Department of Hematopathology, Centre Diagnostic Biomedic, Hospital Clinic, Barcelona, Spain.
Global Blood Advisor, adjunct Professor, Arizona State University, USA.
Transfusion. 2022 Jan;62(1):227-246. doi: 10.1111/trf.16747. Epub 2021 Dec 6.
Standard platelet concentrates (PCs) stored at 22°C have a limited shelf life of 5 days. Because of the storage temperature, bacterial contamination of PCs can result in life-threatening infections in transfused patients. The potential of blood components to cause infections through contaminating pathogens or transmitting blood-borne diseases has always been a concern. The current safety practice to prevent pathogen transmission through blood transfusion starts with a stringent screening of donors and regulated testing of blood samples to ensure that known infections cannot reach transfusion products. Pathogen reduction technologies (PRTs), initially implemented to ensure the safety of plasma products, have been adapted to treat platelet products. In addition to reducing bacterial contamination, PRT applied to PCs can extend their shelf life up to 7 days, alleviating the impact of their shortage, while providing an additional safety layer against emerging blood-borne infectious diseases. While a deleterious action of PRTs in quantitative and qualitative aspects of plasma is accepted, the impact of PRTs on the quality, function, and clinical efficacy of PCs has been under constant examination. The potential of PRTs to prevent the possibility of new emerging diseases to reach cellular blood components has been considered more hypothetical than real. In 2019, a coronavirus-related disease (COVID-19) became a pandemic. This episode should help when reconsidering the possibility of future blood transmissible threats. The following text intends to evaluate the impact of different PRTs on the quality, function, and clinical effectiveness of platelets within the perspective of a developing pandemic.
标准血小板浓缩物(PCs)在 22°C 下储存的保质期有限,仅为 5 天。由于储存温度的原因,PCs 中的细菌污染可能导致输注患者发生危及生命的感染。血液成分通过污染病原体或传播血源性疾病而导致感染的潜在风险一直是人们关注的焦点。目前,通过输血预防病原体传播的安全措施始于对供体进行严格筛选,并对血液样本进行监管检测,以确保已知感染不会进入输血产品。病原体减少技术(PRT)最初是为了确保血浆产品的安全性而实施的,现已被应用于血小板产品的处理。除了减少细菌污染外,PRT 还可以将 PCs 的保质期延长至 7 天,缓解其短缺的影响,同时为新兴的血源性传染病提供额外的安全保障。虽然 PRT 在血浆的数量和质量方面产生了有害作用已被接受,但 PRT 对 PCs 的质量、功能和临床疗效的影响一直受到持续检查。PRT 预防新出现的疾病到达细胞血液成分的可能性被认为更多的是假设,而不是现实。2019 年,一种与冠状病毒相关的疾病(COVID-19)大流行。在重新考虑未来血液传播威胁的可能性时,这一事件应该有所帮助。本文旨在从大流行发展的角度评估不同 PRT 对血小板质量、功能和临床疗效的影响。