Technical solutions to social issues?

How do we forecast tomorrow's transfusion: Infectious safety?

Continuous improvement has led to a very high degree of microbial safety of transfusion. Four issues are likely to impact the future of this safety. There will be further advances in the efficacy and efficiency of donation testing and pathogen reduction, increasing safety and hopefully eliminating unnecessary procedures. While system failures have been essentially eliminated, there will be ongoing, unpredictable issues that are inevitable. Emerging infections are likely the greatest concern and will continue, although advances in science and technology will permit increasingly rapid responses to outbreaks. Finally, the practice of transfusion may eventually impact safety as usage of blood is reduced and perhaps as alternatives to conventional blood components are developed.

Science in action? A critical view of UK blood donation deferral policy and men who have sex with men

The rules that govern blood donation vary globally. Some potential blood donors are ineligible for immediate blood donation, and as such are deferred until such time that they become eligible. This practice, the blood donation deferral period, is intended to reduce the risk of blood-borne infections being transfused into a blood product-recipient. As blood screening technologies improve, the risk of an infected blood product remaining undetected decreases-and so too have the deferral periods for certain donors. Much has been made of the importance of an evidence-based, scientific approach to protecting blood product-recipients. However, these deferrals are controversial. What exactly determines the blood donation deferral period? This article argues that blood donation deferral periods are not merely the result of enacting empirical data. Instead, the deferral periods represent a negotiation between scientific evidence, experts, politically expedient narratives, institutionalised risk aversion, as well as more mundane concerns such as operational feasibility. As a case study, I examine how the UK Advisory Committee on the Safety of Blood, Tissues and Organs changed the 12-month deferral period for blood donation from men who have sex with men to a 3-month deferral period.

Inactivation of a broad spectrum of viruses and parasites by photochemical treatment of plasma and platelets using amotosalen and ultraviolet A light

BACKGROUND

The INTERCEPT Blood System pathogen reduction technology (PRT), which uses amotosalen and ultraviolet A light treatment (amotosalen/UV-PRT), inactivates pathogens in plasma and platelet components (PCs). This review summarizes data describing the inactivation efficacy of amotosalen/UVA-PRT for a broad spectrum of viruses and parasites.

METHODS

Twenty-five enveloped viruses, six nonenveloped viruses (NEVs), and four parasites species were evaluated for sensitivity to amotosalen/UVA-PRT. Pathogens were spiked into plasma and PC at high titers. Samples were collected before and after PRT and assessed for infectivity with cell cultures or animal models. Log reduction factors (LRFs) were defined as the difference in infectious titers before and after amotosalen/UV-PRT.

RESULTS

LRFs of ≥4.0 log were reported for 19 pathogens in plasma (range, ≥4.0 to ≥7.6), 28 pathogens in PC in platelet additive solution (PC-PAS; ≥4.1-≥7.8), and 14 pathogens in PC in 100% plasma (PC-100%; (≥4.3->8.4). Twenty-five enveloped viruses and two NEVs were sensitive to amotosalen/UV-PRT; LRF ranged from >2.9 to ≥7.6 in plasma, 2.4 or greater to greater than 6.9 in PC-PAS and >3.5 to >6.5 in PC-100%. Infectious titers for four parasites were reduced by >4.0 log in all PC and plasma (≥4.9 to >8.4).

CONCLUSION

Amotosalen/UVA-PRT demonstrated effective infectious titer reduction for a broad spectrum of viruses and parasites. This confirms the capacity of this system to reduce the risk of viral and parasitic transfusion-transmitted infections by plasma and PCs in various geographies.