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Chien SH, Huang HY, Chen YJ, Tsai YC, Lu SH, Lee LH, Liu HM, Chen WC, Liu YC, Lin TA, Liu CY. Comparing transfusion reactions between pre-storage and post-storage leukoreduced apheresis platelets: an analysis using propensity score matching. Ann Hematol 2024; 103:1389-1396. [PMID: 38393657 PMCID: PMC10940477 DOI: 10.1007/s00277-024-05652-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/01/2024] [Indexed: 02/25/2024]
Abstract
Transfusion reactions induced by platelet transfusions may be reduced and alleviated by leukocyte reduction of platelets. Although leukoreduction of apheresis platelets can be performed either pre-storage or post-storage, seldom studies directly compare the incidence of transfusion reaction in these two different blood products. We conducted a retrospective study to compare the transfusion reactions between pre-storage and post-storage leukoreduced apheresis platelets. We reviewed the general characteristics and the transfusion reactions, symptoms, and categories for inpatients who received pre-storage or post-storage leukoreduced apheresis platelets. Propensity-score matching was performed to adjust for baseline differences between groups. A total of 40,837 leukoreduction apheresis platelet orders were reviewed. 116 (0.53%) transfusion reactions were reported in 21,884 transfusions with pre-storage leukoreduction, and 174 (0.91%) reactions were reported in 18,953 transfusions with post-storage leukoreduction. Before propensity-score matching, the odds ratio for transfusion reactions in the pre-storage group relative to the post-storage group was 0.57 (95% confidence interval [CI] 0.45-0.72, P < 0.01); the odds ratio after matching was 0.63 (95% CI 0.49-0.80, P < 0.01). A two-proportion z-test revealed pre-storage leukoreduction significantly decreases the symptoms of chills, fever, itching, urticaria, dyspnea, and hypertension as compared with those in post-storage leukoreduction. Pre-storage leukoreduced apheresis platelet significantly decreased febrile non-hemolytic transfusion reaction as compared with post-storage groups. This study suggests pre-storage leukoreduction apheresis platelet significantly decreases the transfusion reaction as compared with those in post-storage leukoreduction.
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Affiliation(s)
- Sheng-Hsuan Chien
- Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec 2, Shih-Pai Road, Taipei, 112, Taiwan
- Faculty of Medicine, National Yang-Ming Chiao Tung University, Taipei, 112, Taiwan
- Institute of Clinical Medicine, National Yang-Ming Chiao Tung University, Taipei, 112, Taiwan
| | - Hsin-Yi Huang
- Biostatistics Task Force, Taipei Veterans General Hospital, Taipei, 112, Taiwan
| | - Ying-Ju Chen
- Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec 2, Shih-Pai Road, Taipei, 112, Taiwan
| | - Yu-Chen Tsai
- Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec 2, Shih-Pai Road, Taipei, 112, Taiwan
| | - Shu-Hua Lu
- Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec 2, Shih-Pai Road, Taipei, 112, Taiwan
| | - Li-Hsuan Lee
- Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec 2, Shih-Pai Road, Taipei, 112, Taiwan
| | - Hsueng-Mei Liu
- Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec 2, Shih-Pai Road, Taipei, 112, Taiwan
| | - Wen-Chun Chen
- Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec 2, Shih-Pai Road, Taipei, 112, Taiwan
- Faculty of Medicine, National Yang-Ming Chiao Tung University, Taipei, 112, Taiwan
- Institute of Clinical Medicine, National Yang-Ming Chiao Tung University, Taipei, 112, Taiwan
| | - Yao-Chung Liu
- Faculty of Medicine, National Yang-Ming Chiao Tung University, Taipei, 112, Taiwan
- Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, 112, Taiwan
| | - Ting-An Lin
- Faculty of Medicine, National Yang-Ming Chiao Tung University, Taipei, 112, Taiwan
- Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, 112, Taiwan
| | - Chun-Yu Liu
- Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec 2, Shih-Pai Road, Taipei, 112, Taiwan.
- Faculty of Medicine, National Yang-Ming Chiao Tung University, Taipei, 112, Taiwan.
