Pathogen reduction technologies: The pros and cons for platelet transfusion

Abstract

The transfusion of platelets is essential for diverse pathological conditions associated with thrombocytopenia or platelet disorders. To maintain optimal platelet quality and functions, platelets are stored as platelet concentrates (PCs) at room temperature under continuous agitation—conditions that are permissive for microbial proliferation. In order to reduce these contaminants, pathogen reduction technologies (PRTs) were developed by the pharmaceutical industry and subsequently implemented by blood banks. PRTs rely on chemically induced cross-linking and inactivation of nucleic acids. These technologies were initially introduced for the treatment of plasma and, more recently, for PCs given the absence of a nucleus in platelets. Several studies verified the effectiveness of PRTs to inactivate a broad array of bacteria, viruses, and parasites. However, the safety of PRT-treated platelets has been questioned in other studies, which focused on the impact of PRTs on platelet quality and functions. In this article, we review the literature regarding PRTs, and present the advantages and disadvantages related to their application in platelet transfusion medicine.

KEYWORDS:

• platelets
• transfusion
• pathogen reduction systems

Declaration of interest

The authors have disclosed no conflicts of interest.

Funding

This work was supported by the Canadian Institutes of Health Research, Foundation program (to E.B) and the Canadian Blood Services (to P.P and E.B). E.B is recipient of a Canadian Institutes of Health Research new investigator award. A.M is a recipient of an award from Mitacs. J.L is a recipient of a graduate fellowship from the Canadian Blood Services. No funding bodies had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The views expressed herein do not necessarily represent the view of the federal government.

Additional information

Funding

This work was supported by the Canadian Institutes of Health Research, Foundation program (to E.B) and the Canadian Blood Services (to P.P and E.B). E.B is recipient of a Canadian Institutes of Health Research new investigator award. A.M is a recipient of an award from Mitacs. J.L is a recipient of a graduate fellowship from the Canadian Blood Services. No funding bodies had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The views expressed herein do not necessarily represent the view of the federal government.