Photochemical inactivation with amotosalen and long-wavelength ultraviolet light of Plasmodium and Babesia in platelet and plasma components

• Published in: Transfusion (Philadelphia, Pa.) Vol. 48; no. 8; pp. 1676 - 1684
• Main Authors: Grellier, Philippe, Benach, Jorge, Labaied, Mehdi, Charneau, Sébastien, Gil, Horacio, Monsalve, Gloria, Alfonso, Ryan, Sawyer, Lynette, Lin, Lily, Steiert, Matthias, Dupuis, Kent
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.08.2008; Blackwell Publishing; Wiley
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Babesia; Babesia microti - drug effects; Babesia microti - growth & development; Babesia microti - radiation effects; Babesiosis - blood; Babesiosis - prevention & control; Babesiosis - transmission; Biological and medical sciences; Blood coagulation. Blood cells; Blood Component Removal; Blood Component Transfusion; Blood Donors; Blood Platelets - parasitology; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Chemical Sciences; Erythrocytes - parasitology; Fundamental and applied biological sciences. Psychology; Furocoumarins; Humans; Life Sciences; Malaria, Falciparum - blood; Malaria, Falciparum - prevention & control; Malaria, Falciparum - transmission; Medical sciences; Mice; Microbiology and Parasitology; Molecular and cellular biology; Photochemistry; Plasma - parasitology; Plasmodium; Plasmodium falciparum; Plasmodium falciparum - drug effects; Plasmodium falciparum - growth & development; Plasmodium falciparum - radiation effects; Platelet; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Ultraviolet Rays; Protozoa; Plasmodium; Apicomplexa; Platelet; Amotosalen; Transfusion; Inactivation; Photochemotherapy; Babesia
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1111/j.1537-2995.2007.01762.x

BACKGROUND: Transfusion‐transmitted cases of malaria and babesiosis have been well documented. Current efforts to screen out contaminated blood products result in component wastage due to the lack of specific detection methods while donor deferral does not always guarantee safe blood products. This study evaluated the efficacy of a photochemical treatment (PCT) method with amotosalen and long‐wavelength ultraviolet light (UVA) to inactivate these agents in red blood cells (RBCs) contaminating platelet (PLT) and plasma components. STUDY DESIGN AND METHODS: Plasmodium falciparum– and Babesia microti–contaminated RBCs seeded into PLT and plasma components were treated with 150 µmol per L amotosalen and 3 J per cm2 UVA. The viability of both pathogens before and after treatment was measured with infectivity assays. Treatment with 150 µmol per L amotosalen and 1 J per cm2 UVA was used to assess the robustness of the PCT system. RESULTS: No viable B. microti was detected in PLTs or plasma after treatment with 150 mol per L amotosalen and 3 J per cm2 UVA, demonstrating a mean inactivation of greater than 5.3 log in PLTs and greater than 5.3 log in plasma. After the same treatment, viable P. falciparum was either absent or below the limit of quantification in three of four replicate experiments both in PLTs and in plasma demonstrating a mean inactivation of at least 6.0 log in PLTs and at least 6.9 log in plasma. Reducing UVA dose to 1 J per cm2 did not significantly affect the level of inactivation. CONCLUSION: P. falciparum and B. microti were highly sensitive to inactivation by PCT. Pathogen inactivation approaches could reduce the risk of transfusion‐transmitted parasitic infections and avoid unnecessary donor exclusions.