- Institute of Clinical Medicine, National Yang-Ming Chiao Tung University, Taipei, 112, Taiwan.
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2
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Valsami S, Grouzi E, Mochandreou D, Pouliakis A, Piroula-Godoy M, Kokori S, Pittaras T, Raikou A, Politou M. Effect of mirasol pathogen reduction technology system on immunomodulatory molecules of apheresis platelets. Transfus Apher Sci 2023; 62:103523. [PMID: 36041977 DOI: 10.1016/j.transci.2022.103523] [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: 05/23/2022] [Revised: 07/28/2022] [Accepted: 08/07/2022] [Indexed: 11/28/2022]
Abstract
Pathogen inactivation for platelets by riboflavin system (MIRASOL) efficiently reduces transfusion related pathogen transmission. However little is known about its impact on platelets' immunomodulatory biochemical profile. We aimed was to assess the effects of MIRASOL treatment on platelet quality parameters and immunomodulatory molecules CD62P, RANTES, and CD40L in Single Donor Platelets (SDPs) resuspended in plasma (SDP-P) or T-PAS and additive solution (SDP-A). Twenty nine SDPs (15 SDP-P and 14 SDP-A) were included in the study. Samples were collected before, after MIRASOL treatment and just before transfusion. P-selectin (CD62P), RANTES, and CD40L were tested by ELISA. Platelet products quality assays were also performed. Platelet count/unit decreased after Mirasol treatment by 13 %. The pH of all units decreased over the 5-day storage period but remained above expected limits and the swirling test was positive throughout storage. P-selectin levels were not different between the three different time points in both SDPs-P and SDPs-A while RANTES levels were found to differ statistically significantly at the three different time points in all units and in the SPD-A subgroup. CD40L levels in all SDP products increased slightly during storage but this was not statistically significant. CD62P, RANTES, and CD40L in all time points were elevated in SDPs-A compared to SDPs-P but not at a statistically significant level. In conclusion MIRASOL treatment apart from RANTES increase does not seem to substantially affect platelets associated other cytokines and immunomodulatory molecules namely P-selectin and sCD40L which are implicated in immune transfusion reactions.
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Affiliation(s)
- S Valsami
- Hematology Laboratory-Blood Bank, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - E Grouzi
- Department of Transfusion Service and Clinical Hemostasis, "Agios Savvas" Regional Cancer Hospital, Athens, Greece
| | - D Mochandreou
- Department of Transfusion Service and Clinical Hemostasis, "Agios Savvas" Regional Cancer Hospital, Athens, Greece
| | - A Pouliakis
- Department of Cytopathology, University of Athens, "ATTIKON" University Hospital, Athens, Greece
| | - M Piroula-Godoy
- Masters of Science Programme "Thrombosis-Haemorrhage-Transfusion Medicine" of the National and Kapodistrian University of Athens, Greece
| | - S Kokori
- Laboratory of Haematology & Blood Bank Unit, "Attikon" University Hospital, National and Kapodistrian Athens, Athens, Greece
| | - T Pittaras
- Hematology Laboratory-Blood Bank, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - A Raikou
- Department of Transfusion Service and Clinical Hemostasis, "Agios Savvas" Regional Cancer Hospital, Athens, Greece
| | - M Politou
- Hematology Laboratory-Blood Bank, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece; Masters of Science Programme "Thrombosis-Haemorrhage-Transfusion Medicine" of the National and Kapodistrian University of Athens, Greece.
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3
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Tsalas S, Petrou E, Tsantes AG, Sokou R, Loukopoulou E, Houhoula D, Mantzios PG, Kriebardis AG, Tsantes AE. Pathogen Reduction Technologies and Their Impact on Metabolic and Functional Properties of Treated Platelet Concentrates: A Systematic Review. Semin Thromb Hemost 2022. [PMID: 36252605 DOI: 10.1055/s-0042-1757897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Pathogen reduction technologies (PRTs) such as Mirasol and Intercept were developed to eliminate transfusion-transmitted infections. The impact of PRTs on platelet function during the storage period, their effect on platelet storage lesions, and the optimal storage duration following PRTs have not been clearly defined. The aim of this study was to systematically review the existing literature and investigate the impact of PRTs on functional alterations of PRT-treated platelets during the storage period. The authors identified 68 studies suitable to be included in this review. Despite the high heterogeneity in the literature, the results of the published studies indicate that PRTs may increase platelet metabolic activity, accelerate cell apoptosis, and enhance platelet activation, which can subsequently lead to a late exhaustion of activation potential and reduced aggregation response. However, these effects have a minor impact on platelet function during the early storage period and become more prominent beyond the fifth day of the storage period. Large in vivo trials are required to evaluate the effectiveness of PRT-treated platelets during the storage period and investigate whether their storage can be safely extended to more than 5 days, and up to the traditional 7-day storage period.
