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Rezvany MR, Moradi Hasan-Abad A, Sobhani-Nasab A, Esmaili MA. Evaluation of bacterial safety approaches of platelet blood concentrates: bacterial screening and pathogen reduction. Front Med (Lausanne) 2024; 11:1325602. [PMID: 38651065 PMCID: PMC11034438 DOI: 10.3389/fmed.2024.1325602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 03/04/2024] [Indexed: 04/25/2024] Open
Abstract
This mini-review analyzed two approaches to screening bacterial contamination and utilizing pathogen reduction technology (PRT) for Platelet concentrates (PCs). While the culture-based method is still considered the gold standard for detecting bacterial contamination in PCs, efforts in the past two decades to minimize transfusion-transmitted bacterial infections (TTBIs) have been insufficient to eliminate this infectious threat. PRTs have emerged as a crucial tool to enhance safety and mitigate these risks. The evidence suggests that the screening strategy for bacterial contamination is more successful in ensuring PC quality, decreasing the necessity for frequent transfusions, and improving resistance to platelet transfusion. Alternatively, the PRT approach is superior regarding PC safety. However, both methods are equally effective in managing bleeding. In conclusion, PRT can become a more prevalent means of safety for PCs compared to culture-based approaches and will soon comprehensively surpass culture-based bacterial contamination detection methods.
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Affiliation(s)
- Mohammad Reza Rezvany
- Department of Hematology, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
- BioClinicum, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
- Pediatrics Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Amin Moradi Hasan-Abad
- Autoimmune Diseases Research Center, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran
| | - Ali Sobhani-Nasab
- Physiology Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Ali Esmaili
- Department of Laboratory Sciences, Sirjan School of Medical Sciences, Sirjan, Iran
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2
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Gravemann U, Handke W, Schulze TJ, Seltsam A. Growth and Distribution of Bacteria in Contaminated Whole Blood and Derived Blood Components. Transfus Med Hemother 2024; 51:76-83. [PMID: 38584696 PMCID: PMC10996057 DOI: 10.1159/000536242] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 01/10/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Bacterial contamination of blood products presumably occurs mainly during blood collection, starting from low initial concentrations of 10-100 colony-forming units (CFUs) per bag. As little is known about bacterial growth behavior and distribution in stored whole blood (WB) and WB-derived blood products, this study aims to provide data on this subject. Methods WB units were inoculated with transfusion-relevant bacterial species (Acinetobacter baumannii, Bacillus cereus, Escherichia coli, Klebsiella pneumoniae, Listeria monocytogenes, Pseudomonas fluorescens, Serratia marcescens, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus dysgalactiae, Streptococcus pyogenes, Yersinia enterocolitica; n = 12 for each species), stored for 22-24 h at room temperature, and then centrifuged for separation into plasma, red blood cells (RBCs), and buffy coats (BCs). The latter were pooled with 3 random donor BCs and one unit of PAS-E each to yield plasma-reduced platelet concentrates (PCs). Samples for bacterial colony counting were collected after WB storage and immediately after blood component production. Sterility testing in PCs (n = 12 for each species) was performed by bacterial culture after 7 days of storage. Results Bacterial growth in WB varied remarkably between donations and species. Streptococcus species produced the highest titers in WB, whereas Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, and Pseudomonas fluorescens did not multiply. Centrifugation resulted in preferential accumulation of bacteria in BCs, with titers of up to 3.5 × 103 CFU/mL in BCs and up to ≤0.9 × 103 CFU/mL in BC-derived PCs. Overall, 72/144 PCs (50%) tested positive for bacteria after storage. Sterility test results were species-dependent, ranging from 12 of 12 PCs tested positive for Streptococcus pyogenes to 1 of 12 PCs positive for Escherichia coli. Bacterial contamination of RBC and plasma units was much less common and was associated with higher initial bacterial counts in the parent WB units. Conclusions Bacterial growth in WB is species-dependent and varies greatly between donations. Preferential accumulation of bacteria in BCs during manufacturing is a critical determinant of the contamination risk of BC-derived pooled PCs.
