The Use of Solvent/Detergent Treatment in Pathogen Reduction of Plasma

Abstract

SummaryThe solvent/detergent (SD) process used for plasma can safely inactivate all lipid-enveloped viruses. The introduction of a specific prion-binding ligand gel in combination with SD treatment, time-reduced from 4 to 1-1.5 h, still ensures efficient virus kill, reduces abnormal prion protein by >5 log steps, and preserves levels of plasmin inhibitor at close to the reference range. Infections with known nonenveloped viruses such as HAV or parvovirus B19 are prevented by ensuring low virus loads in the starting plasma units, dilution through pooling of single plasma units, and neutralization of immune antibodies already present in the initial plasma pools. The major advantages of SD plasma over fresh frozen plasma and the other pathogen-inactivated plasmas are its extreme safety with respect to transfusion-related acute lung injury and the significantly lower likelihood of provoking allergic reactions. Both advantages are best interpreted as results of the dilution effect of pooling. No fewer than 18 clinical studies covering all indications for plasma, and extensive clinical experience have shown that reduced levels of coagulation factors and inhibitors as a result of SD treatment do not impair significantly the clinical efficacy or tolerance of plasma. Properly standardized clotting factor and inhibitor potencies and low batch-to-batch variations when compared with single-donor plasma units makes SD plasma more suitable for standardized treatment. Schlüsselwörter

A Prospective, Randomized Investigation of Plasma First Resuscitation" for Traumatic Hemorrhage and Attenuation of the Acute Coagulopathy of Trauma"

“…This preparation has gone through multiple processing iterations, mainly in Europe, and is now available from $3 European manufacturers. 7 FFP, FP24, and S/DFDP all contain substantially less fibrinogen than fresh plasma (Fig 2).…”

Pathogen Inactivation Plays an Irreplaceable Role in Safeguarding the Safety of Blood Transfusion

“…Solvent/Detergent(S/D), as a chemical method, inactivates products through membrane-disruption. As such, S/D treatment is only effective for lipid-enveloped viruses [6]. The typical S/D treatment condition includes organic solvents (0.3% TNBP) combined with a nonionic detergent【1%Tween 80 (≥ 6 hr) or 1% Triton X-100 (≥ 4 hr)】at 24°C [4]; Following treatment, S/D compounds are removed by chromatography or oil extraction.…”

“…Octaplas, as a mature commercial product based on S/D inactivation, has already been widely used in Europe. Though nonenveloped viruses like Hepatitis A virus（HAV）or Parvovirus B19 are resistant to S/D inactivation, the risk of infection has been greatly reduced because of the presence of neutralization antibodies in the initial product pools [5,6].…”

Usutuvirus

“…Gepooltes Plasma, das mit dem Solvent/Detergent-Verfahren behandelt wurde, ist sicher, da Flaviviren und andere umhüllte Viren durch das S/DVerfahren wirksam inaktiviert werden (Übersichtsarbeit [74]). Methylen-Blau in Kombination mit der Photoinaktivierung inaktiviert Flaviviren in Plasma [75].…”