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Stewart CF, McGoldrick P, Anderson JG, MacGregor SJ, Atreya CD, Maclean M. Microbial reduction of prebagged human plasma using 405 nm light and its effects on coagulation factors. AMB Express 2024; 14:66. [PMID: 38842656 PMCID: PMC11156813 DOI: 10.1186/s13568-024-01725-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/27/2024] [Indexed: 06/07/2024] Open
Abstract
Bacterial contamination is the most prevalent infectious complication of blood transfusion in the developed world. To mitigate this, several ultraviolet light-based pathogen reduction technologies (PRTs), some of which require photo-chemicals, have been developed to minimize infection transmission. Relative to UV light, visible 405-nm light is safer and has shown potential to be developed as a PRT for the in situ treatment of ex vivo human plasma and platelet concentrates, without the need for photo-chemicals. This study investigates the effect of 405-nm light on human plasma, with focus on the compatibility of antimicrobial light doses with essential plasma clotting factors. To determine an effective antimicrobial dose that is compatible with plasma, prebagged human plasma (up to 300 mL) was seeded with common microbial contaminants and treated with increasing doses of 405-nm light (16 mW cm-2; ≤ 403 J cm-2). Post-exposure plasma protein integrity was investigated using an AOPP assay, in vitro coagulation tests, and ELISA-based measurement of fibrinogen and Protein S. Microbial contamination in 300 mL prebagged human plasma was significantly reduced (P ≤ 0.05) after exposure to ≤ 288 J cm-2, with microbial loads reduced by > 96.2%. This dose did not significantly affect the plasma protein quality parameters tested (P > 0.05). Increased doses (≥ 345 J cm-2) resulted in a 4.3% increase in clot times with no statistically significant change in protein activity or levels. Overall, this study has demonstrated that the effective microbicidal 405 light dose shows little to no negative effect on plasma quality.
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Affiliation(s)
- Caitlin F Stewart
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST), Department of Electronic & Electrical Engineering, University of Strathclyde, Royal College Building, 204 George Street, Glasgow, UK
| | - Preston McGoldrick
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - John G Anderson
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST), Department of Electronic & Electrical Engineering, University of Strathclyde, Royal College Building, 204 George Street, Glasgow, UK
| | - Scott J MacGregor
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST), Department of Electronic & Electrical Engineering, University of Strathclyde, Royal College Building, 204 George Street, Glasgow, UK
| | - Chintamani D Atreya
- Office of Blood Research and Review, Center for Biologics Evaluation and Research (CBER), Food and Drug Administration, Silver Spring, MD, USA
| | - Michelle Maclean
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST), Department of Electronic & Electrical Engineering, University of Strathclyde, Royal College Building, 204 George Street, Glasgow, UK.
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK.
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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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Jana S, Kassa T, Wood F, Hicks W, Alayash AI. Changes in hemoglobin oxidation and band 3 during blood storage impact oxygen sensing and mitochondrial bioenergetic pathways in the human pulmonary arterial endothelial cell model. Front Physiol 2023; 14:1278763. [PMID: 37916221 PMCID: PMC10617028 DOI: 10.3389/fphys.2023.1278763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/02/2023] [Indexed: 11/03/2023] Open
Abstract
Red blood cells (RBCs) undergo metabolic, oxidative, and physiological changes during storage, collectively described as the "storage lesion." The impact of storage on oxygen homeostasis, following transfusion, is not fully understood. We show that RBC storage induces changes in oxygen binding that were linked to changes in oxygen sensing (hypoxia-inducible factor, HIF-1α) mechanisms and mitochondrial respiration in human pulmonary arterial endothelial cells (HPAECs). A decrease in oxygen affinity (P50) to approximately 20 from 30 mmHg was seen at the first week but remained unchanged for up to 42 days. This led to the suppression of HIF-1α in the first 3 weeks due to limited oxygen supplies by RBCs. Furthermore, membrane oxidative damage, band 3 alterations, and subsequent microparticle (MP) formation were also noted. Mass spectrometric analysis revealed the upregulation of transitional endoplasmic reticulum ATPase, essential for clearing ROS-damaged membrane proteins and the protein DDI1 homolog, a proteasomal shuttle chaperone. Band 3 complex proteins and superoxide dismutase were among the downregulated proteins. Mitochondrial oxygen consumption rates measured in HPAECs incubated with RBC-derived MPs (14-day and 42-day) showed a rise in maximal respiration. Intervention strategies that target intracellular hemoglobin (Hb)'s redox transitions and membrane changes may lead to the reestablishment of oxygen homeostasis in old RBCs.
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Affiliation(s)
| | | | | | | | - Abdu I. Alayash
- Laboratory of Biochemistry and Vascular Biology, Center for Biologics Evaluation and Research Food and Drug Administration (FDA), Silver Spring, MD, United States
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Belkacemi M, Merbouh MA. Seroprevalence of Human Immunodeficiency Virus, Hepatitis C Virus, and Hepatitis B Virus Among Blood Donors in Sidi Bel Abbes, West Algeria. Cureus 2023; 15:e47066. [PMID: 38022198 PMCID: PMC10644989 DOI: 10.7759/cureus.47066] [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] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Blood transfusions can transmit various viruses. Among them, the most common are hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). These viruses can cause fatal and life-threatening diseases. Worldwide, many people are infected with these viruses. Blood safety has made major progress in recent years. Yet, blood-borne viruses continue to be a major concern for patients, physicians, and policymakers. The aim of this study was to assess the prevalence of HIV, HBV, and HCV in blood donors. Methods A cross-sectional study was performed to assess HIV, HBV, and HCV seropositivity in blood donors. This research was carried out at the blood bank of Sidi Bel Abbes University Hospital. This was a retrospective study based on records of blood donors. All data of 10,386 donors were analyzed from January 2015 to December 2015. Biological screening was performed by enzyme-linked immunosorbent assay (ELISA) using antibodies and/or antigens. The combined HCV and HIV antigen and antibody ELISA test was utilized. To confirm the results, the blood bank and the virology laboratory used the same technique in duplicate. Results The overall seroprevalence of blood-borne viral infections (HIV, HBV, and HCV) in blood donors was 0.8%. The prevalence of HIV was found to be 0.1%, while the prevalence of HBV and HCV was 0.4%. Coinfection was rare with only one case of HBV with HIV. There was a significant difference in seroprevalence rates among blood donors compared to the general population. Significant variations were observed between the prevalence of this study and those conducted in West, East, Central, and South African countries but not with those of neighboring North African countries. The study found no association between seropositivity in blood donors and factors like age, gender, donor status, type of donation, or site. Besides, HIV, HBV, or HCV prevalence was not influenced by ABO and Rhesus blood group. Conclusion The study showed that blood donors in Algeria have a lower prevalence of blood-borne viral infections than the general population. The seropositivity rate of viral markers was similar throughout North African countries. This rate remained low compared to other African countries. Residual risk of infection persists. There is a need to increase blood safety for recipients. This report is the first comprehensive overview of blood-borne viruses among Algerian blood donors. There is a need for further nationwide studies to get a whole picture of the situation.