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Affiliation(s)
- Ute Gravemann
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany
| | - Wiebke Handke
- Bavarian Red Cross Blood Service, Institute Nuremberg, Nuremberg, Germany
| | - Torsten J. Schulze
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany
| | - Axel Seltsam
- Bavarian Red Cross Blood Service, Institute Nuremberg, Nuremberg, Germany
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3
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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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4
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Christensen RD, Bahr TM, Davenport P, Sola-Visner MC, Kelley WE, Ilstrup SJ, Ohls RK. Neonatal Thrombocytopenia: Factors Associated With the Platelet Count Increment Following Platelet Transfusion. J Pediatr 2023; 263:113666. [PMID: 37572863 DOI: 10.1016/j.jpeds.2023.113666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/06/2023] [Accepted: 08/06/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVE To understand better those factors relevant to the increment of rise in platelet count following a platelet transfusion among thrombocytopenic neonates. STUDY DESIGN We reviewed all platelet transfusions over 6 years in our multi-neonatal intensive care unit system. For every platelet transfusion in 8 neonatal centers we recorded: (1) platelet count before and after transfusion; (2) time between completing the transfusion and follow-up count; (3) transfusion volume (mL/kg); (4) platelet storage time; (5) sex and age of platelet donor; (6) gestational age at birth and postnatal age at transfusion; and magnitude of rise as related to (7) pre-transfusion platelet count, (8) method of enhancing transfusion safety (irradiation vs pathogen reduction), (9) cause of thrombocytopenia, and (10) donor/recipient ABO group. RESULTS We evaluated 1797 platelet transfusions administered to 605 neonates (median one/recipient, mean 3, and range 1-52). The increment was not associated with gestational age at birth, postnatal age at transfusion, or donor sex or age. The rise was marginally lower: (1) with consumptive vs hypoproductive thrombocytopenia (P < .001); (2) after pathogen reduction (P < .01); (3) after transfusing platelets with a longer storage time (P < .001); and (4) among group O neonates receiving platelets from non-group O donors (P < .001). Eighty-seven neonates had severe thrombocytopenia (<20 000/μL). Among these infants, poor increments and death were associated with the cause of the thrombocytopenia. CONCLUSION The magnitude of post-transfusion rise was unaffected by most variables we studied. However, the increment was lower in neonates with consumptive thrombocytopenia, after pathogen reduction, with longer platelet storage times, and when not ABO matched.
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Affiliation(s)
- Robert D Christensen
- Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT; Obstetric and Neonatal Operations, Intermountain Health, Murray, UT.
| | - Timothy M Bahr
- Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT; Obstetric and Neonatal Operations, Intermountain Health, Murray, UT
| | - Patricia Davenport
- Division of Newborn Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Martha C Sola-Visner
- Division of Newborn Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Walter E Kelley
- Blood Transfusion Services, American Red Cross, Salt Lake City, UT
| | - Sarah J Ilstrup
- Intermountain Health Transfusion Services and Department of Pathology, Intermountain Medical Center, Murray, UT
| | - Robin K Ohls
- Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT
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5
