Evaluating pathogen reduction of Trypanosoma cruzi with riboflavin and ultraviolet light for whole blood
BACKGROUND: Trypanosoma cruzi, the protozoan parasitic agent of Chagas disease, can be transmitted by blood transfusion. In 2007, most US blood banks started screening blood donations for T. cruzi, but the cost and perceived need of the test have been the subject of ongoing discussion. In this study...
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| Published in | Transfusion (Philadelphia, Pa.) Vol. 52; no. 2; pp. 409 - 416 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Malden, USA
Blackwell Publishing Inc
01.02.2012
Wiley |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0041-1132 1537-2995 1537-2995 |
| DOI | 10.1111/j.1537-2995.2011.03285.x |
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| Abstract | BACKGROUND: Trypanosoma cruzi, the protozoan parasitic agent of Chagas disease, can be transmitted by blood transfusion. In 2007, most US blood banks started screening blood donations for T. cruzi, but the cost and perceived need of the test have been the subject of ongoing discussion. In this study, we evaluated the ability of the Mirasol System (CaridianBCT), which uses riboflavin (RB) and ultraviolet light to inactivate pathogens, to reduce the levels of infectious T. cruzi in whole blood (WB).
STUDY DESIGN AND METHODS: WB units were inoculated with 4, 40, 400, and 4000 trypomastigotes/mL. After addition of RB and illumination at various energy levels, the samples were tested for the presence of live parasites by hemoculture.
RESULTS: All preillumination samples exhibited T. cruzi growth in hemoculture, while postillumination samples from units containing 4 and 40 trypomastigotes/mL showed no signs of viable parasites after 16 weeks of culture. In contrast, at both 400 and 4000 parasites/mL, two of the three units were positive for viable parasites.
CONCLUSIONS: The total log reduction observed for T. cruzi was 3.5 log or greater, but less than 4.5 log. This level of reduction is likely to be orders of magnitude higher than what would be expected in a tainted blood donation, indicating that the Mirasol System could be effective at preventing transfusion of the causative agent of Chagas disease. |
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| AbstractList | Trypanosoma cruzi, the protozoan parasitic agent of Chagas disease, can be transmitted by blood transfusion. In 2007, most US blood banks started screening blood donations for T. cruzi, but the cost and perceived need of the test have been the subject of ongoing discussion. In this study, we evaluated the ability of the Mirasol System (CaridianBCT), which uses riboflavin (RB) and ultraviolet light to inactivate pathogens, to reduce the levels of infectious T. cruzi in whole blood (WB).
WB units were inoculated with 4, 40, 400, and 4000 trypomastigotes/mL. After addition of RB and illumination at various energy levels, the samples were tested for the presence of live parasites by hemoculture.
All preillumination samples exhibited T. cruzi growth in hemoculture, while postillumination samples from units containing 4 and 40 trypomastigotes/mL showed no signs of viable parasites after 16 weeks of culture. In contrast, at both 400 and 4000 parasites/mL, two of the three units were positive for viable parasites.
