Topic Teaching: Pathogen Reduction Technologies: A Review of Existing Technologies and Published Data

Presented by:

Raymond P. Goodrich, PhD
Executive Director, Infectious Disease Research Center
Office of the Vice President for Research
Professor, Department of Microbiology, Immunology and Pathology
Colorado State University

Objectives:

1.    Discuss basic concepts and methods for inactivation of pathogens in blood products.
2.    Review literature on clinical performance of PRT treated products.
3.    Discuss pathogen reduction performance levels and clinical outcomes observed.
4.    Consider applications of pathogen reduction in addressing emerging diseases from a blood transfusion standpoint.
5.    Discuss experience with COVID-19, convalescent plasma and use of PRT methods.

References:

1.    Janna M. Mundt, Lindsay Rouse, Jeroen Van den Bossche and Raymond P. Goodrich.  Chemical and Biological Mechanisms of Pathogen Reduction Technologies Photochemistry and Photobiology (2014) DOI: 10.1111/php.12311
2.    Estcourt LJ, Malouf R, Hopewell S, et al. Pathogen-reduced platelets for the prevention of bleeding. Cochrane Database Systematic Review (2017);7:CD009072
3.    Frédéric Garban, Audrey Guyard , Helene Labussière , Claude-Eric Bulabois, et al. Comparison of the Hemostatic Efficacy of Pathogen-Reduced Platelets vs Untreated Platelets in Patients With Thrombocytopenia and Malignant Hematologic Diseases: A Randomized Clinical Trial. JAMA Oncology; (2018); 4(4):468-475. doi: 10.1001/jamaoncol.2017.5123.
4.    Rebulla P, Garban F, van der Meer PF, Heddle NM, McCullough J. A crosswalk tabular review on methods and outcomes from randomized clinical trials using pathogen reduced platelets.Transfusion (2020);60(6):1267-1277. doi: 10.1111/trf.15791. Epub 2020 Apr 23.
5.    Bah A, Cardoso M, Seghatchian J, Goodrich RP.Reflections on the dynamics of bacterial and viral contamination of blood components and the levels of efficacy for pathogen inactivation processes. Transfusion and Apheresis Science (2018);57(5):683-688. doi: 10.1016/j.transci.2018.09.004. Epub 2018 Sep 11.
6.    Lisette Hauser 1, Anne-Marie Roque-Afonso, Alexandre Beylouné, Marion Simonet, Bénédicte Deau Fischer, Nicolas Burin des Roziers, Vincent Mallet, Pierre Tiberghien, Philippe Bierling Hepatitis E transmission by transfusion of Intercept blood system-treated plasma.  Blood (2014); 30;123(5):796-7. doi: 10.1182/blood-2013-09-524348.
7.    Allain JP, Owusu-Ofori AK, Assennato SM, Marschner S, Goodrich RP, Owusu-Ofori S.  Effect of Plasmodium inactivation in whole blood on the incidence of blood transfusion-transmitted malaria in endemic regions: the African Investigation of the Mirasol System (AIMS) randomised controlled trial.Lancet (2016); 23;387(10029):1753-61. doi: 10.1016/S0140-6736(16)00581-X.
8.    Jayaraman S, Chalabi Z, Perel P, Guerriero C, Roberts I. The risk of transfusion-transmitted infections in sub-Saharan Africa. Transfusion. (2010);50(2):433-42. doi: 10.1111/j.1537-2995.2009.002402.x. Epub 2009 Oct 15.PMID: 19843290.
9.    Mirasol Evaluation of Reduction in Infections Trial (MERIT). NCT03737669. www.clinicaltrials.gov.
10.  Goodrich, R.P., Ignorance Is Not Bliss. Transfusion. (2018);58(3):615-616. doi: 10.1111/trf.14486.
11.   Tiffany Thomas, Davide Stefanoni, Monika Dzieciatkowska, Aaron Issaian, Travis Nemkov, Ryan C Hill, Richard O Francis, Krystalyn E Hudson, Paul W Buehler, James C Zimring, Eldad A Hod,Kirk C Hansen, Steven L Spitalnik, Angelo D'Alessandro  Evidence for structural protein damage and membrane lipid remodeling in red blood cells from COVID-19 patients. MedRXIV (2020) doi: https://doi.org/10.1101/2020.06.29.20142703
12.  Ragan I, Hartson L, Pidcoke H, Bowen R, Goodrich R. Pathogen reduction of SARS-CoV-2 virus in plasma and whole blood using riboflavin and UV light.  PLoS One. (2020); 29;15(5):e0233947. doi: 10.1371/journal.pone.0233947.
13.  https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf  
14.  https://www.history.com/news/blood-plasma-covid-19-measles-spanish-flu
15.  Duan K, Liu B, Li C, Zhang H, Yu T, Qu J, Zhou M, Chen L, Meng S, Hu Y, Peng C, Yuan M, Huang J, et. al. Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proc Natl Acad Sci U S A. (2020); 28;117(17):9490-9496. doi: 10.1073/pnas.2004168117. Epub 2020
16.   Ettinger A, Miklauz MM, Hendrix BK, Bihm DJ, Maldonado-Codina G, Goodrich RP.  Protein stability of previously frozen plasma, riboflavin and UV light-treated, refrozen and stored for up to 2 years at -30 °C. Transfusion and Apheresis Science. (2011) ;44(1):25-31. doi: 10.1016/j.transci.2010.12.005. Epub 2011 Jan 19.
17.  Maintaining a safe and adequate blood supply during the pandemic outbreak of coronavirus disease (COVID-19) ; Interim guidance, WHO 20 March 2020.
18.  FDA Investigational COVID-19 Convalescent Plasma - Emergency INDs March 24, 2020.
19.  EU programme of COVID-19 convalescent plasma collection and transfusion EUROPEAN COMMISSION DIRECTORATE-GENERAL FOR HEALTH AND FOOD SAFETY; April 8, 2020;   https://www.isbtweb.org/working-parties/global-blood-safety/

Note: The session is a self-approved group learning activity (Section 1) as defined by the Maintenance of Certification program of The Royal College of Physicians and Surgeons of Canada.

To register for the LearnTransfusion series, send an email to learn.transfusion@blood.ca with  “Weekly Transfusion Medicine Seminars” in the subject line. Include your name and complete e-mail address in the body of the e-mail, and confirm that you would like to register for the LearnTransfusion series. You will then receive weekly email notifications of upcoming series events with details on how to join the webinars (e.g., call-in number and a link to register for the webinar).

The LearnTransfusion series is the seminar component of the Areas of Focused Competency (AFC)-Diploma Program in Transfusion Medicine. The series, organized by Canadian Blood Services is also open to all practitioners in the field of Transfusion Medicine. Through a series of regular webinars, trainees and practitioners are exposed to various scientific, technical and clinical aspects of transfusion medicine.