Elevated plasma testosterone concentrations from males on testosterone replacement therapy are mitigated with pathogen reduction technology.

IF 2.5 3区 医学 Q2 HEMATOLOGY
Transfusion Pub Date : 2025-01-29 DOI:10.1111/trf.18149
B Greenwall, K Reeder, W Anani
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引用次数: 0

Abstract

Background: Donors on testosterone replacement therapy (TRT) may require frequent whole blood donation due to erythrocytosis, but FDA guidelines prevent the transfusion of plasma-based products from these donors. This study surveyed TRT donor testosterone levels in whole blood components and evaluated a possible mitigation strategy with a pathogen reduction technology using UVA light and compound adsorption device (CAD) steps.

Study design and methods: Whole blood from male TRT donors and controls were processed into red blood cells and plasma components. Free and total testosterone were measured in 78 TRT donors and 48 controls by high-performance liquid chromatography-tandem mass spectrometry. Pathogen reduction (INTERCEPT Blood System) on pooled plasma components (n = 10) with supraphysiologic testosterone were sampled: before treatment, after UVA illumination, and after CAD incubation.

Results: TRT donors had 3.8 and 3.9 times more free testosterone in plasma and red blood cell supernatant, respectively, and 2.3 times more total testosterone in both components than controls (p < .0001). Two controls and 33 TRT donors had supraphysiologic testosterone. The CAD incubation reduced the mean free and total testosterone by 88% (571.72-73.8 pg/mL) and 84% (1498.61-240.59 ng/mL), respectively (p = .0065), but UVA light had no effect (p > .9999).

Discussion: TRT donors had significantly higher testosterone levels than controls. The CAD step in the pathogen reduction process abrogated supraphysiologic testosterone in plasma at or below the reference range. Studies validating testosterone removal from plasma can support the transfusion of pathogen-reduced plasma and platelets from TRT donors.

背景:接受睾酮替代疗法(TRT)的献血者可能会因红细胞增多症而需要频繁捐献全血,但美国食品药物管理局(FDA)的指南禁止从这些献血者处输注血浆类产品。本研究调查了 TRT 献血者全血成分中的睾酮水平,并评估了一种可能的缓解策略,即利用 UVA 光和复合吸附装置(CAD)步骤减少病原体的技术:将男性 TRT 献血者和对照组的全血处理成红细胞和血浆成分。采用高效液相色谱-串联质谱法测量了 78 名 TRT 献血者和 48 名对照者的游离睾酮和总睾酮。在治疗前、UVA 照射后和 CAD 培养后,对含有超生理睾酮的集合血浆成分(n = 10)进行了病原体还原(INTERCEPT 血液系统)采样:结果:与对照组相比,TRT 献血者血浆和红细胞上清液中的游离睾酮分别高出 3.8 倍和 3.9 倍,两种成分中的总睾酮高出 2.3 倍(P.9999):讨论:TRT 献血者的睾酮水平明显高于对照组。病原体还原过程中的 CAD 步骤可将血浆中的超生理睾酮降至或低于参考范围。对血浆中睾酮去除情况进行验证的研究可为输注经病原体还原的 TRT 献血者血浆和血小板提供支持。
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来源期刊
Transfusion
Transfusion 医学-血液学
CiteScore
4.70
自引率
20.70%
发文量
426
审稿时长
1 months
期刊介绍: TRANSFUSION is the foremost publication in the world for new information regarding transfusion medicine. Written by and for members of AABB and other health-care workers, TRANSFUSION reports on the latest technical advances, discusses opposing viewpoints regarding controversial issues, and presents key conference proceedings. In addition to blood banking and transfusion medicine topics, TRANSFUSION presents submissions concerning patient blood management, tissue transplantation and hematopoietic, cellular, and gene therapies.
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