The total log reduction observed for T. cruzi was 3.5 log or greater, but less than 4.5 log. This level of reduction is likely to be orders of magnitude higher than what would be expected in a tainted blood donation, indicating that the Mirasol System could be effective at preventing transfusion of the causative agent of Chagas disease. BACKGROUND: Trypanosoma cruzi, the protozoan parasitic agent of Chagas disease, can be transmitted by blood transfusion. In 2007, most US blood banks started screening blood donations for T. cruzi, but the cost and perceived need of the test have been the subject of ongoing discussion. In this study, we evaluated the ability of the Mirasol System (CaridianBCT), which uses riboflavin (RB) and ultraviolet light to inactivate pathogens, to reduce the levels of infectious T. cruzi in whole blood (WB). STUDY DESIGN AND METHODS: WB units were inoculated with 4, 40, 400, and 4000 trypomastigotes/mL. After addition of RB and illumination at various energy levels, the samples were tested for the presence of live parasites by hemoculture. RESULTS: All preillumination samples exhibited T. cruzi growth in hemoculture, while postillumination samples from units containing 4 and 40 trypomastigotes/mL showed no signs of viable parasites after 16 weeks of culture. In contrast, at both 400 and 4000 parasites/mL, two of the three units were positive for viable parasites. CONCLUSIONS: The total log reduction observed for T. cruzi was 3.5 log or greater, but less than 4.5 log. This level of reduction is likely to be orders of magnitude higher than what would be expected in a tainted blood donation, indicating that the Mirasol System could be effective at preventing transfusion of the causative agent of Chagas disease. BACKGROUND: Trypanosoma cruzi, the protozoan parasitic agent of Chagas disease, can be transmitted by blood transfusion. In 2007, most US blood banks started screening blood donations for T. cruzi , but the cost and perceived need of the test have been the subject of ongoing discussion. In this study, we evaluated the ability of the Mirasol System (CaridianBCT), which uses riboflavin (RB) and ultraviolet light to inactivate pathogens, to reduce the levels of infectious T. cruzi in whole blood (WB). STUDY DESIGN AND METHODS: WB units were inoculated with 4, 40, 400, and 4000 trypomastigotes/mL. After addition of RB and illumination at various energy levels, the samples were tested for the presence of live parasites by hemoculture. RESULTS: All preillumination samples exhibited T. cruzi growth in hemoculture, while postillumination samples from units containing 4 and 40 trypomastigotes/mL showed no signs of viable parasites after 16 weeks of culture. In contrast, at both 400 and 4000 parasites/mL, two of the three units were positive for viable parasites. CONCLUSIONS: The total log reduction observed for T. cruzi was 3.5 log or greater, but less than 4.5 log. This level of reduction is likely to be orders of magnitude higher than what would be expected in a tainted blood donation, indicating that the Mirasol System could be effective at preventing transfusion of the causative agent of Chagas disease. BACKGROUND:Trypanosoma cruzi, the protozoan parasitic agent of Chagas disease, can be transmitted by blood transfusion. In 2007, most US blood banks started screening blood donations for T.cruzi, but the cost and perceived need of the test have been the subject of ongoing discussion. In this study, we evaluated the ability of the Mirasol System (CaridianBCT), which uses riboflavin (RB) and ultraviolet light to inactivate pathogens, to reduce the levels of infectious T.cruzi in whole blood (WB). STUDY DESIGN AND METHODS: WB units were inoculated with 4, 40, 400, and 4000 trypomastigotes/mL. After addition of RB and illumination at various energy levels, the samples were tested for the presence of live parasites by hemoculture. RESULTS: All preillumination