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Updated: Aug 29, 2026
Treatment of Platelet Products with Riboflavin and UV Light: Effectiveness Against High Titer Bacterial Contamination
Published on: August 24, 2015
Improving the bacteriological safety of platelet transfusions
Morris A Blajchman1, Mindy Goldman, Federico Baeza
1Department of Pathology and Molecular Medicine, McMaster University, 1200 Main Street West, HSC 2N34, Hamilton, Notario, Canada L8N 3Z5. blajchma@mcmaster.ca
Abstract:
Despite the increased application of aseptic techniques for blood collection and the preparation of platelet concentrates, morbidity and mortality arising from the transfusion of bacterially contaminated allogeneic platelet products persist. This problem exists because stored platelet concentrates represent a nearly ideal growth medium for bacteria and because they are stored at temperatures (22 degrees +/- 2 degrees C) that facilitate bacterial growth. The presence of bacteria in blood components including platelets has been a problem for many decades and currently is the most common microbiological cause of transfusion-associated morbidity and mortality. A variety of strategies have been devised and/or proposed in an attempt to try to reduce the risk of transfusion-associated sepsis. These include pretransfusion bacterial detection, efforts to reduce the likelihood of bacterial contamination, the optimization of blood product processing and storage, reducing recipient exposure, and the introduction of pathogen inactivation methodology. With regard to doing bacterial detection, a number of automated detection systems have become available to test for contaminated platelet components, but their utility to some extent is restricted by the time they take to indicate the presence of bacteria and/or their lack of sensitivity to detect initially low bacterial loads. A variety of other approaches has been shown to reduce the risk of bacterial contamination and include filtration to remove leukocytes and bacteria, diversion of the initial aliquot of blood during donation, and improved donor skin disinfection. Platelet pathogen inactivation methods under investigation include the addition of L-carnitine, gamma-irradiation, riboflavin plus UVA irradiation, and amotosalen HCl plus UVA irradiation. The latter process is licensed for clinical use with platelets in some countries in Europe. All of these approaches, either collectively or individually, hold considerable promise that the prevalence of adverse events associated with bacteria in platelet products will decline significantly in the very foreseeable future.
Insights
Bacterial contamination in platelet products remains a significant risk for transfusion-associated sepsis. Strategies like pathogen inactivation and improved detection methods aim to reduce this risk, enhancing patient safety.
Area of Science:
- Transfusion Medicine
- Microbiology
- Blood Banking
Background:
- Bacterial contamination of platelet concentrates is a persistent cause of transfusion-associated morbidity and mortality.
- Stored platelet products provide an optimal environment for bacterial growth due to storage temperature and composition.
- This issue represents the most common microbiological hazard in blood component transfusions.
Purpose of the Study:
- To review and discuss strategies for mitigating the risk of bacterial contamination in platelet products.
- To evaluate current and emerging methods for bacterial detection and pathogen inactivation.
- To highlight the ongoing efforts to improve the safety of allogeneic platelet transfusions.
Main Methods:
- Review of existing and proposed strategies including pretransfusion bacterial detection, contamination reduction, and pathogen inactivation.
- Discussion of automated detection systems and their limitations (time, sensitivity).
- Exploration of pathogen inactivation technologies such as amotosalen HCl plus UVA irradiation.
Main Results:
- Various approaches exist to reduce bacterial contamination, including filtration, blood diversion, and improved disinfection.
- Automated bacterial detection systems show promise but face challenges with speed and sensitivity.
- Pathogen inactivation methods, like amotosalen HCl plus UVA, are being developed and implemented.
Conclusions:
- A combination of strategies is essential for significantly reducing adverse events from bacterially contaminated platelets.
- Pathogen inactivation methodologies, particularly amotosalen HCl plus UVA, offer a viable solution.
- Continued research and implementation of these methods are expected to improve transfusion safety in the near future.
