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Aurich K, Fregin B, Palankar R, Wesche J, Hartwich O, Biedenweg D, Nguyen TH, Greinacher A, Otto O. Label-free on chip quality assessment of cellular blood products using real-time deformability cytometry. LAB ON A CHIP 2020; 20:2306-2316. [PMID: 32458864 DOI: 10.1039/d0lc00258e] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Without cellular blood products such as platelet concentrates (PC), red blood cell concentrates (RCC), and hematopoietic stem cells (HPSC) modern treatments in medicine would not be possible. An unresolved challenge is the assessment of their quality with minimal cell manipulation. Minor changes in production, storage conditions, or blood bag composition may impact cell function, which can have important consequences on product integrity. This is especially relevant for personalized medicine, such as autologous T-cell therapy. Today a robust methodology that globally determines cell status directly before transfusion or transplantation is lacking. We demonstrate that measuring viscoelastic characteristics of peripheral blood cells using real-time deformability cytometry (RT-DC) provides comprehensive information on product quality, which is not accessible using conventional quality control tests. In addition, RT-DC requires few cells, a minimal sample volume and has a rapid turnaround time. We compared RT-DC to standard in vitro quality assays assessing: i) PC after storage at 4 °C and room temperature; ii) magnetic nanoparticle labeled platelets; iii) RCC stored in blood bags with different plasticizers; iv) RCC after gamma irradiation; and v) HPSC after cryopreservation with 5% or 10% dimethyl sulfoxide, respectively. Additionally, we evaluated the engraftment time of patients' platelets and leukocytes after transplantation of HPSC products. Our results demonstrate that label-free mechano-phenotyping can be used as a potential biomarker for quality assessment of cell-based pharmaceutical products.
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Affiliation(s)
- Konstanze Aurich
- Transfusionsmedizin, Universitätsmedizin Greifswald, 17475 Greifswald, Germany.
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2
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New strategies for the control of infectious and parasitic diseases in blood donors: the impact of pathogen inactivation methods. EUROBIOTECH JOURNAL 2020. [DOI: 10.2478/ebtj-2020-0007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Abstract
Around 70 infectious agents are possible threats for blood safety.
The risk for blood recipients is increasing because of new emergent agents like West Nile, Zika and Chikungunya viruses, or parasites such as Plasmodium and Trypanosoma cruzi in non-endemic regions, for instance.
Screening programmes of the donors are more and more implemented in several Countries, but these cannot prevent completely infections, especially when they are caused by new agents.
Pathogen inactivation (PI) methods might overcome the limits of the screening and different technologies have been set up in the last years.
This review aims to describe the most widely used methods focusing on their efficacy as well as on the preservation integrity of blood components.
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3
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Godbey EA, Thibodeaux SR. Ensuring safety of the blood supply in the United States: Donor screening, testing, emerging pathogens, and pathogen inactivation. Semin Hematol 2019; 56:229-235. [PMID: 31836028 DOI: 10.1053/j.seminhematol.2019.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Safety of the blood supply has been a critical aspect of the transfusion medicine field since its inception, including infections that can be passed to a blood product recipient. Reactive efforts to identify potentially infected blood products are used throughout the blood donation process and afterward. Before donation, potential donors are provided educational materials about infection risks, examined and then screened through a series of questions that help temporarily, permanently, or indefinitely defer donors who could harbor acute and/or chronic infections. During donation, aseptic technique and diversion pouches reduce the potential to introduce bacteria into the blood product. Before transfusion, the blood products are tested for several infectious diseases by serology, nucleic acid testing, or a combination. During transfusion, the patient is monitored closely, and suspected transfusion reactions should be reported and investigated. The FDA regularly publishes guidance documents to incorporate knowledge gained regarding transfusion-transmitted infections, so that information can be shared and practices updated so that transfusion-related patient care can be optimized over time. Pathogen reduction processes are being developed and deployed that provide a proactive approach to both recognized and emerging pathogens.
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Affiliation(s)
| | - Suzanne R Thibodeaux
- Division of Laboratory and Genomic Medicine, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO.
