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Related Experiment Video

Updated: May 30, 2025

Establishment of Rat Models Mimicking Gender-affirming Hormone Therapies
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Elevated plasma testosterone concentrations from males on testosterone replacement therapy are mitigated with

B Greenwall1, K Reeder1, W Anani1,2

  • 1Transfusion Medicine, ARUP Laboratories, Salt Lake City, Utah, USA.

Transfusion
|January 31, 2025
PubMed
Summary

Testosterone replacement therapy (TRT) donors have elevated testosterone levels. A compound adsorption device (CAD) effectively removed supraphysiologic testosterone from plasma, potentially allowing transfusion of products from TRT donors.

Keywords:
blood component preparationsdonorspathogen reduction technologytestosterone replacement therapy

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Area of Science:

  • Blood banking and transfusion medicine
  • Endocrinology
  • Biochemistry

Background:

  • Donors on testosterone replacement therapy (TRT) may require frequent whole blood donation due to erythrocytosis.
  • FDA guidelines restrict transfusion of plasma products from TRT donors.
  • This study investigated TRT donor testosterone levels and a mitigation strategy.

Purpose of the Study:

  • To quantify testosterone levels in whole blood components from TRT donors.
  • To evaluate the efficacy of a pathogen reduction technology in removing testosterone.

Main Methods:

  • Whole blood from TRT donors and controls was fractionated into red blood cells and plasma.
  • Testosterone levels were measured using high-performance liquid chromatography-tandem mass spectrometry.
  • Pathogen reduction technology (INTERCEPT Blood System) was applied to pooled plasma, with samples taken before and after UVA light and compound adsorption device (CAD) steps.

Main Results:

  • TRT donors exhibited significantly higher free and total testosterone levels in plasma and red blood cell supernatant compared to controls.
  • Supraphysiologic testosterone levels were detected in both controls and TRT donors.
  • CAD incubation significantly reduced mean free and total testosterone by 88% and 84%, respectively (p < 0.01), while UVA light had no effect.

Conclusions:

  • TRT donors have elevated testosterone levels in blood components.
  • The CAD step effectively removes supraphysiologic testosterone from plasma to within reference ranges.
  • These findings may support the transfusion of pathogen-reduced plasma and platelets from TRT donors.