Maintaining plasma quality and safety in the state of ongoing epidemic – The role of pathogen reduction. (February 2021)

• Record Type: Journal Article
• Authors: Wasiluk, Tomasz; Rogowska, Anna; Boczkowska-Radziwon, Barbara; Zebrowska, Agnieszka; Bolkun, Lukasz; Piszcz, Jaroslaw; Radziwon, Piotr
• Is Part Of: Transfusion and apheresis science. Volume 60:Number 1(2021)
• Publication Date: 2021-02
• Subjects: COVID-19 -- SARS-CoV-2 -- Plasma for transfusion -- Pathogen reduction; Blood -- Transfusion -- Periodicals; Hemapheresis -- Periodicals; 615.39
• DOI: 10.1016/j.transci.2020.102953
• Languages: English
• ISSNs: 1473-0502

Abstract

Highlights: Pathogen reduction can be an effective method of reducing emerging infectious agents. Assessment of the effectiveness of pathogen reduction against SARS-CoV-2 is required. The timing of pathogen reduction should be adapted to the actual plasma demand. Pathogen reduction performed post thawing may ensure safe plasma for transfusion. Pathogen reduction techniques can solve the issue of plasma from one-time-only donors. Abstract: In the field of transfusion medicine, many pathogen reduction techniques (PRTs) are currently available, including those based on photochemical (PI) and photodynamic inactivation (PDI). This is particularly important in the face of emerging viral pathogens that may pose a threat to blood recipients, as in the case of the COVID-19 pandemic. However, PRTs have some limitations, primarily related to their adverse effects on coagulation factors, which should be considered before their intended use. A comprehensive search of PubMed, Wiley Online Library and Science Direct databases was conducted to identify original papers. As a result, ten studies evaluating fresh plasma and frozen-thawed plasma treated with different PI/ PDI methods and evaluating concentrations of coagulation factors and natural anticoagulants both before and after photochemical treatment were included in the review. The use of PI and PDI is associated with a significant decrease in the activity of all analysed coagulation factors, while the recovery of natural anticoagulants remains at a satisfactory level, variable for individual inactivation methods. In addition, the published evidence reviewed above does not unequivocally favour the implementation of PI/PDI either before freezing or after thawing as plasma products obtained with these two approaches seem to satisfy the existing quality criteria. Based on current evidence, if implemented responsibly and in accordance with the current guidelines, both PI and PDI can ensure satisfactory plasma quality and improve its safety.