Factors related to the development of high antibody titres against SARS-CoV-2 in convalescent plasma donors from the ConPlas-19 trial.

BACKGROUND AND OBJECTIVES: The efficacy of COVID-19 convalescent plasma (CP) associates with high titres of antibodies. ConPlas-19 clinical trial showed that CP reduces the risk of progression to severe COVID-19 at 28 days. Here, we aim to study ConPlas-19 donors and characteristics that associate with high anti-SARS-CoV-2 antibody levels. MATERIALS AND METHODS: Four-hundred donors were enrolled in ConPlas-19. The presence and titres of anti-SARS-CoV-2 antibodies were evaluated by EUROIMMUN anti-SARS-CoV-2 S1 IgG ELISA. RESULTS: A majority of 80.3% of ConPlas-19 donor candidates had positive EUROIMMUN test results (ratio ≥1.1), and of these, 51.4% had high antibody titres (ratio ≥3.5). Antibody levels decline over time, but nevertheless, out of 37 donors tested for an intended second CP donation, over 90% were still EUROIMMUN positive, and nearly 75% of those with high titres maintained high titres in the second sample. Donors with a greater probability of developing high titres of anti-SARS-CoV-2 antibodies include those older than 40 years of age (RR 2.06; 95% CI 1.24-3.42), with more than 7 days of COVID-19 symptoms (RR 1.89; 95% CI 1.05-3.43) and collected within 4 months from infection (RR 2.61; 95% CI 1.16-5.90). Male donors had a trend towards higher titres compared with women (RR 1.67; 95% CI 0.91-3.06). CONCLUSION: SARS-CoV-2 CP candidate donors' age, duration of COVID-19 symptoms and time from infection to donation associate with the collection of CP with high antibody levels. Beyond COVID-19, these data are relevant to inform decisions to optimize the CP donor selection process in potential future outbreaks.

Association of BDNF risk variant and dorsolateral cortical thickness with long-term treatment response to valproate in type I bipolar disorder: An exploratory study.

Valproate is among the most prescribed drugs for bipolar disorder; however, 87% of patients do not report full long-term treatment response (LTTR) to this medication. One of valproate's suggested mechanisms of action involves the brain-derived neurotrophic factor (BDNF), expressed in the brain areas regulating emotions, such as the prefrontal cortex. Nonetheless, data about the role of BDNF in LTTR and its implications in the structure of the dorsolateral prefrontal cortex (dlPFC) is scarce. We explore the association of BDNF variants and dorsolateral cortical thickness (CT) with LTTR to valproate in bipolar disorder type I (BDI). Twenty-eight BDI patients were genotyped for BDNF polymorphisms rs1519480, rs6265, and rs7124442, and T1-weighted 3D brain scans were acquired. LTTR to valproate was evaluated with Alda's scale. A logistic regression analysis was conducted to evaluate LTTR according to BDNF genotypes and CT. We evaluated CT differences by genotypes with analysis of covariance. LTTR was associated with BDNF rs1519480 and right dlPFC thickness. Insufficient responders with the CC genotype had thicker right dlPFC than TC and TT genotypes. Full responders reported thicker right dlPFC in TC and TT genotypes. In conclusion, different patterns of CT related to BDNF genotypes were identified, suggesting a potential biomarker of LTTR to valproate in our population.

Multivariate Genomic Hybrid Prediction with Kernels and Parental Information.

