Risks associated with red blood cell transfusions: potential benefits from application of pathogen inactivation

Kleinman, Steve; Stassinopoulos, Adonis

A robust PI technology that can inactivate 5 to 8 infectious log of most pathogens would allow for modification of NAT protocols. There would be no need to perform individual NAT for HIV, HCV, HBV, or WNV since minipool testing would be adequate to detect any units with high viral load that otherwise might theoretically escape the full effects of PI. Minipools could be made larger as is currently done in source plasma testing. 146 Consideration could also be given to removing some serologic assays that might be considered redundant; these include anti-HBc, anti-HCV, and even anti-HIV (although the latter might trigger public concern). Of course, modification of blood donor screening protocols would require regulatory authority approval and it would probably take some years of routine use with systematic hemovigilance efforts to accumulate the data required for such changes to be made.