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Cancelas JA, Genthe JR, Stolla M, Rugg N, Bailey SL, Nestheide S, Shaz B, Mack S, Schroeder K, Anani W, Szczepiorkowski ZM, Dumont LJ, Yegneswaran S, Corash L, Mufti N, Benjamin RJ, Erickson AC. Evaluation of amotosalen and UVA pathogen-reduced apheresis platelets after 7-day storage. Transfusion 2022; 62:1619-1629. [PMID: 35808974 PMCID: PMC9546462 DOI: 10.1111/trf.17003] [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: 04/01/2022] [Revised: 05/15/2022] [Accepted: 05/25/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Amotosalen/UVA pathogen-reduced platelet components (PRPCs) with storage up to 7 days are standard of care in France, Switzerland, and Austria. PRPCs provide effective hemostasis with reduced risk of transfusion-transmitted infections and transfusion-associated graft versus host disease, reduced wastage and improved availability compared with 5-day-stored PCs. This study evaluated the potency of 7-day PRPCs by in vitro characterization and in vivo pharmacokinetic analysis of autologous PCs. STUDY DESIGN AND METHODS The in vitro characteristics of 7-day-stored apheresis PRPCs suspended in 100% plasma or 65% platelet additive solution (PAS-3)/35% plasma, thrombin generation, and in vivo radiolabeled post-transfusion recovery and survival of 7-day-stored PRPCs suspended in 100% plasma were compared with either 7-day-stored or fresh autologous conventional platelets. RESULTS PRPCs after 7 days of storage maintained pH, platelet dose, in vitro physiologic characteristics, and thrombin generation when compared to conventional 7-day PCs. In vivo, the mean post-transfusion survival was 151.4 ± 20.1 h for 7-day PRPCs in 100% plasma (Test) versus 209.6 ± 13.9 h for the fresh autologous platelets (Control), (T-ΔC: 72.3 ± 8.8%: 95% confidence interval [CI]: 68.5, 76.1) and mean 24-h post-transfusion recovery 37.6 ± 8.4% for Test versus 56.8 ± 9.2% for Control (T-ΔC: 66.2 ± 11.2%; 95% CI: 61.3, 71.1). DISCUSSION PRPCs collected in both 100% plasma as well as 65% PAS-3/35% plasma and stored for 7 days retained in vitro physiologic characteristics. PRPCs stored in 100% plasma for 7 days retained in vivo survival. Lower in vivo post-radiolabeled autologous platelet recovery is consistent with reported reduced count increments for allogenic transfusion.
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Affiliation(s)
| | | | - Moritz Stolla
- Bloodworks Northwest, Seattle, Washington, USA.,Division of Hematology, Department of Medicine, University of Washington Medical Center, Seattle, Washington, USA
| | - Neeta Rugg
- Hoxworth Blood Center, Cincinnati, Ohio, USA
| | | | | | - Beth Shaz
- Duke University, Durham, North Carolina, USA
| | | | | | | | - Zbigniew M Szczepiorkowski
- Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA.,Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | | | | | | | - Nina Mufti
- Cerus Corporation, Concord, California, 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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7
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Malvaux N, Defraigne F, Bartziali S, Bellora C, Mommaerts K, Betsou F, Schuhmacher A. In Vitro Comparative Study of Platelets Treated with Two Pathogen-Inactivation Methods to Extend Shelf Life to 7 Days. Pathogens 2022; 11:pathogens11030343. [PMID: 35335667 PMCID: PMC8949436 DOI: 10.3390/pathogens11030343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 11/26/2022] Open
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 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.
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Affiliation(s)
- Nicolas Malvaux
- Red Cross of Luxemburg, Boulevard Joseph II, 40, L-1840 Luxembourg, Luxembourg; (F.D.); (S.B.); (A.S.)
- Correspondence: ; Tel.: +352-2755-4000
| | - Fanette Defraigne
- Red Cross of Luxemburg, Boulevard Joseph II, 40, L-1840 Luxembourg, Luxembourg; (F.D.); (S.B.); (A.S.)
| | - Styliani Bartziali
- Red Cross of Luxemburg, Boulevard Joseph II, 40, L-1840 Luxembourg, Luxembourg; (F.D.); (S.B.); (A.S.)
| | - Camille Bellora
- Integrated Biobank of Luxembourg, 1 rue Louis Rech, L-3555 Dudelange, Luxembourg; (C.B.); (K.M.); (F.B.)
| | - Kathleen Mommaerts
- Integrated Biobank of Luxembourg, 1 rue Louis Rech, L-3555 Dudelange, Luxembourg; (C.B.); (K.M.); (F.B.)
- Luxembourg Center for Systems Biomedicine, 6 Av. du Swing, L-4367 Esch-sur-Alzette, Luxembourg
| | - Fay Betsou
- Integrated Biobank of Luxembourg, 1 rue Louis Rech, L-3555 Dudelange, Luxembourg; (C.B.); (K.M.); (F.B.)
- Laboratoire National de Sante, 1 rue Louis Rech, L-3555 Dudelange, Luxembourg
| | - Anne Schuhmacher
- Red Cross of Luxemburg, Boulevard Joseph II, 40, L-1840 Luxembourg, Luxembourg; (F.D.); (S.B.); (A.S.)