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Affiliation(s)
- Stavros Tsalas
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Petrou
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas G Tsantes
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Rozeta Sokou
- Neonatal Intensive Care Unit, "Agios Panteleimon" General Hospital of Nikea, Nikea, Piraeus, Greece
| | - Electra Loukopoulou
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitra Houhoula
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros G Mantzios
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasios G Kriebardis
- Laboratory of Reliability and Quality Control in Laboratory Hematology, Department of Biomedical Science, School of Health and Caring Science, University of West Attica, Athens, Greece
| | - Argirios E Tsantes
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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4
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Escolar G, McCullough J. Platelet in vitro assays: their correspondence with their in vivo hemostatic potential. Transfusion 2019; 59:3783-3793. [PMID: 31642072 DOI: 10.1111/trf.15559] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 07/26/2019] [Accepted: 08/28/2019] [Indexed: 01/01/2023]
Abstract
Developments during the past few years have resulted in multiple kinds of platelet products for transfusion. This involves different collection methods, containers, preservative solutions, modifications of storage temperatures and durations, and additional treatments such as pathogen reduction. Much experience has been obtained testing these processes in vitro to seek indications of in vivo effectiveness. Availability of an in vitro method that correlated with in vivo effectiveness would be extremely valuable for these different kinds of platelet products and as more innovation in platelet preparation occurs in the future. This report reviews the methods for in vitro platelet testing with a view to their in vivo implications and whether such testing could be helpful in projecting the clinical effectiveness of different platelet products.
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Affiliation(s)
- Gines Escolar
- Department of Hemotherapy and Hemostasis, ICMHO, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Jeffrey McCullough
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
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5
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Pathogen-Inaktivierungssysteme für Thrombozytenkonzentrate. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2018; 61:874-893. [PMID: 29931520 PMCID: PMC7079973 DOI: 10.1007/s00103-018-2766-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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6
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Schubert P, Johnson L, Marks DC, Devine DV. Ultraviolet-Based Pathogen Inactivation Systems: Untangling the Molecular Targets Activated in Platelets. Front Med (Lausanne) 2018; 5:129. [PMID: 29868586 PMCID: PMC5949320 DOI: 10.3389/fmed.2018.00129] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 04/19/2018] [Indexed: 12/13/2022] Open
Abstract
Transfusions of platelets are an important cornerstone of medicine; however, recipients may be subject to risk of adverse events associated with the potential transmission of pathogens, especially bacteria. Pathogen inactivation (PI) technologies based on ultraviolet illumination have been developed in the last decades to mitigate this risk. This review discusses studies of platelet concentrates treated with the current generation of PI technologies to assess their impact on quality, PI capacity, safety, and clinical efficacy. Improved safety seems to come with the cost of reduced platelet functionality, and hence transfusion efficacy. In order to understand these negative impacts in more detail, several molecular analyses have identified signaling pathways linked to platelet function that are altered by PI. Because some of these biochemical alterations are similar to those seen arising in the context of routine platelet storage lesion development occurring during blood bank storage, we lack a complete picture of the contribution of PI treatment to impaired platelet functionality. A model generated using data from currently available publications places the signaling protein kinase p38 as a central player regulating a variety of mechanisms triggered in platelets by PI systems.
