Effect of pathogen inactivation on the storage lesion in red cells and platelet concentrates

Pathogen inactivation by riboflavin and ultraviolet light illumination accelerates the red blood cell storage lesion and promotes eryptosis

“…Beyond conventional methods of blood screening, the possibility of undetected microbial contamination in blood products has spurred the development of different pathogen reduction treatments (PRTs) . While these strategies are reliable and effective in reducing the risk of transfusion‐transmitted infections, unlike for platelets (PLTs), there is currently insufficient experimental data to validate their application for red blood cells (RBCs) . Pathogen inactivation by Mirasol technology utilizes treatment with riboflavin and ultraviolet (UV) light, which causes irreversible nucleic acid damage in pathogens .…”

Whole blood treated with riboflavin and ultraviolet light: quality assessment of all blood components produced by the buffy coat method

“…Research studies of PI‐treated PLT and plasma components consistently demonstrate a negative effect on in vitro quality variables triggering ongoing discussions of the risks and benefits of its application . Clinical studies generally indicate that current PI procedures leave PLT components sufficiently viable to achieve an effective transfusion; however, the diverse technologies currently on the market have different mechanisms of action. Pathogen‐inactivated plasma seems to perform as well clinically as standard fresh‐frozen plasma (FFP); however, most reported trials have been underpowered and the evidence for standard FFP being of clinical value is also weak in many cases …”

Model Calculations to Quantify Clinical and Economic Effects of Pathogen Inactivation in Platelet Concentrates

“…Platelets in the normal circulation have a mean life span of 7-10 days only [5,6]. The fact that storing platelets causes well described changes in morphology and biochemistry known as platelet storage lesions explains why fresh platelets are more effective [6,7]. Further, platelet products for transfusion are stored at room temperature in plasma or plasma with additive solution under constant agitation, which can promote bacterial growth [2,6].…”

“…Currently, pathogen inactivation/reduction technologies (PRTs) for PCs comprise 3 methods: pathogen inactivation (PI) with the Intercept Blood System™ (IBS) consisting of treatment with amotosalen and ultraviolet (UV) A light (Cerus Corporation, Concord, CA, USA), the Mirasol ® technology utilizing riboflavin and irradiation with UVB and UVC light (Terumo BCT, Lakewood, CO, USA), and the Theraflex UV™ procedure using irradiation with UVC light alone (MacoPharma, Mouvaux, France) [7,11]. For the Mirasol method, platelets are suspended in plasma or a combination of plasma and additive solution (SSP+, MacoPharma), and treated by the addition of riboflavin (vitamin B 2 ) and subsequent exposure to UVB and UVC light of 265-370 nm delivering a dose of 6.2 Joules/cm 2 for 10 min approximately.…”

“…For the Mirasol method, platelets are suspended in plasma or a combination of plasma and additive solution (SSP+, MacoPharma), and treated by the addition of riboflavin (vitamin B 2 ) and subsequent exposure to UVB and UVC light of 265-370 nm delivering a dose of 6.2 Joules/cm 2 for 10 min approximately. Illumination leads to photo-oxidative damage of nucleic acids by generation of oxygen radicals [7,11]. Similar to other PRTs, negative effects on platelet function have been described for both UVB and UVC light used in the Mirasol and Theraflex UV technology [21].…”