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4
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Atreya C, Glynn S, Busch M, Kleinman S, Snyder E, Rutter S, AuBuchon J, Flegel W, Reeve D, Devine D, Cohn C, Custer B, Goodrich R, Benjamin RJ, Razatos A, Cancelas J, Wagner S, Maclean M, Gelderman M, Cap A, Ness P. Proceedings of the Food and Drug Administration public workshop on pathogen reduction technologies for blood safety 2018 (Commentary, p. 3026). Transfusion 2019; 59:3002-3025. [PMID: 31144334 PMCID: PMC6726584 DOI: 10.1111/trf.15344] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 05/06/2019] [Accepted: 05/06/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Chintamani Atreya
- US Food and Drug Administration, Center for Biologics Evaluation and ResearchOffice of Blood Research and ReviewSilver SpringMaryland
| | - Simone Glynn
- National Heart Lung and Blood InstituteBethesdaMarylandUSA
| | | | | | - Edward Snyder
- Blood BankYale‐New Haven HospitalNew HavenConnecticut
| | - Sara Rutter
- Department of Pathology and Laboratory MedicineYale School of MedicineNew HavenConnecticut
| | - James AuBuchon
- Department of PathologyDartmouth‐Hitchcock Medical CenterLebanonNew Hampshire
| | - Willy Flegel
- Department of Transfusion MedicineNIH Clinical CenterBethesdaMaryland
| | - David Reeve
- Blood ComponentsAmerican Red CrossRockvilleMaryland
| | - Dana Devine
- Department of Lab Medicine and PathologyUniversity of Minnesota Medical CenterMinneapolisMinnesota
| | - Claudia Cohn
- Department of Lab Medicine and PathologyUniversity of Minnesota Medical CenterMinneapolisMinnesota
| | - Brian Custer
- Vitalant Research InstituteSan FranciscoCalifornia
| | - Raymond Goodrich
- Department of Microbiology, Immunology and PathologyColorado State UniversityFort CollinsColorado
| | | | | | - Jose Cancelas
- Hoxworth Blood CenterUniversity of Cincinnati HealthCincinnatiOhio
| | | | - Michelle Maclean
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST)University of StrathclydeGlasgowScotland
| | - Monique Gelderman
- Department of HematologyCenter for Biologics Evaluation and Research, US Food and Drug AdministrationSilver SpringMaryland
| | - Andrew Cap
- U.S. Army Institute of Surgical ResearchSan AntonioTexas
| | - Paul Ness
- Blood BankJohns Hopkins HospitalBaltimoreMaryland
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Bahar B, Tormey CA. Prevention of Transfusion-Associated Graft-Versus-Host Disease With Blood Product Irradiation: The Past, Present, and Future. Arch Pathol Lab Med 2018; 142:662-667. [DOI: 10.5858/arpa.2016-0620-rs] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Transfusion-associated graft-versus-host disease (TA-GVHD) is a disease with a very high mortality rate. In this report, we discuss TA-GVHD from a historical perspective, highlight the pathogenesis of TA-GVHD, and emphasize the importance of blood product irradiation, which is a very effective means to prevent this disease. We summarize the current recommendations in different patient populations from different countries and review recent developments, such as alternatives for the use of radioactive materials. We also speculate on future directions.
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Affiliation(s)
| | - Christopher A. Tormey
- From the Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut (Drs Bahar and Tormey); and the Pathology and Laboratory Medicine Service, VA Connecticut Healthcare System, West Haven, Connecticut (Dr Tormey)
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6
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Cushing MM, Kelley J, Klapper E, Friedman DF, Goel R, Heddle NM, Hopkins CK, Karp JK, Pagano MB, Perumbeti A, Ramsey G, Roback JD, Schwartz J, Shaz BH, Spinella PC, Cohn CS, Cohn CS, Cushing MM, Kelley J, Klapper E. Critical developments of 2017: a review of the literature from selected topics in transfusion. A committee report from the AABB Clinical Transfusion Medicine Committee. Transfusion 2018. [PMID: 29520794 DOI: 10.1111/trf.14520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The AABB compiles an annual synopsis of the published literature covering important developments in the field of Transfusion Medicine. For the first time, an abridged version of this work is being made available in TRANSFUSION, with the full-length report available as an Appendix S1 (available as supporting information in the online version of this paper). STUDY DESIGN AND METHODS Papers published in 2016 and early 2017 are included, as well as earlier papers cited for background. Although this synopsis is comprehensive, it is not exhaustive, and some papers may have been excluded or missed. RESULTS The following topics are covered: duration of red blood cell storage and clinical outcomes, blood donor characteristics and patient outcomes, reversal of bleeding in hemophilia and for patients on direct oral anticoagulants, transfusion approach to hemorrhagic shock, pathogen inactivation, pediatric transfusion medicine, therapeutic apheresis, and extracorporeal support. CONCLUSION This synopsis may be a useful educational tool.