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Affiliation(s)
- Peter Schubert
- Canadian Blood Services, Vancouver, BC, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, BC, Canada
| | - Lacey Johnson
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Dana V Devine
- Canadian Blood Services, Vancouver, BC, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, BC, Canada
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7
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Magron A, Laugier J, Provost P, Boilard E. Pathogen reduction technologies: The pros and cons for platelet transfusion. Platelets 2017; 29:2-8. [PMID: 28523956 DOI: 10.1080/09537104.2017.1306046] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The transfusion of platelets is essential for diverse pathological conditions associated with thrombocytopenia or platelet disorders. To maintain optimal platelet quality and functions, platelets are stored as platelet concentrates (PCs) at room temperature under continuous agitation-conditions that are permissive for microbial proliferation. In order to reduce these contaminants, pathogen reduction technologies (PRTs) were developed by the pharmaceutical industry and subsequently implemented by blood banks. PRTs rely on chemically induced cross-linking and inactivation of nucleic acids. These technologies were initially introduced for the treatment of plasma and, more recently, for PCs given the absence of a nucleus in platelets. Several studies verified the effectiveness of PRTs to inactivate a broad array of bacteria, viruses, and parasites. However, the safety of PRT-treated platelets has been questioned in other studies, which focused on the impact of PRTs on platelet quality and functions. In this article, we review the literature regarding PRTs, and present the advantages and disadvantages related to their application in platelet transfusion medicine.
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Affiliation(s)
- Audrey Magron
- a Centre de Recherche du Centre Hospitalier Universitaire de Québec , Faculté de Médecine de l'Université Laval, Département de Microbiologie et Immunologie , Québec , QC , Canada
| | - Jonathan Laugier
- a Centre de Recherche du Centre Hospitalier Universitaire de Québec , Faculté de Médecine de l'Université Laval, Département de Microbiologie et Immunologie , Québec , QC , Canada
| | - Patrick Provost
- a Centre de Recherche du Centre Hospitalier Universitaire de Québec , Faculté de Médecine de l'Université Laval, Département de Microbiologie et Immunologie , Québec , QC , Canada
| | - Eric Boilard
- a Centre de Recherche du Centre Hospitalier Universitaire de Québec , Faculté de Médecine de l'Université Laval, Département de Microbiologie et Immunologie , Québec , QC , Canada
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8
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Łętowska M, Przybylska Z, Piotrowski D, Lachert E, Rosiek A, Rzymkiewicz L, Cardoso M. Hemovigilance survey of pathogen-reduced blood components in the Warsaw Region in the 2009 to 2013 period. Transfusion 2016; 56 Suppl 1:S39-44. [PMID: 27001360 DOI: 10.1111/trf.13330] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 08/04/2015] [Accepted: 08/05/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND In 2009 the Mirasol Pathogen Reduction Technology (PRT) was introduced to the routine blood component production of the Regional Blood Transfusion Center in Warsaw (RBTCW). The goal of this study was to investigate the safety of Mirasol-treated blood components. STUDY DESIGN AND METHODS The accumulated passive hemovigilance data of Mirasol-treated blood components collected at the RBTCW are presented and compared to historical and contemporary data. Furthermore, active hemovigilance data collected from patients with different hematologic disorders transfused with Mirasol-treated or untreated blood components at the Institute of Hematology and Transfusion Medicine (IHTM) are presented and discussed. RESULTS The adverse reaction (AR) reporting rate by hospitals to the RBTCW after the implementation of the Mirasol technology was 0.39% for Mirasol-treated platelet concentrates (M-PCs) and 0.05% for Mirasol-treated fresh-frozen plasma. When comparing contemporary rates of ARs recorded by RBTCW in the time period 2011 to 2012, no statistical difference was observed between Mirasol-treated and untreated blood components. No serious AR was attributed to Mirasol-treated components. At the IHTM a lower rate of ARs after transfusion of M-PCs was observed than with untreated PCs. Despite the fact that very large amounts of Mirasol-treated plasma have been transfused to patients with congenital or acquired thrombotic thrombocytopenic purpura, no significant increase in AR rates was observed. CONCLUSION Treatment of blood components with the Mirasol PRT System has proven to be safe for patients and is not associated with increased rates and grades of adverse events in patients of hospitals in the Warsaw Region.