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Affiliation(s)
- Malika Belkacemi
- Hemobiology and Blood Transfusion, University Hospital Establishment of Oran, Oran, DZA
- Medicine, Oran 1 University, Oran, DZA
| | - Mohammed Amine Merbouh
- Epidemiology and Preventive Diseases, Hassani Abdelkader University Hospital, Sidi Bel Abbes, DZA
- Medicine, Djilali Liabès University, Sidi Bel Abbes, DZA
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Udvardy M, Illés Á, Gergely L, Pinczés LI, Magyari F, Simon Z. Transfusion-Transmitted Disorders 2023 with Special Attention to Bone Marrow Transplant Patients. Pathogens 2023; 12:901. [PMID: 37513748 PMCID: PMC10383292 DOI: 10.3390/pathogens12070901] [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: 05/30/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023] Open
Abstract
Transfusion medicine is traditionally a strong/fundamental part of clinical practice, saving hundreds of millions of lives. However, blood-borne or transmitted infections are a well-known and feared possibility, a risk we relentlessly mitigate. Pathogens are continuously and rather quickly changing, so during the last decade, many, sometimes exotic, new pathogens and diseases were recorded and analyzed, and some of them were proved to be transmitted with transfusions. Blood or blood component transfusions are carried out after cautious preparative screening and inactivation maneuvers, but in some instances, newly recognized agents might escape from standard screening and inactivation procedures. Here, we try to focus on some of these proven or potentially pathogenic transfusion-transmitted agents, especially in immunocompromised patients or bone marrow transplantation settings. These pathogens are sometimes new challenges for preparative procedures, and there is a need for more recent, occasionally advanced, screening and inactivation methods to recognize and eliminate the threat a new or well-known pathogen can pose. Pathogen transmission is probably even more critical in hemophiliacs or bone marrow transplant recipients, who receive plasma-derived factor preparations or blood component transfusions regularly and in large quantities, sometimes in severely immunosuppressed conditions. Moreover, it may not be emphasized enough that transfusions and plasma-derived product administrations are essential to medical care. Therefore, blood-borne transmission needs continued alertness and efforts to attain optimal benefits with minimized hazards.
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Affiliation(s)
- Miklós Udvardy
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Árpád Illés
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Lajos Gergely
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - László Imre Pinczés
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Ferenc Magyari
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Zsófia Simon
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
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Garraud O. How do I forecast tomorrow's transfusion: Are there any future and/or any breakthroughs for cell banking and transfusion medicine? Transfus Clin Biol 2023:S1246-7820(23)00062-9. [PMID: 37085114 DOI: 10.1016/j.tracli.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Affiliation(s)
- Olivier Garraud
- SAINBIOSE-INSERM-U_1059, University of Lyon, Saint-Etienne, France.
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7
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Weaver MS, Yee MEM, Lawrence CE, Matheny Antommaria AH, Fasano RM. Requests for Directed Blood Donations. Pediatrics 2023; 151:e2022058183. [PMID: 36897227 PMCID: PMC10998552 DOI: 10.1542/peds.2022-058183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2022] [Indexed: 03/11/2023] Open
Abstract
This Ethics Rounds presents a request for directed blood donation. Two parents feel helpless in the setting of their daughter's new leukemia diagnosis and want to directly help their child by providing their own blood for a transfusion. They express hesitancy about trusting the safety of a stranger's blood. Commentators assess this case in the setting of blood as a scarce community resource during a national blood shortage. Commentators review the child's best interest, future risks, and harm-benefit considerations. Commentators recognize the professional integrity, humility, and courage of the physician to admit his own lack of knowledge on the subject and to seek help rather than claim directed donation is not possible without further investigation into options. Shared ideals such as altruism, trust, equity, volunteerism, and solidarity are recognized as values relevant to sustainment of a community blood supply. Pediatric hematologists, a blood bank director, transfusion medicine specialists, and an ethicist conclude that directed donation is only justified by lower risks to the recipient in particular circumstances.
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Affiliation(s)
- Meaghann S Weaver
- Department of Pediatrics, University of Nebraska, Omaha, Nebraska
- VA National Center for Ethics in Health Care, Washington, District of Columbia
| | - Marianne E M Yee
- Department of Pathology and Laboratory Medicine, Center for Transfusion and Cellular Therapy
- Division of Hematology/Oncology, Department of Pediatrics, Emory University, Atlanta, Georgia
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Courtney E Lawrence
- Division of Pediatric Hematology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
- American Red Cross Biomedical Services, Medical Office, Virginia Region, Richmond, Virginia
| | - Armand H Matheny Antommaria
- Ethics Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Ross M Fasano
- Department of Pathology and Laboratory Medicine, Center for Transfusion and Cellular Therapy
- Division of Hematology/Oncology, Department of Pediatrics, Emory University, Atlanta, Georgia
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
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8
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Himmelsbach K, Mueller S, Kress J, Fiedler SA, Miskey C, Ivics Z, Patek A, Chudy M. Second hepatitis C virus transmission by blood components since introduction of mandatory NAT screening in Germany. Transfusion 2023; 63:339-347. [PMID: 36515262 DOI: 10.1111/trf.17224] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Viral safety of blood products in Germany has improved significantly over the last two decades. We describe the second documented transfusion-transmitted (TT) episode for the hepatitis C virus (HCV) in Germany since mandatory nucleic acid amplification techniques (NAT) screening was introduced in 1999. STUDY DESIGN AND METHODS When a repeat donor who had tested negative for anti-HCV tested positive for HCV RNA by NAT in a minipool (MP) of eight, a look-back procedure was initiated. Qualitative, quantitative and genotyping assays were used to investigate the titers of the quarantined fresh frozen plasma (FFP) from the donor and a serum sample from the recipient of the pooled platelet concentrate (PPC). Amplified products of 5'UTR and HVR1 were used for sequence comparison to characterize the HCV genomic identity of donor and recipient samples. RESULTS All NAT tests utilized in this procedure were able to detect a low HCV RNA titer (~15 IU/ml) in the FFP from the donation. Dilution of FFP by factor 8 was performed to mimic an MP, and the detection rate correlated well with the claimed sensitivity of the tests. Analysis of donor and recipient samples revealed genotype 3a viral transmission confirmed by sequence analysis. CONCLUSION This TT HCV case could have been prevented by individual donation (ID) NAT. However, a low titer blood donation in the window period (WP) is very rare. Residual risk calculation for TT HCV in the WP revealed that, compared to MP-NAT testing, ID-NAT would improve blood safety only marginally.
