Analysis of reasons for not implementing pathogen inactivation for platelet concentrates

In the last 10 years three technologies capable of inactivating pathogens in platelet concentrates have been authorized in Europe although only one based on the addition of amotosalen and illumination with ultraviolet A (UVA) light, has been approved by the National Agency for the Safety of Medicines and Health Products (ANSM). An intense debate exists about the implementation of pathogen inactivation technologies for labile blood components in general and for platelet concentrates in particular. In this review, we will analyze some of the most frequently argued reasons for not implementing pathogen inactivation for platelet components, i.e.: current platelet components are safe enough; pathogen inactivation technologies might be toxic for the recipient; and pathogen inactivation technologies affect platelet function and increase the risk of bleeding. The analysis and discussion of the evidence currently available to answer those reservations will be limited to the pathogen inactivation technology based on amotosalen and UVA.