OxyFile #185
UI - 93236667
AU - Friedman LI
AU - Stromberg RR
TI - Viral inactivation and reduction in cellular blood products.
RF - REVIEW ARTICLE: 50 REFS.
AD - American Red Cross, Holland Laboratory, Rockville, MD.
AB - Even though the risks associated with the transfusion of blood
products are lower than ever before, considerable efforts are
being employed to improve the safety of the blood supply. Based
upon available data, a six log (99.9999%) reduction in virus
level from screened and tested blood components should
significantly reduce or eliminate the risk of post-transfusion
infection. The objective has been to identify generic methods,
that is, one that would be applicable to all virus. For red
cells, physical and chemical approaches have been studied; for
platelets, the approaches have been limited to chemical. The
physical methods include depletion of leukocytes by filtration,
removal of plasma by washing, and viral inactivation by heat.
Among the chemicals investigated to inactivate or help displace
virus are ozone, detergents, and hypochlorous acid. Several
photochemicals have also received intensive investigation:
merocyanine 540, a benzoporphyrin derivative, aluminum
phthalocyanine, and methylene blue. For platelets, photochemical
inactivation methods using merocyanine 540, and two psoralen
derivatives, 8-methoxypsoralen (8-MOP) and aminomethyl trimethyl
psoralen (AMT), have also been studied. Approaches which include
washing are not suitable. For the most part, either viral removal
or inactivation has been insufficient, or red cell or platelet
damage unacceptable. However, there are a few indications that at
least inactivation of a specific virus, such as HIV, may be
possible without major cell damage. These studies are in their
early stages and significant work remains. If feasibility is
clearly shown in vitro, it is likely that in vivo primate studies
to demonstrate safety and efficacy will be required.
PT - JOURNAL ARTICLE
PT - REVIEW
PT - REVIEW, TUTORIAL
LA - Eng
SO - Rev Fr Transfus Hemobiol 1993 Jan;36(1):83-91