title: Treatment of Whole Blood With Riboflavin and UV Light: Impact on Malaria Parasite Viability and Whole Blood Storage.
abstract: BACKGROUND
  Sub-Saharan African countries utilize whole blood (WB) to treat severe anemia secondary to severe blood loss or malaria on an emergency basis. In many areas with high prevalence of transfusion-transmissible agents, blood safety measures are insufficient. Pathogen reduction technology applied to WB might considerably improve blood safety.
  
  
  METHODS
  Whole blood from 40 different donors were treated with riboflavin and UV light (pathogen reduction technology) in order to inactivate malaria parasite replication. The extent of parasite inactivation was determined using quantitative polymerase chain reaction methods and was correlated to studies evaluating the replication of malaria parasites in culture. Products were also stored for 21 days at +4°C and monitored for cell quality throughout storage.
  
  
  RESULTS
  Plasmodium amplicon was present in 21 samples (>100 copies/mL), doubtful in four (10-100 genome equivalents [gEq]/mL), and negative in 15 U. The majority of asymptomatic parasitemic donors carried low parasite levels, with only six donors above 5,000 copies/mL (15%). After treatment with riboflavin and UV light, these six samples demonstrated a 0.5 to 1.2 log reduction in quantitative polymerase chain reaction amplification. This correlated to equal to or greater than 6.4 log reductions in infectivity. In treated WB units, cell quality parameters remained stable; however, plasma hemoglobin increased to 0.15 g/dL. All markers behaved similarly to published data for stored, untreated WB.
  
  
  CONCLUSIONS
  Pathogen reduction technology treatment can inactivate malaria parasites in WB while maintaining adequate blood quality during posttreatment cold storage for 21 days.
authors.affiliation: *Transfusion Medicine Unit and †Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology/Komfo Anokye Teaching Hospital, Kumasi, Ghana; ‡Dept of Haematology, University of Cambridge, Cambridge, UK; and §Colorado State University, Ft Collins; and ∥Terumo BCT, Lakewood, Colorado.
authors.forename: Shirley
authors.initials: S
authors.lastname: Owusu-Ofori
authors.forename: Joseph
authors.initials: J
authors.lastname: Kusi
authors.forename: Alex
authors.initials: A
authors.lastname: Owusu-Ofori
authors.forename: Graham
authors.initials: G
authors.lastname: Freimanis
authors.forename: Christine
authors.initials: C
authors.lastname: Olver
authors.forename: Caitlyn R
authors.initials: CR
authors.lastname: Martinez
authors.forename: Shilo
authors.initials: S
authors.lastname: Wilkinson
authors.forename: Janna M
authors.initials: JM
authors.lastname: Mundt
authors.forename: Shawn D
authors.initials: SD
authors.lastname: Keil
authors.forename: Raymond P
authors.initials: RP
authors.lastname: Goodrich
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Allain
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara; D000740:Anemia / Q000628:therapy*; D001771:Blood Banks; D058731:Blood Safety; D001803:Blood Transfusion; D003140:Communicable Disease Control; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008288:Malaria / Q000097:blood / Q000469:parasitology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010963:Plasmodium falciparum / Q000187:drug effects* / Q000528:radiation effects*; D016133:Polymerase Chain Reaction; D012256:Riboflavin / Q000494:pharmacology*; D013696:Temperature; D014466:Ultraviolet Rays
chemical_list: D006454:Hemoglobins; D012256:Riboflavin