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Affiliation(s)
| | - James Kelley
- Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ellen Klapper
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - David F Friedman
- Blood Bank and Transfusion Medicine Department, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ruchika Goel
- Department of Pathology, Weill Cornell Medicine, New York, New York
| | - Nancy M Heddle
- McMaster Center for Transfusion Research, McMaster University, Hamilton, Ontario, Canada
| | | | - Julie Katz Karp
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
| | - Monica B Pagano
- Transfusion Medicine Division, Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - Ajay Perumbeti
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California
| | - Glenn Ramsey
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - John D Roback
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Joseph Schwartz
- Department of Pathology and Cell Biology, Columbia University Medical Center and the New York-Presbyterian Hospital
| | | | - Philip C Spinella
- Department of Pediatrics, Division of Pediatric Critical Care, Washington University School of Medicine, St Louis, Missouri
| | - Claudia S Cohn
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - Claudia S Cohn
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | | | - James Kelley
- Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ellen Klapper
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California
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Roberts DJ. Expanding access to Transfusion Medicine and improving practice: guidelines, patient blood management, protocols and products. Transfus Med 2017; 27 Suppl 5:315-317. [PMID: 29076249 DOI: 10.1111/tme.12484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- D J Roberts
- National Health Service Blood and Transplant, University of Oxford, John Radcliffe Hospital, Oxford, UK
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Drew VJ, Barro L, Seghatchian J, Burnouf T. Towards pathogen inactivation of red blood cells and whole blood targeting viral DNA/RNA: design, technologies, and future prospects for developing countries. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2017; 15:512-521. [PMID: 28488960 PMCID: PMC5649960 DOI: 10.2450/2017.0344-16] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 12/15/2016] [Indexed: 01/22/2023]
Abstract
Over 110 million units of blood are collected yearly. The need for blood products is greater in developing countries, but so is the risk of contracting a transfusion-transmitted infection. Without efficient donor screening/viral testing and validated pathogen inactivation technology, the risk of transfusion-transmitted infections correlates with the infection rate of the donor population. The World Health Organization has published guidelines on good manufacturing practices in an effort to ensure a strong global standard of transfusion and blood product safety. Sub-Saharan Africa is a high-risk region for malaria, human immunodeficiency virus (HIV), hepatitis B virus and syphilis. Southeast Asia experiences high rates of hepatitis C virus. Areas with a tropical climate have an increased risk of Zika virus, Dengue virus, West Nile virus and Chikungunya, and impoverished countries face economical limitations which hinder efforts to acquire the most modern pathogen inactivation technology. These systems include Mirasol® Pathogen Reduction Technology, INTERCEPT®, and THERAFLEX®. Their procedures use a chemical and ultraviolet or visible light for pathogen inactivation and significantly decrease the threat of pathogen transmission in plasma and platelets. They are licensed for use in Europe and are used in several other countries. The current interest in the blood industry is the development of pathogen inactivation technologies that can treat whole blood (WB) and red blood cell (RBC). The Mirasol system has recently undergone phase III clinical trials for treating WB in Ghana and has demonstrated some efficacy toward malaria inactivation and low risk of adverse effects. A 2nd-generation of the INTERCEPT® S-303 system for WB is currently undergoing a phase III clinical trial. Both methodologies are applicable for WB and components derived from virally reduced WB or RBC.
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Affiliation(s)
- Victor J. Drew
- International PhD Program of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taiwan
| | - Lassina Barro
- International PhD Program of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taiwan
- National Center of Blood Transfusion, Ouagadougou, Burkina Faso, United Kingdom
| | - Jerard Seghatchian
- International Consultancy in Blood Components Quality Improvement/Safety, Audit/Inspection and DDR Strategy, London, United Kingdom
| | - Thierry Burnouf
- International PhD Program of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taiwan
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taiwan
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Laughhunn A, Santa Maria F, Broult J, Lanteri MC, Stassinopoulos A, Musso D, Aubry M. Amustaline (S-303) treatment inactivates high levels of Zika virus in red blood cell components. Transfusion 2017; 57:779-789. [DOI: 10.1111/trf.13993] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 12/01/2016] [Accepted: 12/04/2016] [Indexed: 12/16/2022]
Affiliation(s)
| | | | - Julien Broult
- Centre de Transfusion Sanguine de la Polynésie Française, Hôpital du Taaone
| | | | | | - Didier Musso
- Pôle de Recherche et de Veille sur les Maladies Infectieuses Émergentes, Institut Louis Malardé; Tahiti Polynésie Française
| | - Maite Aubry
- Pôle de Recherche et de Veille sur les Maladies Infectieuses Émergentes, Institut Louis Malardé; Tahiti Polynésie Française
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