Genomic selection (GS) plays a pivotal role in hybrid prediction. It can enhance the selection of parental lines, accurately predict hybrid performance, and harness hybrid vigor. Likewise, it can optimize breeding strategies by reducing field trial requirements, expediting hybrid development, facilitating targeted trait improvement, and enhancing adaptability to diverse environments. Leveraging genomic information empowers breeders to make informed decisions and significantly improve the efficiency and success rate of hybrid breeding programs. In order to improve the genomic ability performance, we explored the incorporation of parental phenotypic information as covariates under a multi-trait framework. Approach 1, referred to as Pmean, directly utilized parental phenotypic information without any preprocessing. While approach 2, denoted as BV, replaced the direct use of phenotypic values of both parents with their respective breeding values. While an improvement in prediction performance was observed in both approaches, with a minimum 4.24% reduction in the normalized root mean square error (NRMSE), the direct incorporation of parental phenotypic information in the Pmean approach slightly outperformed the BV approach. We also compared these two approaches using linear and nonlinear kernels, but no relevant gain was observed. Finally, our results increase empirical evidence confirming that the integration of parental phenotypic information helps increase the prediction performance of hybrids.

The Self-Perceived E-Learning Environment Scale: Development and Psychometric Properties in a Nursing Students Samples.

AIM: E-learning is increasingly used in education, creating a learning environment that needs to be studied thoroughly for developing new learning opportunities. BACKGROUND: Drawing from the community of inquiry framework, the present work provides the theoretical foundation and measurement validation of the Self-Perceived E-Learning Environment Scale (SEES). The SEES measures core aspects of the e-learning context: autonomous strategic planning, social interaction, and teacher feedback. METHOD: Through two studies carried out in sample of nursing students, an exploratory (n = 302) and confirmatory (n = 245) factor analysis revealed a three-factor structure. RESULT: The results provide empirical evidence of appropriate psychometric properties (i.e., reliability, validity). CONCLUSION: The SEES can be used in a higher education context, particularly in nursing education programs. Theoretical, methodological, and practical implications for exploring the e-learning environment in nursing educational settings are discussed.

Work-Family Boundaries in the Digital Age: A Study in France on Technological Intrusion, Work-Family Conflict, and Stress.

BACKGROUND: Since previous studies have shown that the request of off-work technology-assisted supplemental work (off-TASW) can contribute to blurring the boundaries between the work and family domain by increasing work- family conflict (WFC), the purpose of this study is to go further, investigating how this relationship impacts stress perceptions. METHOD: A cross-sectional study that involved a sample of 221 French workers was carried out using a self-reported questionnaire. The data collected were analyzed by IBM SPSS 25.0 software, and a mediation model was tested. RESULTS: The results showed that off-TASW was associated with higher levels of WFC (b=.32; p=.000), which was in turn associated with stress perceptions (b=.42; p=.000). CONCLUSIONS: This study contributes to un- derstanding how the intrusion of technologies during off-work times impacts workers' perceptions of psychological wellbeing through work-family conflict. These findings should encourage the debate on the risks of staying connected to work through technologies during off-work and leisure time and stimulate the promotion of campaigns to make workers aware of their right to disconnection, to the benefits of detachment from work and recovery experiences.

Frozen and cold-stored platelets: reconsidered platelet products.

Platelet transfusion, both prophylactic and therapeutic, is a key element in modern medicine. Currently, the standard platelet product for clinical use is platelet concentrates at room temperature (20-24°C) under gentle agitation. As this temperature favors bacterial growth, storage is limited to 5-7 days, which result in high wastage rate, and complicates inventory and product availability at remote areas. Frozen and/or cold storage would ameliorate those disadvantages by reducing the risk of bacterial contamination and by extending the product shelf-life to weeks or even years. Consequently, the usefulness in transfusion medicine of platelet cryopreservation and refrigeration, two old and scarcely used platelet storage approaches, is reemerging. Indeed, there have been substantial recent research efforts to characterize both cold and cryopreserved platelets. Most recent studies indicate that cryopreserved and cold platelets display a pro-coagulant profile that may produce the rapid hemostatic response which is needed in bleeding patients. Thus, it seems appropriate that blood banks and blood transfusion centers explore the possibility of split platelet inventories consisting of platelets stored at room temperature and cryopreserved and cold-stored platelets.

