Platelets are an important therapeutic component for transfusion support of patients with quantitative or qualitative platelet disorders.  Based on the most recent national survey of blood use, ~2.5 million platelet components were transfused in the US in 20171.  Physicians who prescribe platelets, and the patients who receive them, expect their platelets to be safe and effective.

figure 2 mi

 

The risk of acquiring a transfusion-transmitted infection (TTI) due to a contaminating pathogen in a platelet unit has been reduced by improved donor screening and testing methods. However, risks remain due to infection window-periods, emergence of new pathogens, and/or re-emergence of recognized pathogens, in blood donor populations for which sensitive tests are unavailable or unused2.  The majority of patients who require platelet therapy receive multiple platelet units, frequently having extended periods of transfusion support, with exposure to multiple donors.  Thus, the per-patient risk of TTI is considerably greater than the contamination risk per platelet component. 

While donor screening and testing have improved, these are inherently reactive measures. They require time to recognize/identify the pathogen, and develop efficacious tests for it. When new pathogens emerge a large proportion of donor populations can be rapidly infected, and a substantial proportion may be asymptomatic3-5.  Thus, despite improvements in blood donor testing, there is a need for proactive pathogen reduced platelet products to further reduce the risk of TTI for all indications where platelet transfusion is required, while maintaining therapeutic efficacy and safety. 

 


  1. EllingsonKD, et al. Transfusion 2017;57 Suppl2:1588-98.
  2. Kleinman, S., et al., Modeling the risk of an emerging pathogen entering the Canadian blood supply. Transfusion, 2010. 50: p. 2592-2606.
  3. Brouard, C., et al., Estimated risk of Chikungunya viremic blood donation during an epidemic on Reunion Island in the Indian Ocean, 2005 to 2007. Transfusion, 2008. 48: p. 1333-1341.
  4. Stramer, S.L., et al., Dengue viremia in blood donors identified by RNA and detection of dengue transfusion transmission during the 2007 dengue outbreak in Puerto Rico. Transfusion, 2012. 52: p. 1657-66.
  5. W. Van Bortel, et al., Chikungunya outbreak in the Caribbean region, December 2013 to March 2014, and the significance for Europe. Eurosurveillance, 2014. 19(13): p. pii=20759.