Blood Supply Can Be Improved by Pathogen Inactivation Methods

The safety of the American blood supply is maintained by screening potential donors for a variety of risks, including recent infections, recent antibiotic intake, bleeding conditions, fever, and sexual practices, among others. The blood transfusion community should consider pathogen inactivation methods as an alternative way to assure the safety and availability of the nation's blood supply.

For example, if a person has traveled outside of the United States in the past 12 months, they may be prohibited from donating blood. Pathogen inactivation methods, which reduce the risk of human immunodeficiency virus (HIV), West Nile Virus (WNV), and Escherichia coli transmission, are now widely used in Europe, and offer several ways to test and treat blood for use.

The riboflavin method, which works by damaging DNA to eliminate its capability of regenerating, is effective for inactivating intracellular and extracellular HIV, West Nile virus, Staphylococcus, E. coli and several others.

The amotosalen method creates cross-links, preventing harmful DNA or RNA from separating and replicating. Amotosalen also inhibits the synthesis of certain proteins, reducing the likelihood of transfusion reactions. Amotosalen-treated platelets are now widely used in Europe and the riboflavin method was recently approved there. Amotosalen-treated platelets are awaiting approval by the U.S. Food and Drug Administration (FDA; Rockville, MD, USA).

Finally, the red blood cell (RBC) method cross-links DNA and RNA, effectively targeting nucleic acids in pathogens. Further developments are needed to begin a new phase II trial of this method in the United States.

"For more than 20 years we have used a method that includes asking potential donors a series of questions to determine whether or not we should use their blood,” said Jeffrey McCullough, M.D., FASCP, professor of laboratory medicine and pathology at the University of Minnesota (Minneapolis, MN, USA). "But now there are proactive methods available that allow us to use blood that we may not have used if we didn't get a certain answer. We could potentially be turning away a lot of usable blood with the question method. Someone very well may have traveled, but didn't contract anything.”

Prof. McCullough's review of the shortcomings of the current paradigm of blood banking and the newer pathogen inactivating methods appeared in the December 2007 issue of the American Journal of Clinical Pathology (AJCP).


Related Links:
University of Minnesota
U.S. Food and Drug Administration