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Affiliation(s)
| | - Susanne Mueller
- Department Safety of Medicinal Products and Medical Devices, Paul-Ehrlich-Institut, Langen, Germany
| | - Julia Kress
- Department of Virology, Paul-Ehrlich-Institut, Langen, Germany
| | - Sarah A Fiedler
- Department Safety of Medicinal Products and Medical Devices, Paul-Ehrlich-Institut, Langen, Germany
| | - Csaba Miskey
- Department of Medical Biotechnology, Paul-Ehrlich-Institut, Langen, Germany
| | - Zoltan Ivics
- Department of Medical Biotechnology, Paul-Ehrlich-Institut, Langen, Germany
| | - Alexander Patek
- Blood Donation Service Saar-Pfalz, Klinikum Saarbruecken, Saarbruecken, Germany
| | - Michael Chudy
- Department of Virology, Paul-Ehrlich-Institut, Langen, Germany
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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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Handke W, Gravemann U, Müller TH, Wagner FF, Schulze TJ, Seltsam A. New ultraviolet C light-based method for pathogen inactivation of red blood cell units. Transfusion 2022; 62:2314-2323. [PMID: 36087025 DOI: 10.1111/trf.17098] [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: 05/17/2022] [Revised: 08/18/2022] [Accepted: 08/20/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pathogen inactivation (PI) technologies for platelet concentrates and plasma are steadily becoming more established, but new PI treatment options for red blood cells (RBCs), the most commonly used blood component, still need to be developed. We present a novel approach to inactivating pathogens in RBC units employing ultraviolet C (UVC) light. METHODS Whole blood-derived leukoreduced RBCs suspended in PAGGS-C, a third generation additive solution, served as test samples, and RBCs in PAGGS-C or SAG-M as controls. Vigorous agitation and hematocrit reduction by diluting the RBCs with additional additive solution during illumination ensured that UVC light penetrated and inactivated the nine bacteria and eight virus species tested. Bacterial and viral infectivity assays and in vitro analyses were performed to evaluate the system's PI capacity and to measure the RBC quality, metabolic, functional, and blood group serological parameters of UVC-treated versus untreated RBCs during 36-day storage. RESULTS UVC treatment of RBCs in the PAGGS-C additive solution did not alter RBC antigen expression, but significantly influenced some in vitro parameters. Compared to controls, hemolysis was higher in UVC-treated RBC units, but was still below 0.8% at 36 days of storage. Extracellular potassium increased early after PI treatment and reached ≤70 mmol/L by the end of storage. UVC-treated RBC units had higher glucose and 2,3-diphosphoglycerate levels than controls. CONCLUSION As UVC irradiation efficiently reduces the infectivity of relevant bacteria and viruses while maintaining the quality of RBCs, the proposed method offers a new approach for PI of RBC concentrates.
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Affiliation(s)
- Wiebke Handke
- Bavarian Red Cross Blood Service, Nuremberg, Germany
| | - Ute Gravemann
- German Red Cross Blood Service NSTOB, Springe, Germany
| | | | | | | | - Axel Seltsam
- Bavarian Red Cross Blood Service, Nuremberg, Germany
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11
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Belkacemi M, Heddi B. Toxoplasmosis Immunity Status of Blood Donors in Sidi Bel Abbès, West Algeria. Cureus 2022; 14:e28826. [PMID: 36225427 PMCID: PMC9535615 DOI: 10.7759/cureus.28826] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 12/05/2022] Open
Abstract
Background Toxoplasmosis is a zoonotic disease. It is due to an obligate intracellular protozoan called Toxoplasma gondii (T. gondii). Felids are considered definitive hosts, and humans take part as intermediate hosts. At least one-third of the world’s population is seropositive to the parasite. In addition, to the known modes of transmission, the infection can be transmitted through blood transfusions. The aim of this study is to assess the immune status of blood donors about this disease and estimate the potential risk by blood components. Methodology A single cross-sectional study was conducted based on the search for T. gondii antibodies (IgG and IgM) in blood donors. This research was performed using a latex particle agglutination assay confirmed by an enzyme-linked immunosorbent assay (ELISA). Results In all, 103 blood donors were involved in this study. The sex ratio of male/ female was 0.75. The recorded rate of exposure to toxoplasmosis in blood donors was 47.7% (95% CI: 35.1-54.3). Significant differences were observed between the prevalence and those of other African countries in West, East, and Central Africa, but not with those of Algerian pregnant women and neighboring North African countries. There was no association between T. gondii seropositivity and the following factors: sex, age, and blood group ABO or Rhesus. Antitoxoplasma IgG was detectable in all positive donors, while IgM was undetectable. All seropositive donors had an IgG titer ≥9 IU/ml. The potential risk of T. gondii transmission ranges from 1 per 100,000 to 17 per 100,000 blood donations. Conclusion The seroprevalence of T. gondii infection was comparable to those found in Algerian pregnant women and neighboring North African countries. However, the seroprevalence rate was lower than recorded in other African countries. There is even a risk of transmission of toxoplasmosis through blood transfusions. There is a need to enhance blood safety measures for pregnant, immunocompromised, and multi-transfused people. As the immune status of blood donors may vary by region, there is a need to extend the national studies to the entire country. This study provides the first data on the seroprevalence of T. gondii infection among Algerian blood donors and the risk of its transmission by transfusion of blood components.
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Assessing quality of blood components derived from whole blood treated with riboflavin and ultraviolet light and separated with a fully automated device. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2022; 20:395-403. [PMID: 35175188 PMCID: PMC9480972 DOI: 10.2450/2022.0278-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/22/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Combining pathogen reduction and automated separation of whole blood (WB), together with the use of improved additive solutions, may increase reproducibility and extend shelf-life of blood components. MATERIALS AND METHODS Forty WB units were collected from volunteer donors and randomised 1:1 into two groups: 1) pathogen reduction with riboflavin and ultraviolet light (PRT); or 2) no treatment (Control). After two hours (h) at room temperature, all units underwent fully automated separation into red blood cell concentrate (RBCC), plasma and leukopack components. RBCCs were leukoreduced and stored in phosphate-adenine-glucose-guanosine-saline-mannitol (PAGGSM) solution while plasma units were shock frozen within 8 h of collection and stored at ≤ -25°C. RBCCs were sampled on day 1 and weekly thereafter until day 42, while plasma was sampled on days 1 and 30. The main study objective was to assess the in vitro quality of separated RBCCs using biochemical and haematological parameters. Plasma protein content after one cycle of freeze-thaw was also analysed. RESULTS The quality of RBCCs was largely comparable between the PRT and Control groups, except for a significantly higher degree of haemolysis and extracellular potassium levels in the PRT group after 35 days of storage. While potassium concentration was significantly higher in the PRT group at all timepoints, the degree of haemolysis exceeded the accepted European threshold (i.e., <0.8% of red cell mass in ≥ 90.0% of tested units) after day 35. Most plasma protein levels were significantly lower in the PRT than the Control group at both day 1 and day 30. DISCUSSION Pathogen reduction with riboflavin and ultraviolet light treatment of WB can be combined with fully automated separation to obtain RBCCs that may be stored for up to 35 days in PAGGSM solution with acceptable quality, comparable to that of RBCCs from untreated blood. The relative differences between factor concentrations in plasma from the PRT and the Control groups were similar during the 30-day storage.
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13
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Lotens A, Prudent M, Rapaille A. Antioxidants in single methylene-blue-treated plasma units cannot be used to predict pathogen inactivation treatment success. Vox Sang 2022; 117:937-942. [PMID: 35445418 DOI: 10.1111/vox.13273] [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: 10/05/2021] [Revised: 03/08/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Measurement of antioxidant power (AOP) can be useful to validate the execution of the pathogen inactivation (PI) treatment of plasma units. The aim of this study was to evaluate the Theraflex technology for plasma units routinely used in Belgium. MATERIALS AND METHODS AOP was tested on plasma units treated by Theraflex with various non-complete treatment scenarios. AOP was quantified electrochemically using disposable devices and was expressed as equivalent ascorbic acid concentration. RESULTS During a complete PI treatment, AOP rose from 195 ± 32 to 230 ± 42 μmol/L eq. ascorbic acid after addition of methylene blue (MB), and decreased to 192 ± 30 μmol/L eq. ascorbic acid after illumination and finally to 177 ± 27 μmol/L eq. ascorbic acid after final filtration. Without MB, the final filtration had no effect on the plasma AOP (197 ± 22 μmol/L eq. ascorbic acid before filtration and 194 ± 22 μmol/L eq. ascorbic acid after filtration). With no MB and no illumination, there was no significant difference between the plasma AOP at the beginning (188 ± 23 μmol/L eq. ascorbic acid) and at the end of the process (179 ± 21 μmol/L eq. ascorbic acid). CONCLUSION AOP measurement may not indicate the effectiveness of the PI treatment.