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Affiliation(s)
| | | | | | - Elżbieta Lachert
- Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | | | - Lech Rzymkiewicz
- Institute of Hematology and Transfusion Medicine, Warsaw, Poland
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9
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Sandgren P, Berlin G, Tynngård N. Treatment of platelet concentrates with ultraviolet C light for pathogen reduction increases cytokine accumulation. Transfusion 2016; 56:1377-83. [DOI: 10.1111/trf.13601] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/03/2016] [Accepted: 03/03/2016] [Indexed: 12/31/2022]
Affiliation(s)
- Per Sandgren
- Department of Clinical Immunology and Transfusion Medicine; Karolinska University Hospital and Karolinska Institutet; Stockholm, Sweden
| | - Gösta Berlin
- Department of Clinical Immunology and Transfusion Medicine; Linköping University; Linköping Sweden
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
| | - Nahreen Tynngård
- Department of Clinical Immunology and Transfusion Medicine; Linköping University; Linköping Sweden
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
- Department of Clinical Chemistry; Linköping University; Linköping Sweden
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10
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Shukla RV, Shah AP, Shah PV, Gupte SC. Effect of gamma irradiation on cytokines released by platelets during storage. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2016. [DOI: 10.1016/j.jrras.2015.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Loh YS, Dean MM, Johnson L, Marks DC. Treatment of platelets with riboflavin and ultraviolet light mediates complement activation and suppresses monocyte interleukin-12 production in whole blood. Vox Sang 2015; 109:327-35. [DOI: 10.1111/vox.12283] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 03/03/2015] [Accepted: 03/17/2015] [Indexed: 01/07/2023]
Affiliation(s)
- Y. S. Loh
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
| | - M. M. Dean
- Research and Development; Australian Red Cross Blood Service; Brisbane QLD Australia
| | - L. Johnson
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
| | - D. C. Marks
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
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12
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Abonnenc M, Sonego G, Crettaz D, Aliotta A, Prudent M, Tissot JD, Lion N. In vitro study of platelet function confirms the contribution of the ultraviolet B (UVB) radiation in the lesions observed in riboflavin/UVB-treated platelet concentrates. Transfusion 2015; 55:2219-30. [DOI: 10.1111/trf.13123] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 02/24/2015] [Accepted: 02/28/2015] [Indexed: 12/23/2022]
Affiliation(s)
- Mélanie Abonnenc
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - Giona Sonego
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - David Crettaz
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - Alessandro Aliotta
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - Michel Prudent
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - Jean-Daniel Tissot
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - Niels Lion
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
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13
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Pohler P, Müller M, Winkler C, Schaudien D, Sewald K, Müller TH, Seltsam A. Pathogen reduction by ultraviolet C light effectively inactivates human white blood cells in platelet products. Transfusion 2014; 55:337-47. [DOI: 10.1111/trf.12836] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 07/18/2014] [Accepted: 07/21/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Petra Pohler
- German Red Cross Blood Service NSTOB; Institute Springe; Springe Germany
| | - Meike Müller
- Fraunhofer Institute of Toxicology and Experimental Medicine; Hannover Germany
| | - Carla Winkler
- Fraunhofer Institute of Toxicology and Experimental Medicine; Hannover Germany
| | - Dirk Schaudien
- Fraunhofer Institute of Toxicology and Experimental Medicine; Hannover Germany
| | - Katherina Sewald
- Fraunhofer Institute of Toxicology and Experimental Medicine; Hannover Germany
| | - Thomas H. Müller
- German Red Cross Blood Service NSTOB; Institute Springe; Springe Germany
| | - Axel Seltsam
- German Red Cross Blood Service NSTOB; Institute Springe; Springe Germany
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14
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Zhu L, Pan J, Wei C, Wang H, Xiang R, Zhang J, Wang D. The effectiveness of riboflavin photochemical-mediated virus inactivation and changes in protein retention in fresh-frozen plasma treated using a flow-based treatment device. Transfusion 2014; 55:100-7. [PMID: 25070346 DOI: 10.1111/trf.12775] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 05/02/2014] [Accepted: 05/23/2014] [Indexed: 12/27/2022]