samples exhibited T.cruzi growth in hemoculture, while postillumination samples from units containing 4 and 40 trypomastigotes/mL showed no signs of viable parasites after 16 weeks of culture. In contrast, at both 400 and 4000 parasites/mL, two of the three units were positive for viable parasites. CONCLUSIONS: The total log reduction observed for T.cruzi was 3.5 log or greater, but less than 4.5 log. This level of reduction is likely to be orders of magnitude higher than what would be expected in a tainted blood donation, indicating that the Mirasol System could be effective at preventing transfusion of the causative agent of Chagas disease. Trypanosoma cruzi, the protozoan parasitic agent of Chagas disease, can be transmitted by blood transfusion. In 2007, most US blood banks started screening blood donations for T. cruzi, but the cost and perceived need of the test have been the subject of ongoing discussion. In this study, we evaluated the ability of the Mirasol System (CaridianBCT), which uses riboflavin (RB) and ultraviolet light to inactivate pathogens, to reduce the levels of infectious T. cruzi in whole blood (WB).BACKGROUNDTrypanosoma cruzi, the protozoan parasitic agent of Chagas disease, can be transmitted by blood transfusion. In 2007, most US blood banks started screening blood donations for T. cruzi, but the cost and perceived need of the test have been the subject of ongoing discussion. In this study, we evaluated the ability of the Mirasol System (CaridianBCT), which uses riboflavin (RB) and ultraviolet light to inactivate pathogens, to reduce the levels of infectious T. cruzi in whole blood (WB).WB units were inoculated with 4, 40, 400, and 4000 trypomastigotes/mL. After addition of RB and illumination at various energy levels, the samples were tested for the presence of live parasites by hemoculture.STUDY DESIGN AND METHODSWB units were inoculated with 4, 40, 400, and 4000 trypomastigotes/mL. After addition of RB and illumination at various energy levels, the samples were tested for the presence of live parasites by hemoculture.All preillumination samples exhibited T. cruzi growth in hemoculture, while postillumination samples from units containing 4 and 40 trypomastigotes/mL showed no signs of viable parasites after 16 weeks of culture. In contrast, at both 400 and 4000 parasites/mL, two of the three units were positive for viable parasites.RESULTSAll preillumination samples exhibited T. cruzi growth in hemoculture, while postillumination samples from units containing 4 and 40 trypomastigotes/mL showed no signs of viable parasites after 16 weeks of culture. In contrast, at both 400 and 4000 parasites/mL, two of the three units were positive for viable parasites.The total log reduction observed for T. cruzi was 3.5 log or greater, but less than 4.5 log. This level of reduction is likely to be orders of magnitude higher than what would be expected in a tainted blood donation, indicating that the Mirasol System could be effective at preventing transfusion of the causative agent of Chagas disease.CONCLUSIONSThe total log reduction observed for T. cruzi was 3.5 log or greater, but less than 4.5 log. This level of reduction is likely to be orders of magnitude higher than what would be expected in a tainted blood donation, indicating that the Mirasol System could be effective at preventing transfusion of the causative agent of Chagas disease. |
| Author | Tonnetti, Laura Keil, Shawn D. Goodrich, Raymond P. Thorp, Aaron M. Leiby, David A. Reddy, Heather L. |
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| Keywords | Kinetoplastida Riboflavin Protozoa B-Vitamins Transfusion Trypanosoma cruzi |
| Language | English |
