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Pathogen reduction of whole blood: utility and feasibility
Author(s) -
Allain J.P.,
Goodrich R.
Publication year - 2017
Publication title -
transfusion medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 59
eISSN - 1365-3148
pISSN - 0958-7578
DOI - 10.1111/tme.12456
Subject(s) - pathogen , in vivo , blood product , whole blood , medicine , in vitro , immunology , microbiology and biotechnology , biology , surgery , biochemistry
SUMMARY Objectives To collect information on pathogen reduction applied to whole blood. Background Pathogen reduction (PR) of blood components has been developed over the past two decades, and pathogen‐reduced fresh‐frozen plasma and platelet concentrates are currently in clinical use. High cost and incomplete coverage of components make PR out of reach for low‐ and middle‐income countries (LMIC). However, should PR become applicable to whole blood (WB), the main product transfused in sub‐Saharan Africa, and be compatible with the preparation of clinically suitable components, cost would be minimised, and a range of safety measures in place at high cost in developed areas would become redundant. Methods All articles called with “pathogen reduction”, “pathogen inactivation” and “whole blood” were retrieved from Medline. References in articles were utilised. Results One such PR technology (PRT) applied to WB has been developed and has shown efficacious against viruses, bacteria and parasites in vitro; and has been able to inactivate nucleated blood cells whilst retaining the ability to prepare components with acceptable characteristics. The efficacy of this WB PRT has been demonstrated in vivo using the inactivation of Plasmodium falciparum as a model and showing a high degree of correlation between in vitro and in vivo data. Obtaining further evidence of efficacy on other suitable targets is warranted. Shortening of the process, which is currently around 50 min, or increasing the number of units simultaneously processed would be necessary to make PRT WB conducive to LMIC blood services' needs. Conclusions Even if not 100% effective against agents that are present in high pathogen load titres, WB PRT could massively impact blood safety in LMIC by providing safer products at an affordable cost.