Critical role of acute hypoxemia on the cognitive impairment after severe COVID-19 pneumonia: a multivariate causality model analysis.

BACKGROUND: A high proportion of coronavirus disease 2019 (COVID-19) survivors may develop long-term cognitive impairment. We aimed to develop a multivariate causal model exposing the links between COVID-19-associated biomarkers, illness-related variables, and their effects on cognitive performance. METHODS: In this prospective study, we assess the potential drivers for the development of cognitive impairment in patients with severe COVID-19 pneumonia aged ≥ 18 years at 6-month follow-up after hospital discharge, using the Montreal Cognitive Assessment (MoCA). Patients with pre-existing cognitive impairment were excluded. Laboratory results at hospital admission were clustered by principal component analysis (PCA) and included in a path analysis model evaluating the causal relationship between age, comorbidities, hypoxemia, invasive mechanical ventilation (IMV) requirement, in-hospital delirium, and cognitive performance. RESULTS: We studied 92 patients: 54 (58.7%) men and 38 (41.3%) women, with median age of 50 years (interquartile range 42-55), among whom 50 (54.4%) tested positive for cognitive impairment at 6-month follow-up. Path analysis revealed a direct link between the thrombo-inflammatory component of PCA (C-reactive protein, fibrinogen, and neutrophils) and hypoxemia severity at hospital admission. Our model showed that low PaO2/FiO2 ratio values, unlike the thrombo-inflammatory component, had a direct effect on cognitive performance, independent from age, in-hospital delirium, and invasive mechanical ventilation. CONCLUSION: In this study, biomarkers of thrombo-inflammation in COVID-19 and low PaO2/FiO2 had a negative effect on cognitive performance 6 months after hospital discharge. These results highlight the critical role of hypoxemia as a driver for impaired cognition in the mid-term.

Association study of Catechol-O-Methyltransferase (COMT) rs4680 Val158Met gene polymorphism and suicide attempt in Mexican adolescents with major depressive disorder.

AIM: We analyzed the association between SLC6A4, DRD2, COMT and MAOA genes and suicide attempt (SA) in Mexican adolescent patients with major depressive disorder (MDD). METHODS: The sample included 197 adolescents (127 females and 70 males) with principal diagnosis of MDD. Among them, 63 patients had SA at least once and 134 had not SA. The mean age of patients with and without SA was 15 ± 1.4 and 14 ± 1.5 years, respectively. We analyzed the genotype and allele distribution between patients with and without SA of SLC6A4 (5HTTLPR/rs25531), DRD2 (rs6275), COMT (rs4680), and MAOA (uVNTR). RESULTS: We did not find genotype or allele association between SA and SLC6A4 (χ2=0.67, p = 0.71; χ2=0.07, p = 0.77, respectively), DRD2 (χ2=0.05, p = 0.97; χ2=0.003, p = 0.95), and MAOA (females: χ2=0.86, p = 0.64; χ2=0, p = 1/males: χ2=0.008, p = 0.92) genes. However, there were differences in genotype frequencies of COMT/rs4680 between patients with SA and without SA (χ2=11.17, p = 0.003). Also, we observed a high frequency of Met158 allele showing an increased risk of having presented at least one SA (χ2=10.6, p = 0.001; OR = 1.43; 95% CI, 1.17-1.74). CONCLUSIONS: Our findings showed an association between low activity genotype and allele of Val158Met polymorphism of COMT gene and SA in Mexican adolescents with MDD.

Cryopreservation of platelets treated with riboflavin and UV light and stored at -80°C for 1 year.

