Platelet component safety in the era of new advancements in bacterial screening and pathogen reduction: A congress report of the 2024 ISBT Transfusion-Transmitted Infectious Diseases Working Party, Bacteria Subgroup.
Michel-Andrés García-Otálora, Carl McDonald, Jennifer Bearne, Bethany Brown, Anthea Cheng, Catherine Humbrecht, Pierre Tiberghien, Sandra Ramirez-Arcos
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Abstract
Background and objectives: High-income countries have successfully enhanced platelet component (PC) safety with the implementation of mitigation strategies including donor screening, skin disinfection, first aliquot diversion and PC bacterial screening or treatment with pathogen reduction technologies (PRT). This review discusses the experiences of several institutions with the adoption of bacterial screening methods and/or PRT and highlights residual safety risks.
Materials and methods: Data from the American Red Cross (ARC), Australian Red Cross Lifeblood (Lifeblood), Canadian Blood Services (CBS), the Établissement Français du Sang (EFS) and National Health Service Blood and Transplant (NHSBT) were presented at the International Society of Blood Transfusion (ISBT) Congress, Transfusion-Transmitted Infectious Diseases meeting (Barcelona, June 2024) and were summarised in this report.
Results: PC screening with the automated BACT/ALERT culture system began in 2004 in the ARC and CBS, while the system was adopted in 2008 and 2011 by Lifeblood and NHSBT, respectively. Implementation of PC treatment with the PRT INTERCEPT started in 2016, 2022, and 2006 in the ARC, CBS, and EFS, correspondingly.
Conclusions: PC screening and PC treatment with PRT have significantly increased product safety. However, there are still residual safety risks posed by challenging organisms such as sporulated Bacillus spp. and toxin-producing Staphylococcus aureus.
期刊介绍：
Vox Sanguinis reports on important, novel developments in transfusion medicine. Original papers, reviews and international fora are published on all aspects of blood transfusion and tissue transplantation, comprising five main sections:
1) Transfusion - Transmitted Disease and its Prevention:
Identification and epidemiology of infectious agents transmissible by blood;
Bacterial contamination of blood components;
Donor recruitment and selection methods;
Pathogen inactivation.
2) Blood Component Collection and Production:
Blood collection methods and devices (including apheresis);
Plasma fractionation techniques and plasma derivatives;
Preparation of labile blood components;
Inventory management;
Hematopoietic progenitor cell collection and storage;
Collection and storage of tissues;
Quality management and good manufacturing practice;
Automation and information technology.
3) Transfusion Medicine and New Therapies:
Transfusion thresholds and audits;
Haemovigilance;
Clinical trials regarding appropriate haemotherapy;
Non-infectious adverse affects of transfusion;
Therapeutic apheresis;
Support of transplant patients;
Gene therapy and immunotherapy.
4) Immunohaematology and Immunogenetics:
Autoimmunity in haematology;
Alloimmunity of blood;
Pre-transfusion testing;
Immunodiagnostics;
Immunobiology;
Complement in immunohaematology;
Blood typing reagents;
Genetic markers of blood cells and serum proteins: polymorphisms and function;
Genetic markers and disease;
Parentage testing and forensic immunohaematology.
5) Cellular Therapy:
Cell-based therapies;
Stem cell sources;
Stem cell processing and storage;
Stem cell products;
Stem cell plasticity;
Regenerative medicine with cells;
Cellular immunotherapy;
Molecular therapy;
Gene therapy.
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