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Affiliation(s)
- Anaïs Lotens
- Blood Service, Belgian Red Cross, Namur, Belgium
| | - Michel Prudent
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Epalinges, Switzerland.,Faculté de Biologie et de Médecine, Université de Lausanne, Lausanne, Switzerland.,Center for Research and Innovation in Clinical Pharmaceutical Sciences, Institute of Pharmaceutical Sciences of Western Switzerland, University Hospital and University of Lausanne, Lausanne, Switzerland
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14
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Alayash AI. Hemoglobin Oxidation Reactions in Stored Blood. Antioxidants (Basel) 2022; 11:antiox11040747. [PMID: 35453432 PMCID: PMC9027219 DOI: 10.3390/antiox11040747] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/02/2022] [Accepted: 04/04/2022] [Indexed: 02/01/2023] Open
Abstract
Hemoglobin (Hb) inside and outside the red blood cells (RBCs) undergoes constant transformation to an oxidized form in a process known as autoxidation. The ferrous heme iron (Fe2+) of the prosthetic group is spontaneously transformed into an oxidized ferric (Fe3+) form, but under oxidative stress conditions a higher oxidation ferryl heme (Fe4+) is also formed. Although Fe3+ is a non-functional form of Hb, the Fe4+ is also extremely reactive towards other biological molecules due to its high redox potential. The RBC contains an effective reductive machinery that maintains Hb in the functional form with little oxidation during its life span. The redox transformation of Hb occurs to a lesser extent in young RBCs; it may, however, have detrimental effects on the integrity of these cells during ex vivo storage or when RBCs are subjected to pathogen reduction processes. In this review, Hb oxidation reactions (“oxidative lesion”) will be described, including details of how these reactions might impact the clinical use of stored or processed blood for therapeutic purposes.
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Affiliation(s)
- Abdu I Alayash
- Laboratory of Biochemistry and Vascular Biology, Division of Blood Components and Devices (DBCD), Center for Biologics Evaluation and Research (CBER), Food and Drug Administration (FDA), Silver Spring, MD 20993, USA
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15
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Ruby KN, Khan J, Martin IW, Dunbar NM. Application of Standardized Residual Component Culture Criteria for Suspected Septic Transfusion Reactions Would Increase the Component Culturing Rate at a Single Academic Medical Center. Am J Clin Pathol 2022; 158:216-220. [PMID: 35311936 DOI: 10.1093/ajcp/aqac032] [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: 12/27/2021] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The 2019 SCARED study developed the Biomedical Excellence for Safer Transfusion (BEST) criteria in an effort to standardize the decision to culture residual units in the context of suspected septic transfusion reactions (STRs). The goal of this study was to apply the BEST criteria to determine the effect on the transfusion reaction decision to culture. METHODS This retrospective, single-center, cross-sectional study assessed adult transfusion reactions identified in calendar years 2013 to 2020. Reactions following transfusion of RBCs, platelets, and plasma were included, and the decisions to culture following strict application of BEST criteria were compared with decisions to culture in actual practice. RESULTS In total, 1,068 transfusion reactions were reported and 200 (19%) suspected STRs were cultured, all with negative results; 303 (28%) reactions would have been cultured per strict application of the BEST criteria. Concordance between actual culture decision and BEST criteria recommendation was 62% for cultured components and 79% for components that were not cultured. CONCLUSIONS BEST criteria provide objective recommendations of when to culture residual units implicated in suspected STRs, but strict application of these criteria may result in increased culture rates. Clinical correlation to aid in the decision to culture is recommended.
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Affiliation(s)
- Kristen N Ruby
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jenna Khan
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Isabella W Martin
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Nancy M Dunbar
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
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16
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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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17
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The Missing Pieces to the Cold-Stored Platelet Puzzle. Int J Mol Sci 2022; 23:ijms23031100. [PMID: 35163024 PMCID: PMC8835703 DOI: 10.3390/ijms23031100] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 01/28/2023] Open
Abstract
Cold-stored platelets are making a comeback. They were abandoned in the late 1960s in favor of room-temperature stored platelets due to the need for longer post-transfusion platelet recoverability and survivability in patients with chronic thrombocytopenia. However, the current needs for platelet transfusions are rapidly changing. Today, more platelets are given to patients who are actively bleeding, such as ones receiving cardiac surgeries. It has been established that cold-stored platelets are more hemostatically effective, have reduced bacterial growth, and have longer potential shelf lives. These compelling characteristics led to the recent interest in bringing back cold-stored platelets to the blood systems. However, before reinstating cold-stored platelets in the clinics again, a thorough investigation of in vitro storage characteristics and in vivo transfusion effects is required. This review aims to provide an update on the recent research efforts into the storage characteristics and functions of cold-stored platelets using modern investigative tools. We will also discuss efforts made to improve cold-stored platelets to be a better and safer product. Finally, we will finish off with discussing the relevance of in vitro data to in vivo transfusion results and provide insights and directions for future investigations of cold-stored platelets.
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18
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Raj ARR, Shashindran N, Shenoy V, Kumar A. Dengue seropositivity among blood donors in a tertiary hospital in Kerala, Southern India. Ann Afr Med 2022; 21:39-42. [PMID: 35313403 PMCID: PMC9020633 DOI: 10.4103/aam.aam_72_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: The aim of this study was to screen blood donors in a tertiary hospital in Kerala for dengue during the period of peak dengue transmission. Materials and Methods: One hundred and seventy-eight continuous serum samples obtained from asymptomatic blood donors during the monsoon season were subjected to ELISA for Dengue NS1 antigen and dengue immunoglobulin M (IgM) antibodies. Results: Dengue IgM antibodies were positive in 20 (11.23%) donors and NS1 antigen was positive in 1 (0.56%) donor. The presence of these markers in asymptomatic blood donors showed that they may have had active or subclinical dengue infection at the time of donation or in the recent past. The presence of NS1 in particular raises the possibility that the donor may have been viremic at the time of donation. Conclusion: The findings of this study suggest the risk of transfusion transmission of dengue during the monsoon in Kerala and strengthen the case for dengue screening among blood donors during this period of high incidence.
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Affiliation(s)
- A R Rahul Raj
- Department of Microbiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Nandita Shashindran
- Department of Microbiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Veena Shenoy
- Department of Transfusion Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Anil Kumar
- Department of Microbiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
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19
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Liu H, Wang X. Pathogen reduction technology for blood component: A promising solution for prevention of emerging infectious disease and bacterial contamination in blood transfusion services. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY 2021. [DOI: 10.1016/j.jpap.2021.100079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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20
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Raykar NP, Makin J, Khajanchi M, Olayo B, Munoz Valencia A, Roy N, Ottolino P, Zinco A, MacLeod J, Yazer M, Rajgopal J, Zeng B, Lee HK, Bidanda B, Kumar P, Puyana JC, Rudd K. Assessing the global burden of hemorrhage: The global blood supply, deficits, and potential solutions. SAGE Open Med 2021; 9:20503121211054995. [PMID: 34790356 PMCID: PMC8591638 DOI: 10.1177/20503121211054995] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 10/04/2021] [Indexed: 01/28/2023] Open
Abstract
There is a critical shortage of blood available for transfusion in many low- and middle-income countries. The consequences of this scarcity are dire, resulting in uncounted morbidity and mortality from trauma, obstetric hemorrhage, and pediatric anemias, among numerous other conditions. The process of collecting blood from a donor to administering it to a patient involves many facets from donor availability to blood processing to blood delivery. Each step faces particular challenges in low- and middle-income countries. Optimizing existing strategies and introducing new approaches will be imperative to ensure a safe and sufficient blood supply worldwide.
