [Indexed: 11/30/2022]
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17
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Benjamin RJ, Dy B, Perez J, Eder AF, Wagner SJ. Bacterial culture of apheresis platelets: a mathematical model of the residual rate of contamination based on unconfirmed positive results. Vox Sang 2013; 106:23-30. [DOI: 10.1111/vox.12065] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 06/04/2013] [Accepted: 06/04/2013] [Indexed: 11/28/2022]
Affiliation(s)
- R. J. Benjamin
- American Red Cross Biomedical Services; Rockville MD USA
| | - B. Dy
- American Red Cross Biomedical Services; Rockville MD USA
| | - J. Perez
- American Red Cross Biomedical Services; Rockville MD USA
| | - A. F. Eder
- American Red Cross Biomedical Services; Rockville MD USA
| | - S. J. Wagner
- American Red Cross Biomedical Services; Rockville MD USA
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