Abstract
Methods to remove and inactivate pathogens, used extensively in the manufacture of plasma protein fractions, have all but eliminated transmission of infectious agents by these products. 1 Technologies for reducing the risk of infection from single donor blood components have not been embraced as enthusiastically. Several methods have been introduced in Europe. Treatment with solvent/detergent (S/D) or methylene blue have both been applied to plasma components, and psoralen treatment of platelets (PLTs) has begun in several countries. 2-4 Although S/D-treated pooled plasma has been approved for use in the United States and Canada, none of these methods has been adopted for single-donor products in North America. Reasons for slow acceptance include 1) the current safety of the volunteer blood supply; 2) the success of surveillance and development of screening tests to deal with emerging pathogens; 3) the inability of current technologies to inactivate some agents such as spores, prions, and certain small nonencapsulated viruses; 4) concerns regarding remote risks from the residual chemical agents used during the pathogen inactivation (PI) process; 5) absence of any single method to treat whole blood or all components; and 6) the costeffectiveness of these technologies especially compared to strategies to reduce noninfectious risks of transfusion. 5
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