The relative safety of pooled whole-blood-derived platelets prepared by the buffy-coat method versus single-donor (apheresis) platelets.
Conversion to a single-donor (apheresis) platelet inventory in Western Europe and other countries that provide similar health care to the US but rely on buffy-coat pooled whole-blood-derived platelets will confer the benefit of a > or = 2-fold reduction in the risk of all emerging transfusion-transmitted infections (TTIs). In Europe, this benefit will include a > or = 2-fold reduction in the risk of acquiring variant Creutzfeldt-Jakob disease (vCJD) from platelet transfusion. In countries that use buffy coats from first-time donors to produce platelet pools, there will also be a > or = 2-fold reduction in the risk of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus infections. Conversion to a single-donor inventory collected from male donors (or female donors without a history of pregnancy or shown not to have white-blood-cell antibodies) should also reduce the risk of transfusion-related acute lung injury, although this prediction is based on theory and may not materialize or prove hard to document. Because conversion to a single-donor inventory can effect a > or = 2-fold reduction in the risk of all TTIs without incurring any risk, it is a more advantageous risk-reduction strategy for emerging TTIs compared with the introduction of pathogen-reduction systems for platelets. The latter cannot protect from vCJD and potentially also from some other emerging TTIs; moreover, they have recently been associated with an increased risk of bleeding.
Vamvakas
Eleftherios C
EC
Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA. vamvakase@cshs.org
D001781:Blood Component Removal / Q000379:methods*; D001782:Blood Donors; D001792:Blood Platelets; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods; D008297:Male; D010983:Plateletpheresis / Q000379:methods*; D018570:Risk Assessment; D012307:Risk Factors