Frozen and Dried Plasma for Civil and Military Use

Strumia, Max M.; McGraw, John J.

doi:10.1001/jama.1941.02820210024004

Cited by 36 publications

(16 citation statements)

References 31 publications

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“…Transmission of bacteria by transfusion is not a new problem, having been reported nearly 70 years ago [2,3]. In the mid 1990s, the attention of the blood community was drawn to bacterial transmissions due to case reports in the literature and the establishment of haemovigilance systems.…”

Section: Introductionmentioning

confidence: 99%

Interventions Implemented to Reduce the Risk of Transmission of Bacteria by Transfusion in the English National Blood Service

McDonald

2011

Transfus Med Hemother

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Background: Bacterial contamination remains a significant problem in transfusion medicine. A National Health Service Blood and Transplant (NHSBT) study and surveillance data indicated skin commensals derived from the skin of the donor are the major contaminants of blood components. NHSBT therefore explored two interventions: improved donor arm disinfection and diversion. Methods: Improved donor arm disinfection: Commercial and in-house methods of disinfection were evaluated. Swabs at the venepuncture site were taken before and after disinfection and the reduction in bioburden determined. Diversion: Special collection bags were manufactured to allow the initial volume of blood to flow into a pouch, representing the diversion pouch and then the next flow of blood into another pouch representing the collection bag. Pouches were screened for the presence of bacteria. The reduction in bacterial contamination was then determined. Results: A two-step commercial procedure (Donor Prep Kit; DPK) consisting of 70% isopropyl alcohol followed by tincture of iodine was shown to be a best practice procedure (2-min procedure). A 99.79% reduction was obtained, and this method was 10 times more effective than current practice at that time. The DPK was shown in a field trial to increase donor waiting time. A second study was initiated to find a more rapid procedure. ChloraPrep®, consisting of 2% chlorhexidine gluconate and 70% isopropyl alcohol, was shown to have equivalent disinfection efficiency as the DPK, but only took 1 min to perform. In 2006, ChloraPrep was introduced as the national method of donor arm disinfection. Diversion was shown to give a 47% reduction in contamination and was introduced nationally in 2002. Conclusion: Improved donor arm disinfection and diversion are effective, low-cost interventions, but do not eliminate all bacterial transmissions. In 2011, bacterial screening of platelet components was introduced by NHSBT to further increase the safety of the blood supply.

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Section: Introductionmentioning

confidence: 99%

Interventions Implemented to Reduce the Risk of Transmission of Bacteria by Transfusion in the English National Blood Service

McDonald

2011

Transfus Med Hemother

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“…Bacterial sepsis was probably the first recognized transfusion‐transmitted disease 1 . Strumia and McGraw 2 reported a case of transfusion reaction associated with bacterial blood component contamination in 1941, the same year in which the first case of transfusion death due to bacterial contamination was reported in the United States 3,4 . Transfusion‐associated bacterial sepsis is the second most frequently reported cause of transfusion‐related fatalities in the United States, after ABO mismatch, accounting for 46 (17%) of 277 reported transfusion deaths in the period 1990 to 1998 5 .…”

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confidence: 99%

Bacterial contamination of random‐donor platelets in a university hospital in the midwestern region of Brazil

2007

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“…In the 1930s, methods were established to lyophilize plasma and successful infusion was reported in both experimental animal models and humans . Lyophilization was thought a valuable method for preservation to allow plasma to be transported and stored in areas where freezers were not available . Large scale use of dried plasma began in WWII, when millions of units were distributed to Allied Forces world‐wide.…”

Section: Early Dried Plasmamentioning

confidence: 99%

Dried plasma: state of the science and recent developments

et al. 2016

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The early transfusion of plasma is important to ensure optimal survival of patients with traumatic hemorrhage. In military and remote or austere civilian settings, it may be impossible to move patients to hospital facilities within the first few hours of injury. A dried plasma product with reduced logistical requirements is needed to enable plasma transfusion where medically needed, instead of only where freezers and other equipment are available. First developed in the 1930s, pooled lyophilized plasma was widely used by British and American forces in WWII and the Korean War. Historical dried plasma products solved the logistical problem but were abandoned because of disease transmission. Modern methods to improve blood safety have made it possible to produce safe and effective dried plasma. Dried plasma products are available in France, Germany, South Africa, and a limited number of other countries. However, no product is available in the US. Promising products are in development that employ different methods of drying, pathogen reduction, pooling, packaging, and other approaches. Although challenges exist, the in vitro and in vivo data suggest that these products have great potential to be safe and effective. The history, state of the science, and recent developments in dried plasma are reviewed.

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Frozen and Dried Plasma for Civil and Military Use

Cited by 36 publications

References 31 publications

Interventions Implemented to Reduce the Risk of Transmission of Bacteria by Transfusion in the English National Blood Service

Interventions Implemented to Reduce the Risk of Transmission of Bacteria by Transfusion in the English National Blood Service

Bacterial contamination of random‐donor platelets in a university hospital in the midwestern region of Brazil

Dried plasma: state of the science and recent developments

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