Quality control of riboflavin-treated platelet concentrates using Mirasol® PRT system: Polish experience

Abstract

Background. The quality of platelet concentrates (PCs) is affected by preparation, storage, the type of container, and pathogen reduction technology (PRT). The Mirasol® Pathogen Reduction Technology (PRT) system (Terumo BCT Inc., Lakewood, USA), which uses riboflavin and ultraviolet (UV) light, has recently been proven effective against bacteria, viruses, parasites, and leukocytes.

Impact of different pathogen reduction technologies on the biochemistry, function, and clinical effectiveness of platelet concentrates: An updated view during a pandemic

“…Alterations induced by MIRASOL are similar to those observed with INTERCEPT—increased anaerobic metabolism and subsequent acidification after treatment of buffy‐coat, 52–54,56,63,66,68 or apheresis‐derived PCs 46,48–51,55,57–59 . Metabolic changes were accompanied by morphological alterations, reductions in swirling, and altered HSR 48,52,53,55,57–60,63,64,66,68 . Moderate reductions in GPIb with the activation of GPIIb‐IIIa have been similarly reported after MIRASOL exposure, 48,52,53,55,57–60,63,64,66,68 with enhanced expression of platelet activation markers and indicators of apoptosis 46–53,55–60,63,64,66 The type of bag and cell separator used may have some impact on quality parameters 59 .…”

“…Metabolic changes were accompanied by morphological alterations, reductions in swirling, and altered HSR 48,52,53,55,57–60,63,64,66,68 . Moderate reductions in GPIb with the activation of GPIIb‐IIIa have been similarly reported after MIRASOL exposure, 48,52,53,55,57–60,63,64,66,68 with enhanced expression of platelet activation markers and indicators of apoptosis 46–53,55–60,63,64,66 The type of bag and cell separator used may have some impact on quality parameters 59 . Newer formulations of PAS may partially mitigate the effects of PRT when results are compared with those in classic PAS, 63 but overall do not have a critical effect on the in vitro quality alterations 50,53,55–58,63,64,68 …”

“…Table 1 summarizes a selected group of studies focused on the direct functional (adhesive, aggregating, or procoagulant) integrity of platelets in PCs subjected to PRT. Several studies have reported decreased aggregating response of platelets to ADP, collagen, or thrombin after INTERCEPT treatment, 30,32,36,41 and to ADP, collagen, TRAP, or other agonists after MIRASOL treatment 54,56,58,60,61,63,64,66 . Aggregating responses to ADP and collagen were reasonably preserved after THERAFLEX, 19,71 although the published evidence with this technology is sparse relative to INTERCEPT or MIRASOL PRT (Figure 1).…”

“…For the purpose of this review, we have identified a total of 53 relevant publications, 20 evaluating the in vitro quality of PCs subjected to INTERCEPT, 26–45 23 using MIRASOL, 46–68 5 using THERAFLEX, 19,69–72 and 5 studies that have compared INTERCEPT versus MIRASOL 73–77 . Details of these studies are summarized in the Supplemental Table 1.…”

Current status and achievements of Polish transfusion medicine

“…Since there is no effective Jolanta Antoniewicz-Papis et al, Polish transfusion medicine treatment for TA-GvHD, the only way to protect patients at risk of this serious adverse reaction is irradiation and some methods of pathogen inactivation (i.e. Intercept and Mirasol systems) [24,25]. At present, we record sporadic use of only irradiation of RBCs and PCs.…”