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| Notes | ArticleID:TRF3285 ark:/67375/WNG-317R1MXH-T istex:25E531DCBC10EEE0CFBF5BD9E572FF5CE7AE50A1 Supported by CaridianBCT Biotechnologies, DOD Grant W8IXWH‐05‐2‐0001. The U.S. Army Medical Research Acquisition Activity is the awarding and administering acquisition office. The content of the information contained herein does not necessarily reflect the position or the policy of the government and no official endorsement should be inferred. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Undefined-1 ObjectType-Feature-3 |
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ISBT Sci Ser 2007;2:6-11. 2004; 44 1993; 89 2010; 38 2011 1947; 45 2002; 51 2006; 55 1955; 159 1989; 111 1999; 341 2006 2007; 56 1996; 54 2007; 13 2009; 48 2007; 37 1999 1984; 251 2006; 46 2009; 50 2008; 22 2007; 2 1975; 22 2007; 84 2009; 3 2009; 19 2007; 47 2010; 50 2000; 181 e_1_2_7_5_2 e_1_2_7_3_2 e_1_2_7_9_2 e_1_2_7_7_2 e_1_2_7_6_2 e_1_2_7_19_2 e_1_2_7_18_2 e_1_2_7_17_2 e_1_2_7_16_2 e_1_2_7_15_2 Centers for Disease Control and Prevention (e_1_2_7_11_2) 2002; 51 e_1_2_7_14_2 e_1_2_7_13_2 Weinman D (e_1_2_7_4_2) 1947; 45 e_1_2_7_10_2 CDC (e_1_2_7_31_2) 2007; 56 Centers for Disease Control and Prevention (e_1_2_7_12_2) 2006; 55 e_1_2_7_26_2 e_1_2_7_27_2 e_1_2_7_28_2 e_1_2_7_29_2 Organización Panamericana de la Salud (e_1_2_7_2_2) 2006 Cimo PL (e_1_2_7_8_2) 1993; 89 e_1_2_7_25_2 e_1_2_7_24_2 e_1_2_7_30_2 e_1_2_7_23_2 e_1_2_7_22_2 e_1_2_7_32_2 e_1_2_7_21_2 e_1_2_7_20_2 |
| References_xml | – reference: Weinman D, MacAlister J. Prolonged storage of human phatogenic protozoa with conservation of virulence. Am J Hyg 1947;45:102-21. – reference: Asano H, Lee CY, Fox-Talbot K, Koh CM, Erdinc MM, Marschner K, Keil S, Goodrich R, Baldwin WM 3rd. Treatment with riboflavin and ultraviolet light prevents alloimmunization to platelet transfusion and cardiac transplant. Transplantation 2007;84:1174-82. – reference: Filardi LS, Brener Z. Cryopreservation of Trypanosoma cruzi bloodstream forms. J Protozool 1975;22:398-401. – reference: Schiffler RJ, Mansur GP, Navin TR, Limpakarnjanarat K. Indigenous Chagas' disease (American trypanosomiasis) in California. JAMA 1984;251:2983-4. – reference: Young C, Losikoff P, Chawla A, Glasser L, Forman E. Transfusion-aquired Trypanosoma cruzi infection. Transfusion 2007;47:540-4. – reference: Cardo LJ, Salata J, Mendez J, Reddi H, Goodrich R. 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Cost-effectiveness of screening the US blood supply for Trypanosoma cruzi. Transfusion 2010;50:2220-32. – reference: Grant IH, Gold JW, Wittner M, Tanowitz HB, Nathan C, Mayer K, Reich L, Wollner N, Steinhertz L, Ghavimi F, O'Reilly RJ, Armstrong D. Transfusion-associated acute Chagas disease acquired in the United States. Ann Intern Med 1989;111:849-51. – reference: CDC. Blood donor screening for Chagas disease-United States, 2006-2007. MMWR Morb Mortal Wkly Rep 2007;56:141-3. – reference: Duffy T, Bisio M, Altcheh J, Burgos JM, Diez M, Levin MJ, Favaloro RR, Freilij H, Schijman AG. Accurate real-time PCR strategy for monitoring bloodstream parasitic loads in Chagas disease patients. PLoS Negl Trop Dis 2009;3:e419. – reference: Cimo PL, Luper EL, Scouros MA. Transfusion-associated Chagas' disease in Texas: report of a case. J Texas Med 1993;89:48-50. – reference: Nickerson P, Orr P, Schroeder ML, Sekla L, Johnson JB. Transfusion-associated Trypanosoma cruzi infection in a non-endemic area. Ann Intern Med 1989;111:851-3. – reference: Herwaldt BL, Grijalva MJ, Newsome AL, McGhee CR, Powell MR, Nemec DG, Steurer FJ, Eberhard ML. Use of polymerase chain reaction to fiagnose the fifth reported US case of autochthonous transmission of Trypanosoma cruzi in Tennessee,1998. J Infect Dis 2000;181:395-9. – reference: Castro E. Chagas's disease: lesson from routine donation testing. Transfus Med 2009;19:16-23. – reference: Kun H, Moore A, Mascola L, Steurer F, Lawrence G, Kubak B, Radhakrishna S, Leiby D, Herron R, Mone T, Hunter R, Kuehnert M; Chagas Disease in Transplant Recipients Investigation Team. Transmission of Trypanosoma cruzi by heart transplantation. CID 