In Vitro Comparative Study of Platelets Treated with Two Pathogen-Inactivation Methods to Extend Shelf Life to 7 Days.

Nicolas Malvaux,Kathleen Mommaerts,Anne Schuhmacher,Fay Betsou,Styliani Bartziali,Fanette Defraigne,Camille Bellora

doi:10.3390/pathogens11030343

Nicolas Malvaux, Kathleen Mommaerts + Show 5 more

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https://doi.org/10.3390/pathogens11030343

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Abstract

Background and Objectives: Since 2015, platelet products have been pathogen-inactivated (PI) at the Luxemburgish Red Cross (LRC) using Riboflavin and UV light (RF-PI). As the LRC should respond to hospital needs at any time, platelet production exceeds the demand, generating a discard rate of 18%. To reduce this, we consider the extension of storage time from 5 to 7 days. This study’s objective was to evaluate the in vitro 7-day platelet-storage quality, comparing two PI technologies, RF-PI and amotosalen/UVA light (AM-PI), for platelet pools from whole-blood donations (PPCs) and apheresis platelets collected from single apheresis donation (APCs). Materials and Methods: For each product type, 6 double-platelet concentrates were prepared and divided into 2 units; one was treated with RF-PI and the other by AM-PI. In vitro platelet-quality parameters were tested pre- and post-PI, at days 5 and 7. Results: Treatment and storage lesions were observed in PPCs and APCs with both PI methods. We found a higher rate of lactate increase and glucose depletion, suggesting a stronger stimulation of the glycolytic pathway, a higher Annexin V binding, and a loss of swirling in the RF-PI-treated units from day 5. The platelet loss was significantly higher in the AM-PI compared with the RF-PI units. Conclusions: Results suggest that RF-PI treatment has a higher deleterious impact on in vitro platelet quality compared to AM-PI, but we observed higher loss of platelets with AM-PI due to the post-illumination amotosalen adsorption step. If 7-day storage is needed, it can only be achieved with AM-PI, based on our quality criteria.

Highlights

Pathogen inactivation (PI) of platelet (PLT) concentrates (PCs) increases the safety of blood products by reducing the risk of transfusion-transmitted infections [1] and by inactivating leukocytes for the prevention of transfusion-associated graft-versus-host disease (TA-GVHD) [2,3]
All the platelet concentrates conformed to the specifications of the RF-PI and AM-PI treatments, in terms of volume, platelet concentration, and platelet dose
The platelet concentration was consistently higher in AM-PI than RF-PI platelet products, but the platelet dose was lower (Table 1)

Summary

Introduction

Pathogen inactivation (PI) of platelet (PLT) concentrates (PCs) increases the safety of blood products by reducing the risk of transfusion-transmitted infections [1] and by inactivating leukocytes for the prevention of transfusion-associated graft-versus-host disease (TA-GVHD) [2,3]. The second technology uses a photochemical reaction with amotosalen, irreversibly crosslinking nucleic acids in the presence of UVA light and preventing replication and transcription (INTERCEPT Blood System, Cerus, AM-PI). These treatments may contribute to platelet-storage lesions (PSL) [4,5], including PLT activation, degranulation, protein modifications and release, and extracellular milieu composition changes, pro-apoptotic signaling, and morphological changes. Conclusions: Results suggest that RF-PI treatment has a higher deleterious impact on in vitro platelet quality compared to AM-PI, but we observed higher loss of platelets with AM-PI due to the post-illumination amotosalen adsorption step. If 7-day storage is needed, it can only be achieved with AM-PI, based on our quality criteria

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