Pathogen reduction: state of reflection in Ireland

The Irish Blood Transfusion Service is currently assessing the feasibility and affordability of implementing pathogen reduction for platelets in Ireland. Since 2002, almost all plasma transfused in the country has been subjected to a pathogen reduction process in the form of Octaplas™ (or Uniplas™ for group AB recipients), manufactured from plasma from donors at the South Texas Blood and Tissue Center, San Antonio, TX, USA. Pathogen reduction of platelets for Ireland is driven by two major concerns: by the need for robust systems to prevent the transmission of any emerging transfusion transmissible infections or of diseases for which we do not currently test, and by the poor sensitivity and efficacy of even the most sensitive available approaches to bacterial contamination of platelets. While the safety of blood transfusion is a matter of public safety rather than health economics, it is currently the case that money spent in Ireland on pathogen reduction of platelets will result in fewer resources available for public use elsewhere, so that detailed cost balancing is required in deciding whether or not to implement pathogen reduction. Considerations that influence the costs of implementation in our hands include the ability to discontinue platelet irradiation, the ability to maintain a single inventory from the point of view of CMV, extending storage to day 7 of shelf-life as a routine, and avoidance of travel deferrals for platelet donors.