2009;48:1534-40. – reference: Ruane PH, Edrich R, Gampp D, Keil SD, Leonard RL, Goodrich RP. Photochemical inactivation of selected viruses and bacteria in platelets concentrated using riboflavin and light. Transfusion 2004;44:877-85. – reference: Fast LD, Dileone G, Li J, Goodrich R. Functional inactivation of white blood cells by Mirasol treatment. Transfusion 2006;46:642-8. – reference: Dorn PL, Perniciaro L, Yabsley MJ, Roelling DM, Balsamo G, Diaz J, Wesson D. Autochthonous transmission of Trypanosoma cruzi, Luisiana. Emerg Infect Dis 2007;13:605-7. – reference: Organización Panamericana de la Salud. Estimación cuantitativa de la enfermedad de Chagas en las Americas. Document OPS/HDM/CD/425-06. Montevideo, Uruguay: Organización Panamericana de la Salud; 2006. – reference: Schmunis GA. The globalization of Chagas disease. ISBT Sci Ser 2007;2:6-11. – reference: Fast LD, Dileone G, Cardarelli G, Li J, Goodrich R. Mirasol PRT treatment of donor white blood cells prevents the development of xenogenic grft-versus-host disease in Rag2-/-gamma C-/- double knockout mice. Transfusion 2006;46:1553-60. – reference: Goodrich RP, Doane S, Reddy HL. Design and development of a method for the reduction of infectious pathogen load and inactivation of white blood cells in whole blood products. Biologicals 2010;38:20-30. – reference: Leiby DA, Lenes BA, Tibbals MA, Tames-Olmedo MT. Prospect evaluation of a patient with Trypanosoma cruzi infection transmitted by transfusion. N Engl J Med 1999;341:1237-9. – reference: Cancelas JA, Dumont LJ, Rugg N, Szczepiorkowski ZM, Herschel L, Siegel A, Pratt PG, Worsham DN, Erickson A, Propst M, North A, Sherman CD, Mufti NA, Reed WF, Corash L. Stored red blood cell viability is maintained after treatment with a second-generation S-303 pathogen inactivation process. Transfusion 2011 (epub ahead of print). – reference: Centers for Disease Control and Prevention. Chagas disease after organ transplantation-United States, 2006. MMWR Morb Mortal Wkly Rep 2006;55:798-800. – reference: Tonnetti L, Proctor MC, Reddy HL, Goodrich RP, Leiby DA. 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| Snippet | BACKGROUND: Trypanosoma cruzi, the protozoan parasitic agent of Chagas disease, can be transmitted by blood transfusion. In 2007, most US blood banks started... BACKGROUND: Trypanosoma cruzi, the protozoan parasitic agent of Chagas disease, can be transmitted by blood transfusion. In 2007, most US blood banks started... Trypanosoma cruzi, the protozoan parasitic agent of Chagas disease, can be transmitted by blood transfusion. In 2007, most US blood banks started screening... BACKGROUND:Trypanosoma cruzi, the protozoan parasitic agent of Chagas disease, can be transmitted by blood transfusion. In 2007, most US blood banks started... |
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| SubjectTerms | 3T3 Cells Algorithms Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Animals Biological and medical sciences Blood Donors Blood-Borne Pathogens - drug effects Blood-Borne Pathogens - radiation effects Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis Cells, Cultured Chagas Disease - blood Chagas Disease - diagnosis Chagas Disease - prevention & control Chagas Disease - transmission Disinfectants - therapeutic use Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Humans Intensive care medicine Medical sciences Mice Microbial Viability - drug effects Microbial Viability - radiation effects Parasite Load Riboflavin - therapeutic use Sterilization - methods Transfusions. Complications. Transfusion reactions. Cell and gene therapy Trypanosoma cruzi Trypanosoma cruzi - drug effects Trypanosoma cruzi - growth & development Trypanosoma cruzi - isolation & purification Ultraviolet Rays |
| Title | Evaluating pathogen reduction of Trypanosoma cruzi with riboflavin and ultraviolet light for whole blood |
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