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8
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Kamel H, Ramirez-Arcos S, McDonald C. The international experience of bacterial screen testing of platelet components with automated microbial detection systems: An update. Vox Sang 2022; 117:647-655. [PMID: 35178718 DOI: 10.1111/vox.13247] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/23/2021] [Accepted: 12/04/2021] [Indexed: 12/22/2022]
Abstract
In 2014, the bacterial subgroup of the Transfusion-Transmitted Infectious Diseases working party of ISBT published a review on the International Experience of Bacterial Screen Testing of Platelet Components (PCs) with an Automated Microbial Detection System. The purpose of this review, which is focused on publications on or after 2014, is to summarize recent experiences related to bacterial contamination of PCs and the use of an automated culture method to safeguard the blood supply. We first reviewed septic transfusion reactions after PC transfusion as reported in national haemovigilance systems along with a few reports from various countries on bacterial contamination of blood products. Next, we reviewed PC automated culture protocols employed by national blood services in the United Kingdom, Australia, Canada and large blood collection organization and hospital transfusion services in the United States. Then, we acknowledged the limitations of currently available culture methodologies in abating the risks of transfusion-transmitted bacterial infection, through a review of case reports. This review was neither meant to be critical of the literature reviewed nor meant to identify or recommend a best practice. We concluded that significant risk reduction can be achieved by one or a combination of more than one strategy. No one approach is feasible for all institutions worldwide. In selecting strategies, institutions should consider the possible impact on platelet components availability and entertain a risk-based decision-making approach that accounts for operational, logistical and financial factors.
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Affiliation(s)
- Hany Kamel
- Medical Affairs, Vitalant, Scottsdale, Arizona, USA
| | - Sandra Ramirez-Arcos
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Canada.,University of Ottawa, Ottawa, Canada
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9
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Hsien S, Dayton JD, Chen D, Stock A, Bacha E, Cushing MM, Nellis ME. Hemostatic efficacy of pathogen-reduced platelets in children undergoing cardiopulmonary bypass. Transfusion 2022; 62:298-305. [PMID: 34904250 PMCID: PMC8837684 DOI: 10.1111/trf.16768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/10/2021] [Accepted: 11/15/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Pediatric patients undergoing cardiopulmonary bypass (CPB) often require blood component transfusions. Pathogen-reduction (PR) of platelets reduces the risk of microbial contamination; however, its effect on hemostatic efficacy in this population is unclear. This study sought to characterize the hemostatic efficacy of PR platelets in children undergoing CPB. STUDY DESIGN AND METHODS We performed a retrospective chart review of patients admitted to a pediatric intensive care unit following CPB surgery from 2015 to 2019. Demographic data, validated scoring of repair complexity, products received, and outcomes were compared. The primary outcome was postoperative chest tube bleeding. RESULTS A total of 140 patients were enrolled. The majority of surgeries (124/140) were Risk Adjustment for Congenital Heart Surgery (RACHS) 1-3 repairs. Seventy-four percent of patients (104/140) received only standard platelets whereas 26% (36/140) received PR platelets. There were no differences between the groups in the age (p = .90), sex (p = .20) or RACHS score (p = .06). Postoperatively, there was no difference in the median chest tube output for 1 h (p = .27), 2 h (p = .26), 4 h (p = .09), 8 h (p = .16), or for the first 24 h following surgery (p = .23) in patients who received standard versus PR platelets. There was also no difference in receipt of platelets (p = .18), cell saver (p = .79), or cryoprecipitate (p = .28). CONCLUSION Patients receiving PR platelets did not have more blood loss or require more transfusions than those who received standard platelets. This suggests that PR platelets may provide acceptable hemostasis with the additional benefits of reduced risk of microbial contamination in pediatric patients undergoing CPB.