BACKGROUND: The combination of pathogen reduction technologies (PRTs) and cryopreservation can contribute to building a safe and durable platelet (PLT) inventory. Information about cryopreserved riboflavin and UV light-treated PLTs is scarce. STUDY DESIGN AND METHODS: Twenty-four buffy coat (BC) PLT concentrates were grouped into 12 type-matched pairs, pooled, and divided into 12 non-PRT-treated control units and 12 riboflavin and UV light PRT-treated test units. Both were cryopreserved with 5% DMSO and stored at -80°C for 1 year. The cryopreservation method used was designed to avoid the formation of aggregates. PLT variables (PLT recovery, swirling, pH, MPV, and LDH) and hemostatic function measured by thromboelastography (TEG) were analyzed before cryopreservation (day 1) and post-cryopreservation at day 14 and months 3, 6, and 12 of storage at -80°C. The analyses were carried out within 1-h post-thaw. RESULTS: No aggregates were found in either PLT group at any time. Swirling was observed in both groups. MPV increased and mean pH values decreased over time (p < .001), but the mean pH value was never below 6.4 in either group after 12 months of storage at -80°C. PLT recovery was good and clotting time became significantly shorter over the storage period in both groups (p < .001). CONCLUSION: Our cryopreservation and thawing method prevented aggregate formation in cryopreserved riboflavin-UV-light-treated PLTs, which exhibited good recovery, swirling, pH > 6.4, and procoagulant potential, as evidenced by a reduced clotting time after 12 months of storage at -80°C. The clinical relevance of these findings should be further investigated in clinical trials.

Use and safety of riboflavin and UV light-treated platelet transfusions in children over a five-year period: focusing on neonates.

BACKGROUND: There are very few published reports about the use and safety of pathogen reduction technology (PRT) based on riboflavin and UV light for platelet (PLT) transfusion in children. STUDY DESIGN AND METHODS: A two-part study was conducted: 1) a study investigating the safety of PLTs treated with riboflavin and UV light-PRT transfused to 379 children and 1,980 adults over a 5-year period; 2) an observational study evaluating the efficacy of PLT use in 132 neonates transfused with PRT-treated PLT compared with 99 neonates receiving standard PLTs over two 5-year periods. RESULTS: The rate of adverse reactions related to transfusions with PRT-treated PLTs was found to be slightly higher in adults than in children, although not statistically significant (0.19% vs. 0.12%; p = 0.85). All PLT transfusion events in children were mild. From 2013 to 2017, 379 children received 4,236 riboflavin and UV light-treated PLTs. Hemato-oncology patients received the most PLT transfusions (61.2%), followed by critically ill children in the Pediatric Intensive Care Unit (PICU) (24.6%), and neonates in the Neonatal Intensive Care Unit (NICU) (10.5%). A significant increase in PLT transfusions was found in 132 neonates transfused with 458 PRT-treated PLTs compared with 99 neonates receiving 176 standard PLTs, measuring PLT use/patient (p = 0.031) and total PLT dose/patient (p = 0.041). CONCLUSIONS: Riboflavin and UV light-based PRT for PLTs seems to be safe for children. Neonates required a higher number of PLT transfusions when these were PRT-treated rather than standard. A long-term follow-up for chronically transfused children and randomized clinical trials are needed.

Association between 5-HTTLPR polymorphism, suicide attempt and comorbidity in Mexican adolescents with major depressive disorder.

INTRODUCTION: The World Health Organization reports that suicide is among the leading causes of death for young people. Depression is the most frequently related disorder with suicidal behaviors. There is increasing evidence that suicidal behavior has a strong genetic contribution. Several studies report an association between the genotype "SS" and the "S" allele of the 5-HTTLPR polymorphism of the serotonin transporter gene and suicidal behavior. The aim of the study was to determine the association of variants of the serotonin transporter gene with suicidal attempt and comorbidity in depressed adolescents. METHODS: The frequencies of ss genotypes and s allele were compared between a sample of 200 adolescents with a diagnosis of depression and the antecedent of a suicide attempt who were evaluated with K-SADS-PL and a group of 235 healthy controls. Genotyping of the 5-HTTLPR polymorphism was performed by PCR. RESULTS: Analysis of the frequencies of genotypes and alleles showed a statistically significant difference between the groups (Genotypes: x2=11.1, df=2, p=0.004, Alleles: x2=11.9, df=1, p=0.0009). There were no associations with comorbid disorders. CONCLUSIONS: The results support the hypothesis that the serotonin transporter gene, specifically the s allele and the ss genotype of the 5-HTTLPR polymorphism, are related to the history of depression and suicide attempt in adolescents.