Abstract
BACKGROUND A flow-based treatment device using riboflavin and ultraviolet (UV) light was developed to inactivate viruses in fresh-frozen plasma (FFP). The objective of this study was to evaluate the in vitro effectiveness of virus inactivation and changes in protein quality in FFP treated with this device. STUDY DESIGN AND METHODS FFP-contaminating viruses were treated with riboflavin and UV light using a one-pass linear flow device. The infectivity of viruses was measured using established biologic assays. Real-time polymerase chain reaction (PCR) was performed to detect damage to viral nucleotides after treatment. Treated plasma was analyzed using standard coagulation assays. RESULTS FFP treated at the UV dose of 3.6 J/cm(2) (J) exhibited a mean reduction of virus titer of more than 4 logs. The effectiveness increased significantly at higher doses. Real-time PCR showed that the cycle threshold values for both complete inactivation and virus recultivation were higher than that of the untreated sample. At doses of 3.6, 5.4, and 7.2 J, the protein recovery rates were 60.2 ± 8.6, 46.6 ± 9.4, and 28.0 ± 1.0% for fibrinogen; 67.0 ± 3.1, 57.3 ± 8.0, and 49.2 ± 3.8% for Factor VIII; 93.6 ± 2.8, 89.6 ± 6.1, and 86.5 ± 5.3% for antithrombin-III; and 72.1 ± 5.6, 59.8 ± 14.2, and 49.2 ± 8.4% for Protein C, respectively. CONCLUSION The effectiveness of virus inactivation was enhanced, but total activity of plasma factors was reduced, in a UV dose-dependent manner.
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Affiliation(s)
- Liguo Zhu
- Department of Blood Transfusion, Chinese PLA General Hospital, Beijing, China
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15
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Loh YS, Johnson L, Kwok M, Marks DC. Pathogen reduction treatment alters the immunomodulatory capacity of buffy coat-derived platelet concentrates. Transfusion 2013; 54:577-84. [PMID: 23829895 DOI: 10.1111/trf.12320] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 04/30/2013] [Accepted: 05/19/2013] [Indexed: 12/26/2022]
Abstract
BACKGROUND Storage of platelet concentrates (PCs) after Mirasol pathogen reduction technology (PRT) treatment changes platelet (PLT) surface marker expression and secretion of immunomodulatory factors. Given that PLTs are known to participate in immune function, PRT may alter the way PLTs interact with the immune cells of a recipient upon transfusion. As such, the aim of this study was to assess the effects of PRT treatment on the functional ability of PLTs to interact with peripheral blood mononuclear cells (PBMNCs). STUDY DESIGN AND METHODS Buffy coat-derived PCs were pooled and split to obtain matched pairs. One unit was treated using the Mirasol PRT system, while the control PC remained untreated. After 5 days of storage, either the PLTs or the PLT supernatants from the PCs were cocultured with PBMNCs, with or without lipopolysaccharide (LPS). The immunomodulatory factors secreted into culture medium after coculture were examined. RESULTS PRT-treated PLTs and PLT supernatant significantly increased the interleukin (IL)-8 concentration, which was manifested only in the presence of LPS. Conversely, PRT-treated PLTs secreted less soluble P-selectin (sCD62P) upon coculture with PBMNCs. CONCLUSION PRT-treatment induced differential secretion of IL-8 and sCD62P during coculture, which may be attributed to either bioactive substances present in PLT supernatant or as a result of cell-cell interactions.
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Affiliation(s)
- Yen S Loh
- Research and Development, Australian Red Cross Blood Service, Sydney, Australia
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Cata JP, Wang H, Gottumukkala V, Reuben J, Sessler DI. Inflammatory response, immunosuppression, and cancer recurrence after perioperative blood transfusions. Br J Anaesth 2013; 110:690-701. [PMID: 23599512 DOI: 10.1093/bja/aet068] [Citation(s) in RCA: 318] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Debate on appropriate triggers for transfusion of allogeneic blood products and their effects on short- and long-term survival in surgical and critically ill patients continue with no definitive evidence or decisive resolution. Although transfusion-related immune modulation (TRIM) is well established, its influence on immune competence in the recipient and its effects on cancer recurrence after a curative resection remains controversial. An association between perioperative transfusion of allogeneic blood products and risk for recurrence has been shown in colorectal cancer in randomized trials; whether the same is true for other types of cancer remains to be determined. This article focuses on the laboratory, animal, and clinical evidence to date on the mechanistic understanding of inflammatory and immune-modulatory effects of blood products and their significance for recurrence in the cancer surgical patient.
