Pathogen reduction by ultraviolet <scp>C</scp> light effectively inactivates human white blood cells in platelet products

Pohler, Petra; Müller, Meike; Winkler, Carla; Schaudien, Dirk; Sewald, Katherina; Müller, Thomas; Seltsam, Axel

doi:10.1111/trf.12836

Cited by 39 publications

(26 citation statements)

References 34 publications

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“…UVC treatment inactivates a wide spectrum of bacteria, parasites, viruses, and contaminating leukocytes [4,6,27,28,29,30]. Although HIV, and possibly other retroviruses, appear less sensitive to inactivation by UVC light, this is somewhat compensated by the fact that the residual risk of HIV transmission in Australia is exceptionally small (modelled to be less than 1 in 7 million) [31].…”

Section: Discussionmentioning

confidence: 99%

“…The goal of implementing a PI system is to provide proactive protection against pathogens, thus reducing the need to introduce additional testing and potentially replace processing steps such as gamma-irradiation [27], with minimal impact on the quality of the treated blood components. UVC treatment inactivates a wide spectrum of bacteria, parasites, viruses, and contaminating leukocytes [4,6,27,28,29,30].…”

Section: Discussionmentioning

confidence: 99%

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In vitro Quality of Platelets with Low Plasma Carryover Treated with Ultraviolet C Light for Pathogen Inactivation

Johnson

Hyland

Tan

et al. 2015

Transfus Med Hemother

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Background: The THERAFLEX UV-Platelets system uses shortwave ultraviolet C light (UVC, 254 nm) to inactivate pathogens in platelet components. Plasma carryover influences pathogen inactivation and platelet quality following treatment. The plasma carryover in the standard platelets produced by our institution are below the intended specification (<30%). Methods: A pool and split study was carried out comparing untreated and UVC-treated platelets with <30% plasma carryover (n = 10 pairs). This data was compared to components that met specifications (>30% plasma). The platelets were tested over storage for in vitro quality. Results: Platelet metabolism was accelerated following UVC treatment, as demonstrated by increased glucose consumption and lactate production. UVC treatment caused increased externalization of phosphatidylserine on platelets and microparticles, activation of the GPIIb/IIIa receptor (PAC-1 binding), and reduced hypotonic shock response. Platelet function, as measured with thrombelastogram, was not affected by UVC treatment. Components with <30% plasma were similar to those meeting specification with the exception of enhanced glycolytic metabolism. Conclusion: This in vitro analysis demonstrates that treatment of platelets with <30% plasma carryover with the THERAFLEX UV-Platelets system affects some aspects of platelet metabolism and activation, although in vitro platelet function was not negatively impacted. This study also provides evidence that the treatment specifications of plasma carryover could be extended to below 30%.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

In vitro Quality of Platelets with Low Plasma Carryover Treated with Ultraviolet C Light for Pathogen Inactivation

Johnson

Hyland

Tan

et al. 2015

Transfus Med Hemother

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“…PI technologies other than INTERCEPT have also demonstrated in vitro T cell inactivation comparable to or better than irradiation and prevention of TA‐GVHD in similar mouse models, even though their mechanisms of action are different (Table ) …”

Section: Literature Review Of Ta‐gvhd Casesmentioning

confidence: 99%

Transfusion‐associated graft‐versus‐host disease reexamined: potential for improved prevention using a universally applied intervention

Kleinman

Stassinopoulos

2018

Transfusion

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BACKGROUND Transfusion‐associated graft‐versus‐host disease (TA‐GVHD) is a rare, often fatal complication of blood transfusion that can occur in immunocompromised or immunocompetent recipients and is the result of viable T cells present in the blood components transfused. STUDY DESIGN AND METHODS We examined the TA‐GVHD clinical case literature including numerous original clinical case reports and several comprehensive case series. We also evaluated recent in vitro experimental data on the inhibition of T cell proliferation, comparing the effect of a specific pathogen inactivation (PI) technology to that of the Food and Drug Administration–recommended gamma irradiation dose of 2500 cGy. RESULTS We identified 12 published TA‐GVHD cases with atypical/milder or delayed symptom presentations and/or an atypical clinical course; these included cases attributed to leukoreduced or suboptimally irradiated units. We summarize recent in vitro data using a sensitive limiting dilution assay that establish that, compared to irradiation at the recommended 2500 cGy dose, PI using amotosalen/ultraviolet A, or amustaline/glutathione achieves a greater degree of inhibition of T cell proliferation. CONCLUSION We propose that TA‐GVHD has a spectrum of disease severity indicating that additional mild cases may still occur but be undiagnosed and/or underreported, opening up the possibility, supported by in vitro experimental data, that irradiation at the currently established dose may not be fully protective. Furthermore, since many US institutions use component irradiation selectively only for immunocompromised patients, immunocompetent recipients are not fully protected. PI technologies appear to be at least equal to, if not better than, gamma irradiation in abrogating the ability of T cells to proliferate, and if applied to all blood components, protection against TA‐GVHD would be an additional benefit that would allow for the elimination of component irradiation.

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“…Si l'irradiation n'apporte rien au niveau de la réduction des signes encore résiduels pro-inflammatoires liés aux leucocytes, en revanche l'application des procédés de réduction ou d'inactivation de pathogènes (PI/PR ou PRT) semble réduire encore la capacité à l'allo-immunisation [34][35][36] ; toutefois, le procédé Amotosalen (le seul à avoir été testé) ne modifie pas les séquences de sécrétion de BRM par les plaquettes [37,38].…”

Section: Les Leucocytesunclassified

Transfusion et inflammation : hier – aujourd’hui – demain

Garraud

Hamzeh‐Cognasse

Laradi

et al. 2015

Transfusion Clinique et Biologique

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Pathogen reduction by ultraviolet C light effectively inactivates human white blood cells in platelet products

Cited by 39 publications

References 34 publications

In vitro Quality of Platelets with Low Plasma Carryover Treated with Ultraviolet C Light for Pathogen Inactivation

In vitro Quality of Platelets with Low Plasma Carryover Treated with Ultraviolet C Light for Pathogen Inactivation

Transfusion‐associated graft‐versus‐host disease reexamined: potential for improved prevention using a universally applied intervention

Transfusion et inflammation : hier – aujourd’hui – demain

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