Progress towards an appropriate pathogen reduction technology for whole blood in Africa

Abstract

BackgroundInterest in an effective pathogen reduction technology (PRT) for whole blood (WB) tailored to address specific needs of limited‐resource settings is growing. The Swiss Red Cross Humanitarian Foundation (SRCHF) supports a clinical programme to promote PRT for WB in resource‐limited settings where rates of WB use and transfusion‐transmitted infections are high.Pathogen reduction technology for whole bloodCerus Corporation (INTERCEPT® Blood System) and Terumo BCT (Mirasol®) are investing in clinical trials for red‐blood‐cell (RBC) and WB PRT. The SRCHF selected the INTERCEPT WB PRT for its clinical programme in Africa based on data related to the INTERCEPT system's pathogen reduction effectiveness and the company's goal of producing a processing kit requiring minimal electricity.Adapting the INTERCEPT RBC PRT for WBThe INTERCEPT PRT for RBC and WB uses amustaline (0·2 mm) to irreversibly cross‐link nucleic acids and glutathione (GSH) (20 mm for RBC and 2 mm for WB) to quench unreacted amustaline. Laboratory and clinical trial results for the RBC PRT form the basis for the WB PRT. Preliminary studies have demonstrated preservation of RBC quality in amustaline/GSH‐treated WB. A Phase 1 safety trial in Côte d'Ivoire and development of a WB processing kit requiring limited electricity are described.DiscussionAssessing the clinical safety of a WB PRT under local conditions is a positive step in the development of a suitable WB PRT for low‐resource settings.