Clinical Experience With Pathogen Inactivation Of Platelet Components For Transfusion Support

Blood transfusion is a critical supportive therapy for health care. The demand for platelet components (PCs), either derived from apheresis or from whole blood buffy coats, has continually increased as health A care technology and life expectancy have increased. The public and the medical community expect that PCs for transfusion will be safe and available when needed. Pharmaceutical standards for medications to be administered intravenously to patients require sterility and absence of pyrogens. However, sterilization or inactivation of pathogens remains a major challenge for blood components. A number of physical methods (heat, light, and filtration) and chemical techniques (solvent-detergent) have been applied with success to therapeutic plasma and purified plasma proteins. However, pathogen inactivation treatment of the labile cellular blood components (platelets and red blood cells) has been much more difficult to achieve without significant loss of cell viability and cell function. The safety of labile blood products, including PCs, has previously been ensured by medical and biological donor selection measures. While these measures have improved the safety of blood transfusion, they are reactive and have not eliminated the risk of transfusion-transmitted infection. In addition to the residual risk of recognized viral, bacterial and parasitic contamination of PCs, there is the recurring risk associated with emerging pathogens as demonstrated by several recent epidemics and a continuing pattern of emergence and reemergence of transfusion-transmitted pathogens [1]. Pathogen inactivation of PCs has been implemented into routine practice and offers the potential to protect against the residual risk of known pathogens and the risk of emerging pathogens for which diagnostic tests are not available. Recently, this technology has demonstrated its utility during an epidemic of an emerging pathogen, and represents a paradigm shift in the approach to blood transfusion safety. (C) 2008 S. Karger GmbH, Freiburg i.Br.