Lu Wen, Fung Mark
Section of Transfusion Medicine, Robert Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA.
Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington, VT, USA.
F1000Res. 2020 Jan 23;9. doi: 10.12688/f1000research.20816.1. eCollection 2020.
Allogeneic platelets collected for transfusion treated with pathogen reduction technology (PRT), which has been available in some countries for more than a decade, are now increasingly available in the United States (US). The implementation of PRT-treated platelets, also known as pathogen-reduced platelets (PRPs), has been spurred by the need to further decrease the risk of sepsis associated with bacterial contamination coupled with the potential of this technology to reduce the risk of infections due to already recognized, new, and emerging infectious agents. This article will review available PRP products, examine their benefits, highlight unresolved questions surrounding this technology, and summarize pivotal research studies that have compared transfusion outcomes (largely in adult patients) for PRPs with non-PRT-treated conventional platelets (CPs). In addition, studies describing the use of PRPs in pediatric patients and work done on the association between PRPs and HLA alloimmunization are discussed. As new data emerge, it is critical to re-evaluate the risks and benefits of existing PRPs and newer technologies and reassess the financial implications of adopting PRPs to guide our decision-making process for the implementation of transfusing PRPs.
采用病原体灭活技术(PRT)处理的用于输血的异体血小板,在一些国家已有十多年的应用历史,如今在美国也越来越普遍。实施经PRT处理的血小板,也称为病原体灭活血小板(PRP),是由于需要进一步降低与细菌污染相关的败血症风险,以及该技术有可能降低因已知、新出现和正在出现的传染原导致的感染风险。本文将回顾现有的PRP产品,探讨其益处,突出围绕该技术尚未解决的问题,并总结将PRP与未经PRT处理的传统血小板(CP)的输血效果(主要针对成年患者)进行比较的关键研究。此外,还将讨论描述PRP在儿科患者中的应用以及PRP与HLA同种免疫之间关系的研究。随着新数据的出现,重新评估现有PRP和新技术的风险与益处,以及重新评估采用PRP的财务影响,对于指导我们实施PRP输血的决策过程至关重要。