Friedman L I, Stromberg R R, Wagner S J
Product Development Department, Jerome H. Holland Laboratory, American Red Cross, Rockville, MD 20855, USA.
Immunol Invest. 1995 Jan-Feb;24(1-2):49-71. doi: 10.3109/08820139509062762.
The safety of the nation's blood supply has improved over the last several years as a result of more intensive donor screening and viral testing. Concurrently, there has been more judicious use of blood components. Although the risk is small, transmission of blood borne viruses, bacteria and parasites can occur. Investigators have studied a myriad of processes for pathogen depletion and/or inactivation, including the use of chemicals, extended storage, filtration, heating, irradiation, photochemicals and washing. Pasteurization, methylene blue and solvent-detergent processes have been introduced in parts of Europe for improving the safety of plasma used for transfusion. The FDA is reviewing a license application for the solvent-detergent process. For red cells, use of highly efficient leukodepletion filters is believed to be equivalent to antibody testing for the prevention of CMV disease transmission. Otherwise, no successful treatments have yet been identified for red cells or platelets. Several photochemicals, which may be useful for treating these components, are being studied. However, there appear to be trade-offs between the extent of pathogen inactivation, platelet or red cell damage, and genotoxicity. These as well as other biological parameters and operational issues will need to be further evaluated before implementation can be considered.
在过去几年中，由于加强了献血者筛查和病毒检测，国家血液供应的安全性有所提高。与此同时，血液成分的使用也更加谨慎。尽管风险很小，但血源性病毒、细菌和寄生虫仍可能传播。研究人员已经研究了无数种病原体清除和/或灭活的方法，包括使用化学物质、延长储存时间、过滤、加热、辐照、光化学物质和洗涤。巴氏消毒法、亚甲蓝和溶剂去污法已在欧洲部分地区引入，以提高用于输血的血浆的安全性。美国食品药品监督管理局（FDA）正在审查溶剂去污法的许可证申请。对于红细胞，使用高效白细胞滤除器被认为等同于抗体检测，可预防巨细胞病毒（CMV）疾病传播。否则，尚未确定针对红细胞或血小板的成功治疗方法。正在研究几种可能对处理这些成分有用的光化学物质。然而，在病原体灭活程度、血小板或红细胞损伤以及遗传毒性之间似乎存在权衡。在考虑实施之前，这些以及其他生物学参数和操作问题需要进一步评估。
