Significant bacterial contamination risk reduction with the use of diversion pouch

Lee, C. K.; Wong, Henry K.; Ho, Pak-Leung; Tsoi, W.C.; Lee, K. Y.; Tsui, Grace; Chua, E.; Leung, Jennifer; Lin, Che-Kit

doi:10.1111/j.1365-3148.2012.01194.x

Cited by 15 publications

(19 citation statements)

References 31 publications

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“…Photochemical treatment of platelets can also inactivate many bacteria (Lin et al , ). Other measures to reduce bacterial contamination include: skin scrubbing, use of diversion pouch (Wagner et al , ; McDonald et al , ; Lee et al , ), reducing recipient exposure, pathogen inactivation, and standardising blood component processing and storage (Goldman & Blajchman ). Recently, rapid detection systems and flow cytometric assays have been used effectively to screen platelets for bacterial contamination (Vollmer et al , ; Harm et al , ).…”

Section: Discussionmentioning

confidence: 99%

Clinical and quality evaluation of apheresis vs random‐donor platelet concentrates stored for 7 days

Hussein

2015

Transfusion Medicine

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Section: Discussionmentioning

confidence: 99%

Clinical and quality evaluation of apheresis vs random‐donor platelet concentrates stored for 7 days

Hussein

2015

Transfusion Medicine

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“…The main keystones include careful donor selection and procedures such as the selection of the venepuncture site, effective skin disinfection, separation of the first volume from the blood donation (predonation sampling, also called diversion) and the consistent monitoring of the bag systems. Collectively, these have proven very effective in reducing the rates of bacterial contamination and associated septic transfusions reactions by 50 to 75% . Nonetheless, the residual contamination risk is approximately 1 in 10 000 transfused PCs with nonfatal reactions occurring in 1 in 100 000 and fatal reactions in 1 in 500 000 transfused PCs, respectively, further action is needed .…”

Section: Concepts Of Microbial Safetymentioning

confidence: 99%

Microbial safety of cellular therapeutics—lessons from over ten years’ experience in microbial safety of platelet concentrates

Störmer

Wood

Gathof

2018

ISBT Science Series

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Bacterial safety of cellular preparations, including blood products and cellular therapeutics, presents ongoing challenges for physicians, manufacturers and regulators. Although there have been many new approaches to enhance the microbial safety of cellular products during the last decade, established methods for microbiological control still need to be fully adapted to the special circumstances of cellular preparations. The experience from transfusion medicine regarding microbial safety of blood components has demonstrated the variety of problems and risk factors for the development of new strategies for microbial safety. Special attention has been given to the prevention and detection of bacterial contamination of platelet concentrates. But so far, none of the targeted strategies for rapid detection or pathogen reduction have become routinely implemented worldwide, in part at least because development and requirements of new technologies and their implementation into the routine setting are a whole different problem. But factors including the short shelf life and nontraditional lot sizes for cellular and gene therapy products are driving the need for rapid microbiological methods. In conclusion, lessons from the microbial safety of platelet concentrates enable us to understand that the detection or reduction in bacteria represents a more difficult challenge in comparison with viruses. Recent regulatory changes demonstrate that we are getting closer to the goal of a shift from the traditional view of sterility evaluation (identify and inactivate anything and everything) to a new thinking about microbiological control.

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“…Tissue fragments, commonly called ‘skin plugs,’ from phlebotomy during blood donation are the major cause of contamination of blood products because pathogens in deeper regions may not be eliminated by skin disinfection (Buchta et al , ). Hence, there is a theoretically higher chance of platelet unit contamination as the number of donors and donor ‘skin plugs’ increases, although there are current diversion methods to minimise this risk (Lee et al , ). Palavecino et al () have published a comprehensive review on the bacterial contamination of platelet concentrates.…”

Section: Bacterial Contaminationmentioning

confidence: 99%

I am the 9%: Making the case for whole‐blood platelets

Seheult

Triulzi

Yazer

2016

Transfusion Medicine

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Over the last 15 years, there has been a trend in the United States towards the increasing use of apheresis platelet (AP) concentrates over whole-blood-derived platelets (WBP). Although 1-h- and 24-h-corrected count increments tend to be higher with AP, this does not translate into improved haemostatic efficiency when used to prevent bleeding in haematology/oncology patients. WBP expose the recipient to more donors than apheresis products. However, recent studies have shown no significant differences in the rates of bacterial contamination, human leukocyte antigen alloimmunisation, RhD alloimmunisation, transfusion-related acute lung injury or febrile non-haemolytic transfusion reactions between these two products. Given the overall low rates of virally contaminated units in the era of nucleic acid testing and rigorous donor screening, the difference in donor exposures of 4-6 vs 1 has minimal clinical relevance. Although studies point to a marginally increased risk of donor adverse events associated with WBP, the absolute risk is too miniscule to act as a deterrent to making whole-blood donations. Both types of platelet concentrates should therefore be considered clinically equivalent; in this light, the most responsible use of the community donor resource pool, which both optimises the utility of a whole-blood donation and meets the clinical needs of thrombocytopenic recipients, is to have a mix of both types of platelet products so as to mitigate the risk of shortages.

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Significant bacterial contamination risk reduction with the use of diversion pouch

Abstract: Integration of diversion pouch into blood bags to divert the first 30 mL blood during blood collection on top of the current skin disinfection protocol can significantly reduce the risk of bacterial contamination.

Cited by 15 publications

References 31 publications

Clinical and quality evaluation of apheresis vs random‐donor platelet concentrates stored for 7 days

Clinical and quality evaluation of apheresis vs random‐donor platelet concentrates stored for 7 days

Microbial safety of cellular therapeutics—lessons from over ten years’ experience in microbial safety of platelet concentrates

I am the 9%: Making the case for whole‐blood platelets

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