Transfusions are very safe in 2016, but is there a way to get rid of the remaining potential “bugs in the bag?” Well, yes, but pathogen inactivation is not yet fully implemented in the United States. Dr. Jeff McCullough explains.
Most everyone would agree that blood transfusion in 2016 is really, really safe from potential infectious disease transmission. At the same time, there are a few situations that worry blood bankers, including the residual risk of bacterial contamination of platelets (despite increased efforts in recent years to detect such contamination) and emerging infections like Zika, Dengue, and Chikungunya viruses. One potential solution to these issues is called “pathogen inactivation” (also called pathogen reduction by many). This is simply a method to treat blood products after they are collected in order to remove residual organisms that either were not detected by current tests or for which we do not yet have a test (and further, may not even know about the organism!). Dr. McCullough shares the basics of the two main types of pathogen inactivation platforms under discussion for current and future use in the United States (both of which are already used in many other countries).
DISCLAIMER: The opinions expressed on this episode are those of my guest and I alone, and do not reflect those of the organizations with which either of us is affiliated. Neither Dr. McCullough nor I have any relevant financial disclosures (discussed during the first five minutes of the episode).
- Snyder EL et al. The Safety of the Blood Supply — Time to Raise the Bar. NEJM 2015;372:1882-1885.
- McCullough J et al. Cost implications of implementation of pathogen-inactivated platelets. Transfusion 2015;55:2312-20.
- Allain JP et al. Effect of Plasmodium inactivation in whole blood on the incidence of blood transfusion-transmitted malaria in endemic regions: the African Investigation of the Mirasol System (AIMS) randomised controlled trial. Lancet 2016;387:1753-61.
- Ramsey G. Hemostatic Efficacy of Pathogen-Inactivated Blood Components. Semin Thromb Hemost 2016;42:172-82.
- Slichter SJ et al. Dose of Prophylactic Platelet Transfusions and Prevention of Hemorrhage (PLADO). NEJM 2010;362:600-13.