Update on pathogen reduction technology for therapeutic plasma: An overview

Universal Pathogen-Reduced Plasma in Elective Open-Heart Surgery and Liver Resection

“…In Norway, no adverse reactions have been reported after the requirement of an anti-A/anti-B IgM/IgG titer <250 was introduced in 1995 for apheresis platelets containing such antibodies reactive with a recipient's RBCs. 29,30 The observation that a Uniplas transfusion episode of 50.7 ml/kg was well tolerated in a blood group A patient is thus in agreement with the experience with IVIg and apheresis plasma.…”

“…34,35,36,37 Cost-effectiveness of pathogen reduction is low in the developed world due to the very low risk of transfusion transmittable infections after introduction of modern methods for the detection of infectious agents. 29 High cost per quality-adjusted life year estimates of US $2-9 million have been published for SD-treated plasma. 38,39 If, however, noninfective transfusion-related complications are included in the calculations, significantly more favourable estimates are obtained for this product.…”

“…29,30 For IVIg, a dose of 40 ml/kg of a 3% solution is accepted per infusion episode, while an apheresis platelet transfusion episode seldom exceeds 10 ml/kg. In Norway, no adverse reactions have been reported after the requirement of an anti-A/anti-B IgM/IgG titer <250 was introduced in 1995 for apheresis platelets containing such antibodies reactive with a recipient's RBCs.…”

Low Incidence of Hyperfibrinolysis and Thromboembolism in 195 Primary Liver Transplantations Transfused with Solvent/Detergent-Treated Plasma

“…[2][3][4] Due to dilution and possible neutralization of the responsible antibodies, SD-plasma has a markedly lower rate of allergic/immunologic reactions including no reported cases of transfusion related acute lung injury (TRALI) despite over 10 million units transfused. 5,6 Further, SD-plasma can be regarded as a biopharmaceutical product with Si gnificant perioperative bleeding and transfusions of plasma, red blood cells (RBCs), and platelets are considered part of the normal clinical course of orthotopic liver transplantation (OLT).…”

“…One disadvantage of SD-plasma is that the SD-process inevitably reduces the levels of α2-antiplasmin and protein S, and could increase the risk of hyperfibrinolysis 8 or thromboembolic events such as pulmonary embolism during liver transplantation. 9 In addition to the track record of SD-plasma in Europe during the last two decades, both randomized controlled trials [10][11][12] and critical reviews 4,6 have suggested that these risks are largely theoretical. US SD-plasma was first introduced in 1998, but production was terminated in [2002][2003] in part due to thromboembolic complications not observed with European SD-plasma.…”