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Affiliation(s)
- Sophia Hsien
- Department of Pediatrics, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA
| | - Jeffrey D Dayton
- Division of Pediatric Cardiology, Department of Pediatrics, Weill Cornell Medicine, New York, New York, USA
| | - Dennis Chen
- New York-Presbyterian Hospital, Weill Cornell Medical Center, Transfusion Medicine and Cellular Therapy Laboratory, New York, New York, USA
| | - Arabella Stock
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Weill Cornell Medicine, New York, New York, USA
| | - Emile Bacha
- Division of Cardiac, Thoracic and Vascular Surgery, Columbia University, New York, New York, USA
| | - Melissa M Cushing
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Marianne E Nellis
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Weill Cornell Medicine, New York, New York, USA
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10
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Hindawi SI, El-Kafrawy SA, Hassan AM, Badawi MA, Bayoumi MM, Almalki AA, Zowawi HM, Tolah AM, Alandijany TA, Abunada Q, Picard-Maureau M, Damanhouri GA, Azhar EI. Efficient inactivation of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in human apheresis platelet concentrates with amotosalen and ultraviolet A light. Transfus Clin Biol 2021; 29:31-36. [PMID: 34411748 PMCID: PMC8366050 DOI: 10.1016/j.tracli.2021.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/06/2021] [Accepted: 08/12/2021] [Indexed: 12/11/2022]
Abstract
Objectives The detection of SARS-CoV-2 RNA in blood and platelet concentrates from asymptomatic donors, and the detection of viral particles on the surface and inside platelets during in vitro experiments, raised concerns over the potential risk for transfusion-transmitted-infection (TTI). The objective of this study was to assess the efficacy of the amotosalen/UVA pathogen reduction technology for SARS-CoV-2 in human platelet concentrates to mitigate such potential risk. Material and methods Five apheresis platelet units in 100% plasma were spiked with a clinical SARS-CoV-2 isolate followed by treatment with amotosalen/UVA (INTERCEPT Blood System), pre- and posttreatment samples were collected as well as untreated positive and negative controls. The infectious viral titer was assessed by plaque assay and the genomic titer by quantitative RT-PCR. To exclude the presence of infectious particles post-pathogen reduction treatment below the limit of detection, three consecutive rounds of passaging on permissive cell lines were conducted. Results SARS-CoV-2 in platelet concentrates was inactivated with amotosalen/UVA below the limit of detection with a mean log reduction of > 3.31 ± 0.23. During three consecutive rounds of passaging, no viral replication was detected. Pathogen reduction treatment also inhibited nucleic acid detection with a log reduction of > 4.46 ± 0.51 PFU equivalents. Conclusion SARS-CoV-2 was efficiently inactivated in platelet concentrates by amotosalen/UVA treatment. These results are in line with previous inactivation data for SARS-CoV-2 in plasma as well as MERS-CoV and SARS-CoV-1 in platelets and plasma, demonstrating efficient inactivation of human coronaviruses.
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Affiliation(s)
- S I Hindawi
- Department of Hematology, Blood Transfusion Services, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia.
| | - S A El-Kafrawy
- Special Infectious Agents Unit, BSL3, King Fahd Medical Research Center and Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - A M Hassan
- Special Infectious Agents Unit, BSL3, King Fahd Medical Research Center and Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - M A Badawi
- Department of Hematology, Blood Transfusion Services, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - M M Bayoumi
- Blood Transfusion Services, King Abdulaziz University Hospital, Jeddah 21589, Saudi Arabia
| | - A A Almalki
- Blood Transfusion Services, King Abdulaziz University Hospital, Jeddah 21589, Saudi Arabia
| | - H M Zowawi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh 11481, Saudi Arabia
| | - A M Tolah
- Special Infectious Agents Unit, BSL3, King Fahd Medical Research Center and Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - T A Alandijany
- Special Infectious Agents Unit, BSL3, King Fahd Medical Research Center and Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Q Abunada
- Cerus Europe B.V., Stationsstraat 79-D, 3811 Amersfoort, The Netherlands
| | - M Picard-Maureau
- Cerus Europe B.V., Stationsstraat 79-D, 3811 Amersfoort, The Netherlands
| | - G A Damanhouri
- Department of Hematology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - E I Azhar
- Special Infectious Agents Unit, BSL3, King Fahd Medical Research Center and Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia.
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