Supervisors info:
Πολίτου Μαριάννα, Αναπληρώτρια Καθηγήτρια Ιατρική, ΕΚΠΑ
Κωνσταντόπουλος Κωνσταντίνος, Καθηγητής, Ιατρική, ΕΚΠΑ
Αγγελοπούλου Μαρία, Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Summary:
The term «Pathogen Reduction Technology» refers to novel methods applied to blood products, which aim at reducing the risk of infectious transmission related with blood transfusion. In recent years, the novel technology plays a key-role in the department of blood transfusion therapy, as more and more countries are using techniques of plasma and platelet deactivation, whereas red blood cells deactivation is still at the stage of clinical trials. Ideally these techniques should be effective in eliminating an extended range of pathogenic microorganisms. Therefore, they could potentially replace the routine serological and molecular screening for HIV, HBV, HCV, HTLV, Treponema pallidum, as well as specialized screening tests that are performed in specific circumstances, for example the screening of blood donors or blood products for CMV, reduce the residual risk of virus, bacterial or parasite transmission and eliminate the transmission of newly emerging and re-emerging pathogens as well as the risk of bacterial contamination, mainly of platelet concentrates which are stored at room temperature. In addition, their application would minimize the use of gamma irradiation, since they are equally effective in the elimination of residual lymphocytes in blood packs, therefore preventing transfusion-associated graft-vs-host disease (TA-GVHD). It is certain that the extended application of these new methods will reduce the residual risk of transfusion pathogen transmission even further. However, questions arise about the haemostatic effectiveness of blood products that are exposed to these treatments, that is if they are equally sufficient with common blood products in the prevention and treatment of bleeding, especially in hematologic patients that require frequent transfusions. It is vital that the blood products maintain their haemostatic effectiveness, after their exposure to treatment, along with the integrity of the cellular components of platelets and red blood cells concentrates, and coagulation factors of plasma units. In order for these parameters to be evaluated it is necessary that a number of clinical trials be carried out with a large number of participants, including in vitro studies. The results of the clinical trials concerning deactivated platelets and plasma are encouraging thus far, which has led to wide usage of these products in the last decade. It appears that, in general, they are equally safe and effective with common blood products, and the observed loss of power is of small clinical significance. In order for the results to prove credible, more clinical trials should be conducted with a greater number of participants, including special categories of patients, such as pediatric patients. Finally, advancements in the deactivation of red blood cell concentrates are still required.
