Impact of implementing pathogen reduction technologies for platelets on reducing outdates

Gorria, Carlos; Labata-Lezaun, Gorka; Lezaun, Mikel; López, F. Javier; Aliaga, Ana Isabel Pérez; Vaquero, Miguel Ángel Pérez

doi:10.1111/vox.12860

Cited by 8 publications

(4 citation statements)

References 18 publications

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“…The bacterial growth in platelets stored at room temperature limits their shelf life to 5 days. A study by Gorria et al [ 24 ] showed that a 2-day extension to the shelf life of PCs results in reductions in outdates ranging from 88.4% to 100%. Our discard rate, using a 5-day expiry time, has been 18% for combined whole-blood-derived and apheresis PCs.…”

Section: Discussionmentioning

confidence: 99%

In Vitro Comparative Study of Platelets Treated with Two Pathogen-Inactivation Methods to Extend Shelf Life to 7 Days

Malvaux¹,

Defraigne²,

Bartziali³

et al. 2022

Pathogens

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Background and Objectives: Since 2015, platelet products have been pathogen-inactivated (PI) at the Luxemburgish Red Cross (LRC) using Riboflavin and UV light (RF-PI). As the LRC should respond to hospital needs at any time, platelet production exceeds the demand, generating a discard rate of 18%. To reduce this, we consider the extension of storage time from 5 to 7 days. This study’s objective was to evaluate the in vitro 7-day platelet-storage quality, comparing two PI technologies, RF-PI and amotosalen/UVA light (AM-PI), for platelet pools from whole-blood donations (PPCs) and apheresis platelets collected from single apheresis donation (APCs). Materials and Methods: For each product type, 6 double-platelet concentrates were prepared and divided into 2 units; one was treated with RF-PI and the other by AM-PI. In vitro platelet-quality parameters were tested pre- and post-PI, at days 5 and 7. Results: Treatment and storage lesions were observed in PPCs and APCs with both PI methods. We found a higher rate of lactate increase and glucose depletion, suggesting a stronger stimulation of the glycolytic pathway, a higher Annexin V binding, and a loss of swirling in the RF-PI-treated units from day 5. The platelet loss was significantly higher in the AM-PI compared with the RF-PI units. Conclusions: Results suggest that RF-PI treatment has a higher deleterious impact on in vitro platelet quality compared to AM-PI, but we observed higher loss of platelets with AM-PI due to the post-illumination amotosalen adsorption step. If 7-day storage is needed, it can only be achieved with AM-PI, based on our quality criteria.

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Section: Discussionmentioning

confidence: 99%

In Vitro Comparative Study of Platelets Treated with Two Pathogen-Inactivation Methods to Extend Shelf Life to 7 Days

Malvaux¹,

Defraigne²,

Bartziali³

et al. 2022

Pathogens

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“…The treatment leads to minimal platelet loss. It was cost-effective since it allowed the extension of the shelf life in PCs from 5 to 7 days, reducing expiry rates [32,33], it significantly decreased stock rupture as well as eliminating the need for gamma irradiation [16]. Moreover, if PRT is in place for a certain fraction of components as it is in our case, only a short lead time is required to scale up production to 100% of blood components in the case of infectious disease outbreaks [34].…”

Section: Discussionmentioning

confidence: 99%

Improvement of Blood Processing and Safety by Automation and Pathogen Reduction Technology