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Affiliation(s)
- J P Cata
- Department of Anaesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Centre, 1515 Holcombe Blvd, Unit 409, Houston, TX 77030, USA.
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17
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Keustermans GCE, Hoeks SBE, Meerding JM, Prakken BJ, de Jager W. Cytokine assays: an assessment of the preparation and treatment of blood and tissue samples. Methods 2013; 61:10-7. [PMID: 23603216 DOI: 10.1016/j.ymeth.2013.04.005] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 04/05/2013] [Accepted: 04/09/2013] [Indexed: 11/25/2022] Open
Abstract
Cytokines are key components of the innate and adaptive immune system. As pivotal players in the progression or regression of a pathological process, these molecules provide a window through which diseases can be monitored and can thus act as biomarkers. In order to measure cytokine levels, a plethora of protocols can be applied. These methods include bioassays, protein microarrays, high-performance liquid chromatography (HPLC), sandwich enzyme-linked immunosorbent assay (ELISA), Meso Scale Discovery (MSD) electrochemiluminescence and bead based multiplex immunoassays (MIA). Due to the interaction and activity of cytokines, multiplex immunoassays are at the forefront of cytokine analysis by allowing multiple cytokines to be measured in parallel. However, even with optimized protocols, sample standardization needs to occur before these proteins can optimally act as biomarkers. This review describes various factors influencing the levels of cytokines measured in plasma, serum, dried blood spots and tissue biopsies, focusing on sample collection and handling, long term storage and the repetitive use of samples. By analyzing how each of these factors influences protein levels, it is concluded that samples should be stored at low temperatures in order to maintain cytokine stability. In addition, within a study, sample manipulations should be kept the same, with measurement protocols being chosen for their compatibility with the research in question. By having a clear understanding of what factors influence cytokine levels and how to overcome these technical issues, minimally confounded data can be obtained and cytokines can achieve optimal biomarker activity.
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Affiliation(s)
- Genoveva C E Keustermans
- Department of Pediatric Immunology (KC01.069.0), Centre for Molecular and Cellular Intervention, University Medical Centre Utrecht, Utrecht, The Netherlands
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Johnson L, Loh YS, Kwok M, Marks DC. In vitroassessment of buffy-coat derived platelet components suspended in SSP+ treated with the INTERCEPT Blood system. Transfus Med 2013; 23:121-9. [DOI: 10.1111/tme.12020] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 01/29/2013] [Accepted: 01/30/2013] [Indexed: 12/01/2022]
Affiliation(s)
- L. Johnson
- Research and Development; Australian Red Cross Blood Service; Sydney; Australia
| | - Y. S. Loh
- Research and Development; Australian Red Cross Blood Service; Sydney; Australia
| | - M. Kwok
- Research and Development; Australian Red Cross Blood Service; Sydney; Australia
| | - D. C. Marks
- Research and Development; Australian Red Cross Blood Service; Sydney; Australia
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Marrocco C, D'Alessandro A, Girelli G, Zolla L. Proteomic analysis of platelets treated with gamma irradiation versus a commercial photochemical pathogen reduction technology. Transfusion 2013; 53:1808-20. [DOI: 10.1111/trf.12060] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 09/20/2012] [Accepted: 10/12/2012] [Indexed: 12/18/2022]
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Tauszig ME, Picker SM, Gathof BS. Platelet derived cytokine accumulation in platelet concentrates treated for pathogen reduction. Transfus Apher Sci 2011; 46:33-7. [PMID: 22119364 DOI: 10.1016/j.transci.2011.10.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2011] [Revised: 09/28/2011] [Accepted: 10/18/2011] [Indexed: 10/15/2022]
Abstract
