Tackling the gaps in blood safety
Canadian Blood Services is committed to blood safety because lives depend on it. To reduce the risk of infectious disease transmission from donor to patient, donors are extensively screened for risk factors prior to their donation. Every blood donation is tested for specific infectious disease agents (pathogens) known to be transmissible through blood. These are just some of the many measures Canadian Blood Services employ to keep the blood supply safe.
Despite these safeguards, the risk of infectious disease transmission, though very low, remains. Testing for infectious disease agents is very effective, although even the most sophisticated tests have detection limits. However, the main risks come from unknown agents, for which there are no tests, or from unanticipated infectious agents for which tests are not performed, or from bacterial contamination of platelet components, for which there are tests, but they are imperfect. These testing limitations are currently managed by the multiple layers of safeguards built into the system, but gaps remain. Pathogen inactivation technologies could help to tackle those gaps and make the blood supply even safer.
What are pathogen inactivation technologies?
Pathogen inactivation technologies offer broad-spectrum treatment against potential pathogens (bacteria, viruses and parasites) within blood and blood products. These technologies target and damage nucleic acids (DNA and RNA) in pathogens using ultraviolet (UV) light. DNA and RNA contain genetic information, and when a pathogen’s DNA or RNA is damaged, it prevents the pathogen from reproducing. This effectively destroys a pathogen’s ability to cause illness. As pathogen inactivation treatment attacks all nucleic acids, including those in residual white blood cells found in blood products, it may remove the need for additional treatments of blood products (e.g. irradiation) that are required for certain patient populations.
Altering the blood safety paradigm
Pathogen inactivation technologies potentially fill in the gaps in current blood safety approaches. Rather than focusing on the detection of specific, known pathogens, these technologies focus on inactivating any pathogens that may be present in a blood product. These technologies add a new layer of safety against emerging or unknown pathogens. Pathogen inactivation is often called a paradigm-altering approach because it is a pro-active rather than a re-active approach to blood safety.
Image - The pathogen inactivation process
What pathogen inactivation technologies are available in Canada?
What is Canadian Blood Services doing to prepare for pathogen inactivation technologies in Canada?
Research to understand the impact of these technologies on Canadian Blood Services processes and product quality is continuing. The work of the Centre for Innovation will help ensure that pathogen inactivation, or any other new technologies we consider implementing, will bring benefit and allow us to continue to meet the needs of Canadian patients.
Hemostatic efficacy of pathogen-inactivated vs untreated platelets: a randomized controlled trial.
van der Meer PF, Ypma PF, van Geloven N, van Hilten JA, van Wordragen-Vlaswinkel RJ, Eissen O, Zwaginga JJ, Trus M, Beckers EAM, Te Boekhorst P, Tinmouth A, Lin Y, Hsia C, Lee D, Norris PJ, Goodrich RP, Brand A, Hervig T, Heddle NM, van der Bom JG, Kerkhoffs JH.
Blood. 2018 Jul 12;132(2):223-231.
Pathogen Inactivation Strategies to Improve Blood Safety: Let's Not Throw Pathogen-Reduced Platelets Out With Their Bath Water.
JAMA Oncol. 2018 Apr 1;4(4):458-459.
Implementation of pathogen inactivation technology: how to make the best decisions?
Transfusion. 2017 May;57(5):1109-1111. doi: 10.1111/trf.14117. No abstract available.
Pathogen Inactivation Technologies: The Advent of Pathogen-Reduced Blood Components to Reduce Blood Safety Risk.
Devine DV, Schubert P.
Hematol Oncol Clin North Am. 2016 Jun;30(3):609-17. doi: 10.1016/j.hoc.2016.01.005. Review.
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Through discovery, development and applied research, Canadian Blood Services drives world-class innovation in blood transfusion, cellular therapy and transplantation—bringing clarity and insight to an increasingly complex healthcare future. Our dedicated research team and extended network of partners engage in exploratory and applied research to create new knowledge, inform and enhance best practices, contribute to the development of new services and technologies, and build capacity through training and collaboration. Find out more about our research impact.
The opinions reflected in this post are those of the author and do not necessarily reflect the opinions of Canadian Blood Services nor do they reflect the views of Health Canada or any other funding agency.