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Affiliation(s)
- Nakul P Raykar
- Trauma & Emergency General Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.,Departments of Surgery and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Jennifer Makin
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Bernard Olayo
- Center for Public Health and Development, Nairobi, Kenya
| | | | - Nobhojit Roy
- Health Systems Strengthening Unit, CARE-India, Bihar, India.,Department of Surgery, KEM Hospital, Mumbai, India
| | - Pablo Ottolino
- Department of Surgery, Hospital Sotero Del Rio, Universidad Católica, Santiago, Chile
| | - Analia Zinco
- Department of Surgery, Hospital Sotero Del Rio, Universidad Católica, Santiago, Chile
| | - Jana MacLeod
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.,Business School, Strathmore University, Nairobi, Kenya
| | - Mark Yazer
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Jayant Rajgopal
- Department of Industrial Engineering, School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bo Zeng
- Department of Industrial Engineering, School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hyo Kyung Lee
- Department of Industrial Engineering, School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bopaya Bidanda
- Department of Industrial Engineering, School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Pratap Kumar
- Business School, Strathmore University, Nairobi, Kenya
| | - Juan Carlos Puyana
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Kristina Rudd
- Department of Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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21
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Alabdullatif M, Osman IE, Alrasheed M, Ramirez-Arcos S, Alyousef M, Althawadi S, Alhumiadan H. Evaluation of riboflavin and ultraviolet light treatment against Klebsiella pneumoniae in whole blood-derived platelets: A pilot study. Transfusion 2021; 61:1562-1569. [PMID: 33687079 DOI: 10.1111/trf.16347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 12/27/2020] [Accepted: 12/27/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Bacterial contamination of platelet concentrates (PCs) is the predominant cause of infectious transfusion reactions. The Pathogen Inactivation Mirasol system was implemented at the King Faisal Specialist Hospital (Saudi Arabia) to reduce the risk of transfusing contaminated PCs. This pilot study evaluated the effectiveness of Mirasol against Klebsiella pneumoniae, a pathogen associated with transfusion reactions, in whole blood-derived PCs. STUDY DESIGN AND METHODS Whole blood (WB) units inoculated with one of six K. pneumoniae strains (five clinical isolates and ATCC-700603) at a concentration of 3-38 CFU/unit, were processed using the platelet-rich plasma (PRP) method. Each spiked PC was pooled with four unspiked units. The pooled PC was split into three Mirasol storage bags: an untreated unit (control), and two units treated with Mirasol at 26 and 32 h post-WB collection, respectively. PC samples obtained before and after Mirasol treatment were used for BacT/ALERT cultures and determination of bacteria quantification. Each experiment was repeated three independent times. RESULTS Five strains were detected prior to PC treatment (24 h post-WB spiking), while one clinical isolate was not detected. Mirasol treatment after 26 h of WB collection resulted in complete inactivation of all K. pneumoniae strains. However, treatment 32 h post-WB collection resulted in the breakthrough of one clinical isolate in two of the three replicates with ~7.8 log10 CFU/unit detected on day 5 of PC storage. CONCLUSION Delayed Mirasol treatment from 26 to 32 h post-WB collection, resulted in one breakthrough. These results highlight the importance of minimizing the time between WB collection and PI treatment.
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Affiliation(s)
- Meshari Alabdullatif
- Department of Pathology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia.,Department of Microbiology, SmartLab, Riyadh, Saudi Arabia
| | - Imad Eldin Osman
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mai Alrasheed
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | | | - Manal Alyousef
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Sahar Althawadi
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hind Alhumiadan
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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22
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Schubert P, Culibrk L, Culibrk B, Conway EM, Goodrich RP, Devine DV. Releasates of riboflavin/UV-treated platelets: Microvesicles suppress cytokine-mediated endothelial cell migration/proliferation. Transfusion 2021; 61:1551-1561. [PMID: 33629371 DOI: 10.1111/trf.16337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 01/09/2021] [Accepted: 02/04/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Accelerated development of the platelet (PLT) storage lesion upon pathogen inactivation (PI) is associated with the release of proteins from granules and platelet microvesicles (PMVs). Whether PI treatments alter the interaction between PLT factors and the vessel endothelium is of interest in understanding the risk profile of these technologies. STUDY DESIGN AND METHODS In a pool-and-split study, one platelet concentrate (PC) was treated with riboflavin/UV (RF/UV) light, while the other one was kept as an untreated control. Releasates and PMV-depleted releasates were prepared by differential centrifugation steps on days 0, 1, 5, and 7 of storage. Cytokine/chemokine release following PI treatment was analyzed by an antibody array, and results were verified by the enzyme-linked immunosorbent assay. PMVs were enumerated by CD41 labeling and flow cytometry. Wound scratch assays were performed using cultured Ea.hy926 cells exposed to the differently prepared releasates. Effects of releasates on the phosphorylation levels of kinases ERK and p38 expressed by endothelial cells were analyzed by immunoblot. RESULTS Cytokine/chemokine assays identified a 2-fold increase in epidermal growth factor released from PCs treated with RF/UV light compared with control. PMV count increased ~100-fold following PI treatment. Unmodified releasates and PMV-depleted releasates displayed different contributions to the kinetics of endothelial cell wound closure. This observation was associated with an increased ERK versus unaltered p38 activation in the endothelial cells. CONCLUSION This study identified an inhibitory impact of PMVs on endothelial cell migration/proliferation upon stimulation by released cytokines and PMVs from PLTs treated with RF/UV light for endothelial cell wound closure.
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Affiliation(s)
- Peter Schubert
- Centre for Innovation, Canadian Blood Services, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Luka Culibrk
- Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Brankica Culibrk
- Centre for Innovation, Canadian Blood Services, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Edward M Conway
- Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada.,Departement of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Raymond P Goodrich
- Infectious Disease Research Center, Colorado State University, Fort Collins, Colorado, USA
| | - Dana V Devine
- Centre for Innovation, Canadian Blood Services, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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23
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Kumukova I, Trakhtman P, Starostin N, Borsakova D, Ignatova A, Bayzyanova Y. Quality assessment of red blood cell suspensions derived from pathogen-reduced whole blood. Vox Sang 2020; 116:547-556. [PMID: 33222171 DOI: 10.1111/vox.13039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND We used laboratory indicators to evaluate the quality of pathogen-reduced red blood cell suspension (RBCS) compared with gamma-irradiated RBCS. MATERIALS AND METHODS To determine biochemical and metabolic parameters of RBCS, we obtained 50 whole blood units from healthy volunteers and randomized them into 2 groups: 25 were pathogen-reduced, and then, RBCS prepared from them. RBCS from the other 25 was gamma-irradiated. Sampling was carried out on day zero before and after treatment and at 7, 14, 21 and 28 days. To determine lymphocyte inactivation, we collected another 35 whole blood units. Each was sampled to form 3 study groups: untreated, gamma-irradiated and pathogen-reduced. Daily sampling was carried out during 3 days of storage. RESULTS The quality of RBCS from both groups was largely the same, except for haemolysis and red blood cell fragility, which were more pronounced in the pathogen-reduced group. This finding limited the shelf life of pathogen-reduced RBCS to 14 days. Lymphocyte viability was significantly reduced after both treatments. Proliferation of lymphocytes after pathogen reduction was reduced to the detection limit, while low-level proliferation was observed in gamma-irradiated samples. CONCLUSION Pathogen-reduced red blood cells have acceptable quality and can be used for transfusion within 14 days. Results of inactivation of lymphocytes demonstrate that pathogen reduction technology, applied on WB, can serve as an alternative to irradiation.