BACKGROUND Pathogen reduction technologies (PRTs) prevent replication and proliferation of pathogens in platelet (PLT) concentrates (PCs) by modifying nucleic acids. Due to increased cell activation, PRT may also lead to increased cytokine release from α granules and promote adverse transfusion reactions in the recipient. DESIGN Fifteen double-dose leukoreduced apheresis PCs were collected on the Trima Accel platform (vs. 5.2.) allowing for the resuspension in PLT additive solution (PAS) immediately after collection. After a 2-h resting period (1st hour without, 2nd hour with agitation), splitting was performed: one unit remained untreated to serve as control (C), while the other was riboflavin-UVB treated using the Mirasol-PRT system according to the manufacturer's instructions (M). During 8 days of storage, PCs were analyzed for contaminating white and red blood cells, bacterial growth, PLT activation, LDH and cytokine release (MIP-1 α, RANTES, PF4, and TGF-β-1). Results obtained were opposed to a former study, where triple-dose PCs underwent Mirasol-PRT prior to resuspension or the INTERCEPT BLOOD SYSTEM (psoralen-UVA) or remained untreated. RESULTS Despite similar LDH release, PRT treatment was associated with significantly higher (p<0.05) cell activation but only slightly higher cytokine accumulation during storage. Differences became significant only for PF4 and RANTES at day 8 of storage. On the other hand, in the investigation on triple-dose PCs (yielding higher cytokine levels), TGF beta-1 and RANTES remained significantly (p<0.05) lower after PRT treatment compared to untreated units. CONCLUSION Factors, such as collection modality, onset of resuspension and additional amounts of magnesium/potassium in the PAS used may be of equal or even greater impact for cytokine accumulation in stored PCs than PRT treatment.
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Affiliation(s)
- Marie E Tauszig
- Transfusion Medicine, University Hospital of Cologne, Germany.
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Johnson L, Winter KM, Reid S, Hartkopf-Theis T, Marschner S, Goodrich RP, Marks DC. The effect of pathogen reduction technology (Mirasol) on platelet quality when treated in additive solution with low plasma carryover. Vox Sang 2011; 101:208-14. [DOI: 10.1111/j.1423-0410.2011.01477.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Fast LD, DiLeone G, Marschner S. Inactivation of human white blood cells in platelet products after pathogen reduction technology treatment in comparison to gamma irradiation. Transfusion 2010; 51:1397-404. [PMID: 21155832 DOI: 10.1111/j.1537-2995.2010.02984.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND During the transfusion of blood products, the transfer of allogeneic donor white blood cells (WBCs) can mediate adverse reactions in recipients. To minimize reactions, blood components are leukoreduced and/or exposed to gamma irradiation. Nucleic acid-targeted pathogen reduction technologies (PRTs) processes are well suited for WBC inactivation. The Mirasol PRT system (CaridianBCT Biotechnologies) uses riboflavin and ultraviolet light to reduce the active pathogen load and inactivate residual WBCs in blood products used for transfusion. The aim of this study was to compare the effect of PRT treatment to gamma irradiation. MATERIALS AND METHODS WBCs were resuspended in 100% plasma or in plasma containing 65% platelet additive solution (SSP+). A single product was split into three aliquots: control, PRT treatment, or gamma irradiation. After treatment, peripheral blood mononuclear cells were isolated from products, and cell viability and functionality were assessed in limiting dilution assays (LDAs), by CD69 expression, by proliferation, and by cytokine accumulation after lipopolysaccharide addition. RESULTS PRT treatment and gamma irradiation reduced the ability of the T cells to proliferate by similar degrees as evidenced by a 6 log or greater reduction in the LDA and a lack of response to several stimuli. However, gamma-irradiated T cells were still capable of up regulating surface CD69, inducing a proliferative response in allogeneic responder cells, and producing levels of proinflammatory cytokines similar to those of untreated control cells, responses that PRT-treated T cells were incapable of mediating. CONCLUSIONS These in vitro results demonstrate that PRT treatment is more effective than gamma irradiation at abrogating selected WBC immune functions.
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Affiliation(s)
- Loren D Fast
- Department of Medicine, Rhode Island Hospital/Warren Alpert School of Medicine at Brown University, Providence, Rhode Island, USA
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