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[Virus inactivated plasma]
1Abteilung Transfusionsmedizin, Klinik der Universität Göttingen.
Abstract:
Two different virus inactivated plasma preparations are available in Germany. Methylene blue ephotoxidized (MB) plasma is plasma from a single donation, which is photoxidized using 1 microM methylene blue and visible light (1 hour 60,000 Lux). Photochemical inactivation reduces HIV by at least 5 log10, but also fibrinogen is altered. To date, the clinical significance of this finding is still unclear, since prospective clinical studies are lacking. Solvent detergent (SD) plasma is manufactured from a pool of about 2000 plasma donations, and triton-X-100 and tri-n-butyl-phosphate (TNBP) are added for virus inactivation. HIV and hepatitis viruses are thus reduced by 5 to 6 log10. SD treatment reduces protein S and alpha-2-antiplasmin by about 40%. Clinical studies have already demonstrated, that SD plasma is comparable with untreated, native fresh frozen plasma in terms of efficacy.
Insights
Two virus-inactivated plasma products, methylene blue (MB) and solvent detergent (SD) plasma, are available. While SD plasma shows comparable efficacy to fresh frozen plasma, MB plasma
Area of Science:
- Blood product safety and efficacy
- Viral inactivation technologies
- Plasma derivative analysis
Background:
- Germany offers two primary virus-inactivated plasma preparations: Methylene Blue (MB) and Solvent Detergent (SD) plasma.
- Both methods aim to mitigate viral transmission risks in transfusion medicine.
Purpose of the Study:
- To compare the characteristics and clinical implications of MB and SD plasma.
- To evaluate the efficacy and safety profiles of these two plasma products.
Main Methods:
- MB plasma undergoes photoxidation with methylene blue and visible light.
- SD plasma is treated with Triton X-100 and tri-n-butyl phosphate after pooling donations.
- Analysis of viral reduction, protein alterations (fibrinogen, protein S, alpha-2-antiplasmin), and clinical efficacy.
Main Results:
- MB plasma photoxidation inactivates HIV by over 5 log10 but alters fibrinogen, with unclear clinical significance.
- SD plasma treatment reduces HIV and hepatitis viruses by 5–6 log10 and decreases protein S and alpha-2-antiplasmin by approximately 40%.
- Clinical studies indicate SD plasma's efficacy is comparable to untreated fresh frozen plasma.
Conclusions:
- SD plasma demonstrates established efficacy and safety, comparable to fresh frozen plasma.
- Further clinical studies are needed to ascertain the clinical significance of fibrinogen alterations in MB plasma.
- Both MB and SD plasma represent advancements in ensuring safer blood transfusions.