The 4-Year Experience with Implementation and Routine Use of Pathogen Reduction in a Brazilian Hospital.

Roberta Fachini,Mayra Brito,Rita Fontão-Wendel,Ruth Achkar,Silvano Wendel,Patrícia Scuracchio,Marcelo Amaral

doi:10.3390/pathogens10111499

Roberta Fachini, Mayra Brito + Show 5 more

Open Access

https://doi.org/10.3390/pathogens10111499

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Journal: Pathogens	Publication Date: Nov 18, 2021
Citations: 5	License type: CC BY 4.0

Affiliation: Hospital Sírio-Libanês

Abstract

(1) Background: We reviewed the logistics of the implementation of pathogen reduction (PR) using the INTERCEPT Blood System™ for platelets and the experience with routine use and clinical outcomes in the patient population at the Sírio-Libanês Hospital of São Paulo, Brazil. (2) Methods: Platelet concentrate (PC), including pathogen reduced (PR-PC) production, inventory management, discard rates, blood utilization, and clinical outcomes were analyzed over the 40 months before and after PR implementation. Age distribution and wastage rates were compared over the 10 months before and after approval for PR-PC to be stored for up to seven days. (3) Results: A 100% PR-PC inventory was achieved by increasing double apheresis collections and production of double doses using pools of two single apheresis units. Discard rates decreased from 6% to 3% after PR implementation and further decreased to 1.2% after seven-day storage extension for PR-PCs. The blood utilization remained stable, with no increase in component utilization. A significant decrease in adverse transfusion events was observed after the PR implementation. (4) Conclusion: Our experience demonstrates the feasibility for Brazilian blood centers to achieve a 100% PR-PC inventory. All patients at our hospital received PR-PC and showed no increase in blood component utilization and decreased rates of adverse transfusion reactions.

Highlights

Since the emergence of human immunodeficiency virus (HIV), technological advances have been increasingly introduced to improve blood safety and prevent transfusiontransmitted infections (TTIs) [1]
It is possible to observe that we needed to adjust significantly the volumes and, the platelet concentrations per mL, in order to meet the ideal parameters established by the manufacturer to the treatment and, at the same time, achieve our requirements regarding the platelet therapeutic dose
These may have been collected from a single donor by apheresis, or obtained from a pool of 5–6 UNITS of random platelets, where each unit was produced from a whole blood donation

Summary

Introduction

Since the emergence of human immunodeficiency virus (HIV), technological advances have been increasingly introduced to improve blood safety and prevent transfusiontransmitted infections (TTIs) [1]. Several measures have been implemented at various levels, such as careful donor selection, strategies to reduce bacterial contamination, development of sensitive screening assays, and hemovigilance programs [2] Despite such improvements, the risks associated with bacterial contamination of platelets, viruses, vector-borne pathogens, and emerging infectious diseases remain a problem. Disparities in blood safety remain between developed and low/middle-income countries (LMICs) The latter are often burdened by a higher prevalence of infectious diseases, endemic for vector-borne parasitic or viral agents, and are at risk of outbreaks of new emerging infectious diseases (EIDs). The most recent experience with SARS-CoV-2 emergence has shown that, SARS-CoV-2 may not be transfusion-transmitted, blood continuity can be adversely affected during pandemics [15,16]

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