Inactivation photochimique des pathogènes des plaquettes et du plasma : cinq ans d’utilisation clinique de routine et d’hémovigilance. Vers un changement de paradigme de la sécurité en transfusion

Abstract

The transfusion of labile blood products is vital and essential for patients in absence of alternative treatment. Patients and doctors have always feared transfusion-transmitted infections by blood, blood components and blood-derived drugs. Photochemical inactivation of platelet concentrates and plasma, using a technique associating amotosalen and UVA, has been used for five years in a French region for the whole population and a large spectrum of patients, with efficacy and safety. It would seem wise to introduce labile blood products, submitted to pathogen inactivation by a technique already approved by a regulatory agency and not to wait for a perfect system including red blood cells concentrates. Universal implementation of pathogen inactivation in labile blood products is a major and key step to improve safety against infection in transfusion.

A regional haemovigilance retrospective study of four types of therapeutic plasma in a ten‐year survey period in France

“…It must be stated that two of the four products – namely BM and AI FFP – were particularly scrutinized because of claims of allergy for BM and of postmarketing surveillance for AI: despite exhaustive surveillance and improvement of surveillance culture, hazard reports did not increase. Although the number of BM plasma components transfused was low in our regional experience (10 253 units), compared to other sources of FFP, it did not lead to remarkable hazard; our relatively large experience with AI plasma represents one of the first reports of this product use, after Cazenave's , and one of the largest reported so far; AI FFP proves to be safe to patients. Although Q plasma delivery is accompanied by more AEs in patients than with SD, the recorded number of events was, however, extremely low, allowing the conclusion that this plasma is safe (and actually, the number of grade 3 AEs is quite similar to the other FFPs).…”

Biochemical and functional characteristics of stored (double‐dose) buffy‐coat platelet concentrates treated with amotosalen and a prototype UVA light‐emitting diode illuminator

“…The INTERCEPT technique moderately increases platelet storage lesions in PCs stored in SSP + or PAS-III/ plasma, [9][10][11][12][13] which might account for the reduced posttransfusion platelet recovery reported in some clinical trials, without altering the clinical hemostatic performance of platelets. [14][15][16] The composition of the additive solution could also influence the occurrence of storage lesions; PAS-III M (SSP + ), which contains potassium and magnesium, has demonstrated improved preservation of the quality of both apheresis-and BC-derived platelets compared with PAS-III, regardless of the INTERCEPT treatment. 9,13,17,18 However, there exists no detailed comparison of SSP + and PAS-III additive solutions for the conservation of INTERCEPT-treated BC-PCs with regard to the storage damage including in vitro platelet functional properties.…”