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Affiliation(s)
- Irina Kumukova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology Oncology and Immunology, Moscow, Russia
| | - Pavel Trakhtman
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology Oncology and Immunology, Moscow, Russia
| | - Nicolay Starostin
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology Oncology and Immunology, Moscow, Russia
| | - Daria Borsakova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology Oncology and Immunology, Moscow, Russia.,Laboratory of Physiology and Biophysics of the Cell, Center for Theoretical Problems of Physicochemical Pharmacology, Russian Academy of Sciences, Moscow, Russia
| | - Anastasia Ignatova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology Oncology and Immunology, Moscow, Russia
| | - Yana Bayzyanova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology Oncology and Immunology, Moscow, Russia
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24
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Gupta A, Karki R, Dandu HR, Dhama K, Bhatt ML, Saxena SK. COVID-19: benefits and risks of passive immunotherapeutics. Hum Vaccin Immunother 2020; 16:2963-2972. [PMID: 32962524 PMCID: PMC7544960 DOI: 10.1080/21645515.2020.1808410] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Passive immunotherapeutics (PITs), including convalescent plasma, serum, or hyperimmune immunoglobulin, have been of clinical importance during sudden outbreaks since the early twentieth century for the treatment of viral diseases such as severe acute respiratory syndrome (SARS), middle east respiratory syndrome (MERS) and swine flu (H1N1). With the recent SARS-CoV-2 pandemic, wherein effective antivirals and vaccines are still lacking, an interest in convalescent plasma therapy as a lifesaving option has resurfaced due to its capacity for antigenic neutralization and reducing viremia. This review summarizes convalescent blood products (CBPs) in terms of current technologies and the shortcomings related to the collection, manufacture, pathogen inactivation, and banking of CBPs, with a specific focus on their plausible applications, benefits, and risks in the COVID-19 pandemic.
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Affiliation(s)
- Ankur Gupta
- Ceutica & Chemie Healthcare Pvt. Ltd ., Bangalore, India
| | - Rashmi Karki
- Ceutica & Chemie Healthcare Pvt. Ltd ., Bangalore, India
| | - Himanshu R Dandu
- Department of Internal Medicine, King George's Medical University , Lucknow, India
| | - Kuldeep Dhama
- Division of Pathology, Indian Veterinary Research Institute (IVRI) , Bareilly, India
| | - Madan Lb Bhatt
- Department of Centre for Advanced Research (CFAR), Faculty of Medicine, King George's Medical University (KGMU) , Lucknow, India
| | - Shailendra K Saxena
- Department of Centre for Advanced Research (CFAR), Faculty of Medicine, King George's Medical University (KGMU) , Lucknow, India
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25
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Abstract
AbstractThe characterization of platelet concentrates (PCs) in transfusion medicine has been performed with different analytical methods and platelet lesions (from biochemistry to cell biology) have been documented. In routine quality assessment and validation of manufacturing processes of PCs for transfusion purposes, only basic parameters are monitored and the platelet functions are not included. However, PCs undergo several manipulations during the processing and the basic parameters do not provide sensitive analyses to properly picture out the impact of the blood component preparation and storage on platelets. To improve the transfusion supply chain and the platelet functionalities, additional parameters should be used. The present short review will focus on the different techniques to monitor ex vivo platelet lesions from phenotype characterization to advanced omic analyses. Then, the opportunities to use these methods in quality control, process validation, development, and research will be discussed. Functional markers should be considered because they would be an advantage for the future developments in transfusion medicine.
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26
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Tang TTM, Tran MH. Transfusion transmitted babesiosis: A systematic review of reported cases. Transfus Apher Sci 2020; 59:102843. [PMID: 32616365 DOI: 10.1016/j.transci.2020.102843] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/30/2020] [Accepted: 05/31/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Transfusion transmitted babesiosis (TTB) has a high mortality rate but may go unrecognized, particularly in non-endemic areas. We therefore conducted a systematic review to better characterize clinical aspects of TTB. METHODS A literature search was conducted in PubMed and CINAHL databases, from which 25 eligible articles describing 60 TTB patients met criteria for data extraction. RESULTS Symptom evaluation was provided for 25 implicated donors: 18/25 (72%) were asymptomatic while 7/25 (28%) had mild flu-like symptoms but were asymptomatic at time of donation. It was common for a single donor or donation to infect multiple patients. Where reported, species included B. microti - 54/60 (90%), B. duncani - 3/60 (5%), and B. divergens-like/MO-1 - 1/60 (2%). Most TTB patients (44/60, 73%) resided in endemic states, while most TTB deaths 6/9 (67%) occurred in non-endemic states. Severity of hemolysis was proportional to degree of parasitemia. Mortality in our series was 9/60 (15%); most deaths occurred at extremes of the age spectrum: 6/9 non-survivors were aged >55 years, 2/9 were <1 year, only 1/9 was 2-54 years. Number of comorbidities was higher among non-survivors (median = 4) compared to survivors (median = 1). CONCLUSIONS All implicated donors (for which symptoms data were reported) resulting in TTB infections were asymptomatic at the time of donation, and it was common for a single donor or donation to infect multiple patients. Mortality of TTB appeared highest among those with more comorbidities and in non-endemic states. Heightened awareness of this diagnosis is key in its recognition.
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Affiliation(s)
| | - Minh-Ha Tran
- UC Irvine School of Medicine, Department of Pathology and Laboratory Medicine, United States.
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27
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New strategies for the control of infectious and parasitic diseases in blood donors: the impact of pathogen inactivation methods. EUROBIOTECH JOURNAL 2020. [DOI: 10.2478/ebtj-2020-0007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Abstract
Around 70 infectious agents are possible threats for blood safety.
The risk for blood recipients is increasing because of new emergent agents like West Nile, Zika and Chikungunya viruses, or parasites such as Plasmodium and Trypanosoma cruzi in non-endemic regions, for instance.
Screening programmes of the donors are more and more implemented in several Countries, but these cannot prevent completely infections, especially when they are caused by new agents.
Pathogen inactivation (PI) methods might overcome the limits of the screening and different technologies have been set up in the last years.
This review aims to describe the most widely used methods focusing on their efficacy as well as on the preservation integrity of blood components.
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A Fatal Case of Septic Shock Secondary to Acinetobacter Bacteremia Acquired from a Platelet Transfusion. Case Rep Med 2019; 2019:3136493. [PMID: 32089699 PMCID: PMC7029672 DOI: 10.1155/2019/3136493] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 01/05/2023] Open
Abstract
Background Transfusion of blood products is a frequent and often necessary lifesaving intervention. While changes to blood bank practices over the past several decades have reduced the infectious complications associated with transfusions, risks still exist. Septic transfusion reactions caused by bacterial contamination of blood products, especially platelets, still occur relatively frequently. Unfortunately, clinical recognition of septic transfusion reactions is difficult due to significant symptom, exam, and laboratory abnormality overlap between different types of transfusion reactions, as well as other conditions. Novel methods have been developed to detect blood product contamination but have yet to be widely implemented in the United States. Case Report A 67-year-old male with chronic thrombocytopenia was transfused with platelets prior to a planned procedure. Shortly afterwards, he developed fever and hypotension. He was transferred to the intensive care unit where he was treated with aggressive fluid resuscitation and broad-spectrum antibiotics. The patient went on to develop progressively worsening shock and profound disseminated intravascular coagulation. Blood cultures from the patient and the transfused platelets grew an Acinetobacter species. Despite aggressive resuscitative efforts and appropriate antibiotics, the patient died approximately 48 hours following the transfusion reaction. Conclusion We report a fatal case of septic shock associated with Acinetobacter bacteremia caused by platelet transfusion. Our review of the literature revealed only one other documented platelet transfusion associated fatality caused by Acinetobacter species. Novel pathogen reduction and contamination detection methods have been developed but have yet to be widely adopted in the United States.