Aliaga¹,

Labata-Lezaun

Aranda³

et al. 2021

Transfus Med Hemother

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Introduction: The objective of the present study was to describe the experience of the Blood and Tissues Bank of Aragon with the Reveos® Automated Blood Processing System and Mirasol® Pathogen Reduction Technology (PRT) System, comparing retrospectively routine quality data obtained in two different observation periods. Methods: Comparing quality data encompassing 6,525 blood components from the period 2007–2012, when the semi-automated buffy coat method was used in routine, with 6,553 quality data from the period 2014–2019, when the Reveos system and subsequently the Mirasol system were implemented in routine. Results: Moving from buffy coat to Reveos led to decreased discard rates of whole blood units (1.2 to 0.1%), increased hemoglobin content (48.1 ± 7.6 to 55.4 ± 6.6 g/unit), and hematocrit (58.9 ± 6.5% to 60.0 ± 4.9%) in red blood cell concentrates. Platelet concentrates (PCs) in both periods had similar yields (3.5 ×1011). Whereas in the earlier period, PCs resulted from pooling 5 buffy coats, in the second period 25% of PCs were prepared from 4 interim platelet units. The mean level of factor VIII in plasma was significantly higher with Reveos (92.8 vs. 97.3 IU). Mirasol PRT treatment of PCs reduced expiry rates to 1.2% in 2019. One septic transmission was reported with a non-PRT treated PCs, but none with PRT-treated PCs. Conclusion: Automation contributed to standardization, efficiency, and improvement of blood processing. Released resources enabled the effortless implementation of PRT. The combination of both technologies guaranteed the self-sufficiency and improvement of blood safety.

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“…For example, a robust platelet inventory management system 27 has long been in place to minimize outdating and wastage; this diminishes some of the concerns that might otherwise favor a strategy that allows for a 7-day shelf life (eg, PR). 28 Likewise, there are sufficient personnel in the JHH blood bank to contend with the added workload associated with routine SBC. Second, while the study had statistical power to detect a difference in proportion of false-positive results between the two inoculum groups (ie, 5 mL vs 10 mL), this was not the case for detection of a difference in true-positive results by sampling volume.…”

Section: Discussionmentioning

confidence: 99%

Secondary bacterial culture of platelets to mitigate transfusion‐associated sepsis: A 3‐year analysis at a large academic institution

et al. 2020

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Background In 2019, the United States Food and Drug Administration published its final recommendations to mitigate bacterial contamination of platelets. We sought to evaluate our secondary bacterial culture (SBC) strategy in light of those recommendations. Study Design and Methods A retrospective analysis was conducted of SBC data (October 2016‐2019) at our institution. SBC was performed upon receipt (Day 3 after collection); 5 mL of platelet product was inoculated aseptically into an aerobic bottle and incubated at 35°C for 3 days. For 8 months, a 10‐mL inoculum was trialed. No quarantine was applied. All positive cultures underwent Gram staining and repeat culture of the platelet product (if available). A probable true positive was defined as concordant positive culture between the initial and repeat culture. The incidence of probable true‐ and false‐positive cultures were reported descriptively and differences evaluated by sampling volume. Results Over 3 years, 55 896 platelet products underwent SBC, yielding 30 initial positive results (approx. 1/1863 platelets); 25 (83.3%) signaled within 24 hours of SBC. The rates of probable true positive, false positive, and indeterminate for 5 mL were 0.027% (1/3771), 0.002% (1/45 251) and 0.018% (1/5656), respectively. The respective rates for 10 mL were 0.018% (1/5323), 0.07% (1/1521), and 0%. Seven of eight (87.5%) false‐positive SBCs occurred with a 10‐mL inoculum. No septic transfusion reactions were reported. Conclusion SBC continues to interdict bacterially contaminated units of platelets. Our findings suggest higher rates of false positivity using large‐volume inocula.

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Impact of implementing pathogen reduction technologies for platelets on reducing outdates

Cited by 8 publications

References 18 publications

In Vitro Comparative Study of Platelets Treated with Two Pathogen-Inactivation Methods to Extend Shelf Life to 7 Days

In Vitro Comparative Study of Platelets Treated with Two Pathogen-Inactivation Methods to Extend Shelf Life to 7 Days

Improvement of Blood Processing and Safety by Automation and Pathogen Reduction Technology

Secondary bacterial culture of platelets to mitigate transfusion‐associated sepsis: A 3‐year analysis at a large academic institution

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