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Inactivation of viruses in fresh-frozen plasma
J U Wieding1, P Hellstern, M Köhler
1Department of Transfusion Medicine, University Hospital, Göttingen, Germany.
Abstract:
Methylene blue (MB) or solvent/detergent (SD) treatment is used for the inactivation of lipid-enveloped viruses in plasma. One important characteristic of the SD treatment is the necessity to pool plasma from different donors, thus inducing the risk of spreading infectious particles. MB treatment can be applied to single-donor plasma, causing no greater infectious risk than conventional fresh-frozen plasma (FFP). However, the virucidal efficacy of the SD method regarding HIV, HBV and HCV has been significantly better examined and proven than the MB treatment. Most of the therapeutic constituents of both plasma products are well maintained; coagulation factors decrease by roughly 5-20%. SD treatment reduces protein S and alpha 2-antiplasmin by approximately 40%, whereas MB treatment leads to a significant photooxidative alteration of fibrinogen with a disturbance of fibrin polymerization. As current studies show, the use of either plasma product is obviously not limited by acute or chronic toxicity. Several studies are in progress to evaluate the relevance of alterations in FFP quality which may affect the clinical efficacy of virus-inactivated plasma.
Insights
Methylene blue (MB) treatment offers a safer alternative for virus inactivation in single-donor plasma compared to solvent/detergent (SD) treatment, which requires pooled plasma. While both methods maintain most therapeutic components, MB treatment impacts fibrinogen, and SD treatment affects protein S and alpha 2-antiplasmin.
Area of Science:
- Blood product safety and processing
- Viral inactivation technologies
- Transfusion medicine
Background:
- Lipid-enveloped virus inactivation in plasma is crucial for transfusion safety.
- Current methods include Methylene Blue (MB) and Solvent/Detergent (SD) treatments.
- SD treatment necessitates plasma pooling, posing a risk of infectious particle spread.
Purpose of the Study:
- To compare the safety and efficacy of MB and SD treatments for virus inactivation in plasma.
- To evaluate the impact of each treatment on plasma therapeutic constituents.
- To assess the risk profiles associated with each plasma processing method.
Main Methods:
- Review of existing studies on MB and SD viral inactivation methods.
- Comparative analysis of treatment effects on plasma components like coagulation factors, protein S, and alpha 2-antiplasmin.
- Assessment of virucidal efficacy against HIV, HBV, and HCV for both methods.
Main Results:
- MB treatment can be applied to single-donor plasma, minimizing infectious risk compared to pooled SD plasma.
- SD treatment has more extensively proven efficacy against HIV, HBV, and HCV.
- Both treatments maintain most therapeutic constituents; MB affects fibrinogen, while SD reduces protein S and alpha 2-antiplasmin by ~40%.
Conclusions:
- MB treatment presents a potentially safer alternative for virus-inactivated plasma due to single-donor application.
- Further research is ongoing to understand the clinical implications of plasma component alterations from both treatments.
- The choice between MB and SD treated plasma may depend on specific clinical needs and risk-benefit assessments.