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Zhang Q, Wu C, Fan Y, Xu T, Meng Q, Wang S, Liu Q, Yao C, Jiang T. Nucleic acid-targeted pathogen reduction technique in red blood cells by UV-generated oxygen radicals for optimising recipient safety. Transfus Med 2019; 30:51-60. [PMID: 31823441 DOI: 10.1111/tme.12654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 10/17/2019] [Accepted: 11/25/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVES A novel pathogen reduction technique based on vacuum ultraviolet (VUV) irradiation was developed to reduce pathogen numbers in red blood cell (RBC) components. BACKGROUND Contaminated blood components pose a great risk of infection in blood recipients. The continuous development of blood screening techniques and pathogen inactivating systems has significantly reduced this risk, but many limitations remain. METHODS Escherichia coli and Bacillus cereus, and bacteriophage (BP) and Lentivirus (LV) were spiked into suspended red blood cells (sRBCs) or plasma. VUV light with maximum emission at 185 nm and an average dosage of 164 μW/cm2 was placed 5 cm above the targeted products to reduce the pathogen numbers. RESULTS Treatment for 5 minutes was effective; 3 and 10 log reductions of E coli counts were observed in sRBCs and plasma, and 2 and 3 log reductions of B cereus counts were observed in sRBCs and plasma, respectively. The BP titre was reduced by two and five log points in sRBCs and plasma, respectively; the LV titre was reduced by at least three log points in both sRBCs and plasma. VUV-based irradiation of RBCs does not cause significant structural and functional harmful effects. This novel strategy provides moderate photonic energy to generate oxygen radicals from H2 O and O2 and to selectively decrease DNA integrity of the potential pathogens. CONCLUSION The VUV-based pathogen reduction technique is a simple and fast procedure with high pathogen reduction efficacy, low toxicity and limited adverse effects on cellular blood products.
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Affiliation(s)
- Qiang Zhang
- Health Management Center, Chongqing General Hospital, Chongqing, China.,Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chunxi Wu
- Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Yahan Fan
- Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Ting Xu
- Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Qiang Meng
- Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Shichun Wang
- Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Qi Liu
- Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chunyan Yao
- Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Tianlun Jiang
- Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
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Bahar B, Schulz WL, Gokhale A, Spencer BR, Gehrie EA, Snyder EL. Blood utilisation and transfusion reactions in adult patients transfused with conventional or pathogen-reduced platelets. Br J Haematol 2019; 188:465-472. [PMID: 31566724 PMCID: PMC7003815 DOI: 10.1111/bjh.16187] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 06/27/2019] [Indexed: 01/23/2023]
Abstract
Pathogen-reduced (PR) platelets are routinely used in many countries. Some studies reported changes in platelet and red blood cell (RBC) transfusion requirements in patients who received PR platelets when compared to conventional (CONV) platelets. Over a 28-month period we retrospectively analysed platelet utilisation, RBC transfusion trends, and transfusion reaction rates data from all transfused adult patients transfused at the Yale-New Haven Hospital, New Haven, CT, USA. We determined the number of RBC and platelet components administered between 2 and 24, 48, 72 or 96 h. A total of 3767 patients received 21 907 platelet components (CONV = 8912; PR = 12 995); 1,087 patients received only CONV platelets (1578 components) and 1,466 patients received only PR platelets (2604 components). The number of subsequently transfused platelet components was slightly higher following PR platelet components (P < 0·05); however, fewer RBCs were transfused following PR platelet administration (P < 0·05). The mean time-to-next platelet component transfusion was slightly shorter following PR platelet transfusion (P = 0·002). The rate of non-septic transfusion reactions did not differ (all P > 0·05). Septic transfusion reactions (N = 5) were seen only after CONV platelet transfusions (P = 0·011). These results provide evidence for comparable clinical efficacy of PR and CONV platelets. PR platelets eliminated septic transfusion reactions without increased risk of other types of transfusions with only slight increase in platelet utilisation.
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Affiliation(s)
- Burak Bahar
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Wade L Schulz
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA.,Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, USA
| | - Amit Gokhale
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA
| | | | - Eric A Gehrie
- Department of Pathology and Laboratory Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Edward L Snyder
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA
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Atreya C, Glynn S, Busch M, Kleinman S, Snyder E, Rutter S, AuBuchon J, Flegel W, Reeve D, Devine D, Cohn C, Custer B, Goodrich R, Benjamin RJ, Razatos A, Cancelas J, Wagner S, Maclean M, Gelderman M, Cap A, Ness P. Proceedings of the Food and Drug Administration public workshop on pathogen reduction technologies for blood safety 2018 (Commentary, p. 3026). Transfusion 2019; 59:3002-3025. [PMID: 31144334 PMCID: PMC6726584 DOI: 10.1111/trf.15344] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 05/06/2019] [Accepted: 05/06/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Chintamani Atreya
- US Food and Drug Administration, Center for Biologics Evaluation and ResearchOffice of Blood Research and ReviewSilver SpringMaryland
| | - Simone Glynn
- National Heart Lung and Blood InstituteBethesdaMarylandUSA
| | | | | | - Edward Snyder
- Blood BankYale‐New Haven HospitalNew HavenConnecticut
| | - Sara Rutter
- Department of Pathology and Laboratory MedicineYale School of MedicineNew HavenConnecticut
| | - James AuBuchon
- Department of PathologyDartmouth‐Hitchcock Medical CenterLebanonNew Hampshire
| | - Willy Flegel
- Department of Transfusion MedicineNIH Clinical CenterBethesdaMaryland
| | - David Reeve
- Blood ComponentsAmerican Red CrossRockvilleMaryland
| | - Dana Devine
- Department of Lab Medicine and PathologyUniversity of Minnesota Medical CenterMinneapolisMinnesota
| | - Claudia Cohn
- Department of Lab Medicine and PathologyUniversity of Minnesota Medical CenterMinneapolisMinnesota
| | - Brian Custer
- Vitalant Research InstituteSan FranciscoCalifornia
| | - Raymond Goodrich
- Department of Microbiology, Immunology and PathologyColorado State UniversityFort CollinsColorado
| | | | | | - Jose Cancelas
- Hoxworth Blood CenterUniversity of Cincinnati HealthCincinnatiOhio
| | | | - Michelle Maclean
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST)University of StrathclydeGlasgowScotland
| | - Monique Gelderman
- Department of HematologyCenter for Biologics Evaluation and Research, US Food and Drug AdministrationSilver SpringMaryland
| | - Andrew Cap
- U.S. Army Institute of Surgical ResearchSan AntonioTexas
| | - Paul Ness
- Blood BankJohns Hopkins HospitalBaltimoreMaryland
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Schubert P, Culibrk B, Chen D, Serrano K, Levin E, Chen Z, Zoescher P, Goodrich RP, Yoshida T, Devine DV. Improved in vitro quality of stored red blood cells upon oxygen reduction prior to riboflavin/UV light treatment of whole blood. Transfusion 2019; 59:3197-3204. [DOI: 10.1111/trf.15485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 06/10/2019] [Accepted: 06/18/2019] [Indexed: 01/09/2023]
Affiliation(s)
- Peter Schubert
- Centre for Innovation, Canadian Blood ServicesUniversity of British Columbia Vancouver British Columbia Canada
- Centre for Blood ResearchUniversity of British Columbia Vancouver British Columbia Canada
- Department of Pathology and Laboratory MedicineUniversity of British Columbia Vancouver British Columbia Canada
| | - Brankica Culibrk
- Centre for Innovation, Canadian Blood ServicesUniversity of British Columbia Vancouver British Columbia Canada
- Centre for Blood ResearchUniversity of British Columbia Vancouver British Columbia Canada
| | - Deborah Chen
- Centre for Blood ResearchUniversity of British Columbia Vancouver British Columbia Canada
- Department of Pathology and Laboratory MedicineUniversity of British Columbia Vancouver British Columbia Canada
| | - Katherine Serrano
- Centre for Innovation, Canadian Blood ServicesUniversity of British Columbia Vancouver British Columbia Canada
- Centre for Blood ResearchUniversity of British Columbia Vancouver British Columbia Canada
- Department of Pathology and Laboratory MedicineUniversity of British Columbia Vancouver British Columbia Canada
| | - Elena Levin
- Centre for Innovation, Canadian Blood ServicesUniversity of British Columbia Vancouver British Columbia Canada
- Centre for Blood ResearchUniversity of British Columbia Vancouver British Columbia Canada
- Department of Pathology and Laboratory MedicineUniversity of British Columbia Vancouver British Columbia Canada
| | - Zhongming Chen
- Centre for Innovation, Canadian Blood ServicesUniversity of British Columbia Vancouver British Columbia Canada
- Centre for Blood ResearchUniversity of British Columbia Vancouver British Columbia Canada
| | - Peter Zoescher
- Centre for Blood ResearchUniversity of British Columbia Vancouver British Columbia Canada
| | - Raymond P. Goodrich
- Infectious Disease Research Center at Colorado State University Fort Collins Colorado
| | | | - Dana V. Devine
- Centre for Innovation, Canadian Blood ServicesUniversity of British Columbia Vancouver British Columbia Canada
- Centre for Blood ResearchUniversity of British Columbia Vancouver British Columbia Canada
- Department of Pathology and Laboratory MedicineUniversity of British Columbia Vancouver British Columbia Canada
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Rutter S, Snyder EL. How do we … integrate pathogen reduced platelets into our hospital blood bank inventory? Transfusion 2019; 59:1628-1636. [PMID: 30883807 PMCID: PMC6850142 DOI: 10.1111/trf.15241] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 12/17/2022]
Abstract
For more than 50 years there has been an ongoing effort to combat transfusion-transmitted infections and provide patients with the safest possible blood. This initiative has driven much of the research within the transfusion community. Initial methods included screening donors for travel histories to banned areas and for high-risk behaviors, but pathogen-specific assays performed at the collection and manufacturing sites also have become key factors in assuring blood safety. Many of these have focused on donor and laboratory-based screening for transfusion-transmitted diseases, as evidenced by the hepatitis and human immunodeficiency virus screening in the 1970s, 1980s, and 1990s. More recently, this effort has expanded to develop donor screening assays to identify other blood-borne pathogens, such as Zika and West Nile viruses and Babesia. Bacterial contamination of units of platelets (PLTs), however, remains a significant concern. In recent years, the Food and Drug Administration has approved rapid tests to identify bacterially contaminated PLT units in the blood bank before transfusion. Other supplemental methods have been developed, however, that aim to inactivate blood-borne pathogen(s) present in the blood product, rather than to rely on our ability to identify and interdict contaminated and infected components. Pathogen reduction technology, as this is referred to, provides a proactive way to further reduce the risk posed by transfusion-transmitted infections.
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Affiliation(s)
- Sara Rutter
- Department of Laboratory Medicine, Division of Transfusion MedicineYale University School of MedicineNew HavenConnecticut
| | - Edward L. Snyder
- Department of Laboratory Medicine, Division of Transfusion MedicineYale University School of MedicineNew HavenConnecticut
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Trakhtman P, Kumukova I, Starostin N, Borsakova D, Balashov D, Ignatova A, Kadaeva L, Novichkova G, Rumiantcev A. The pathogen‐reduced red blood cell suspension: single centre study of clinical safety and efficacy in children with oncological and haematological diseases. Vox Sang 2019; 114:223-231. [DOI: 10.1111/vox.12757] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/19/2018] [Accepted: 01/10/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Pavel Trakhtman
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology Moscow Russia
| | - Irina Kumukova
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology Moscow Russia
| | - Nikolay Starostin
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology Moscow Russia
| | - Daria Borsakova
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology Moscow Russia
- Laboratory of Physiology and Biophysics of the Cell Center for Theoretical Problems of Physicochemical Pharmacology Russian Academy of Sciences Moscow Russia
| | - Dmitry Balashov
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology Moscow Russia
| | - Anastasia Ignatova
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology Moscow Russia
| | - Leilya Kadaeva
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology Moscow Russia
| | - Galina Novichkova
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology Moscow Russia
| | - Alexander Rumiantcev
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology Moscow Russia
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Störmer M, Wood EM, Gathof B. Microbial safety of cellular therapeutics-lessons from over ten years’ experience in microbial safety of platelet concentrates. ACTA ACUST UNITED AC 2018. [DOI: 10.1111/voxs.12452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Melanie Störmer
- Transfusion Medicine; University Hospital Cologne; Cologne Germany
| | - Erica M. Wood
- Transfusion Research Unit; Department of Epidemiology and Preventive Medicine; Monash University; Melbourne VIC Australia
| | - Birgit Gathof
- Transfusion Medicine; University Hospital Cologne; Cologne Germany
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Niederhauser C. [Transfusion-transmitted Infections: How Useful and Costly is Testing for new Infectious Disease Pathogens?]. PRAXIS 2018; 107:521-529. [PMID: 29690842 DOI: 10.1024/1661-8157/a002967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Zusammenfassung. Bis Anfang der 1990er Jahre waren Blutprodukte nicht selten mit HIV oder HCV kontaminiert, was zu vielen transfusionsbedingten Infektionen führte. Seither wurde die Sicherheit von Blutprodukten in Bezug auf die Infektionsübertragung mit aufwendigen Massnahmen stark erhöht. Aktuell stehen sogenannte (re)emerging-Infektionserreger im Fokus, beispielsweise West Nile-, Zika- und Hepatitis-E-Viren. Ob und wie sich neue Massnahmen, die eine Übertragung dieser Viren verhindern sollen, kosteneffizient einführen lassen, muss mit klar definierten Vorgaben abgeklärt werden. Der entsprechende Entscheid muss gemeinsam mit den involvierten Stakeholdern und auch aufgrund von Kosten-Nutzen-Überlegungen getroffen werden. Grundsätzlich gilt, dass es eine 100-prozentige Sicherheit in Bezug auf die Übertragung von Infektionserregern mit Blutprodukten nie geben wird.
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