Our experience in riboflavin and ultraviolet light pathogen reduction technology for platelets: from platelet production to patient care.

BACKGROUND: Pathogen reduction technology (PRT) enhances blood component safety, but its implementation is hampered by loss of blood quality and cost. STUDY DESIGN AND METHODS: A retrospective study was conducted to investigate the efficacy, safety, and cost of 9673 riboflavin and ultraviolet light-treated platelet (PLT) transfusions given to 1211 patients during a 3-year period. The results were compared with the efficacy, safety, and cost of 6424 nontreated PLT transfusions administered to 1500 patients during a 3-year comparison period before PRT implementation. RESULTS: Despite a similar PLT transfusion dose per unit for both periods (pre-PRT period 3.26 vs. PRT period 3.19), the mean number of PLT concentrates per patient (4.2 vs. 7.8; p = 0.006) and the total dose of PLTs received by patients were higher in the PRT period (13.6 vs. 24.8; p = 0.0002). Hematology and medical and surgical patient categories had the highest PLT use per patient. However, febrile (2.5% vs. 1.2%; p = 0.02) and allergic (0.16% vs. 0.08%; p = 0.01) reactions were lower during the PRT period. The blood center saved €284,805.58 due to a reduction of outdated PLTs from 16.8% to 0.72% after PRT implementation. CONCLUSIONS: Although PRT can improve PLT safety, it can increase the amount of PLTs required for transfusion in some patient categories. The cost of PRT can be partially offset by the savings associated with a lower rate of PLT outdates. This cost reduction can be a key factor in settings where inventory management is challenged by a high percentage of wasted PLTs due to outdating.

A Simple Thermodynamic Model of the Internal Convective Zone of the Earth.

As it is well known both atmospheric and mantle convection are very complex phenomena. The dynamical description of these processes is a very difficult task involving complicated 2-D or 3-D mathematical models. However, a first approximation to these phenomena can be by means of simplified thermodynamic models where the restriction imposed by the laws of thermodynamics play an important role. An example of this approach is the model proposed by Gordon and Zarmi in 1989 to emulate the convective cells of the atmospheric air by using finite-time thermodynamics (FTT). In the present article we use the FTT Gordon-Zarmi model to coarsely describe the convection in the Earth's mantle. Our results permit the existence of two layers of convective cells along the mantle. Besides the model reasonably reproduce the temperatures of the main discontinuities in the mantle, such as the 410 km-discontinuity, the Repetti transition zone and the so-called D-Layer.

The effectiveness of riboflavin and ultraviolet light pathogen reduction technology in eliminating Trypanosoma cruzi from leukoreduced whole blood.

BACKGROUND: The parasitic Chagas disease is caused by the protozoan Trypanosoma cruzi, which is mainly transmitted by insect vectors. Other infection routes, both in endemic and in nonendemic areas, include organ and marrow transplantation, congenital transmission, and blood transfusion. Asymptomatic chronic chagasic individuals may have a low and transient parasitemia in peripheral blood and, consequently, they can unknowingly transmit the disease via blood transfusion. Riboflavin and ultraviolet (UV) light pathogen reduction is a method to reduce pathogen transfusion transmission risk based on damage to the pathogen nucleic acids. STUDY DESIGN AND METHODS: In this study, we tested the effectiveness of this technology for the elimination of T. cruzi parasites in artificially contaminated whole blood units (WBUs) and thus for decreasing the risk of T. cruzi transfusion transmission. The contaminated WBUs were leukoreduced by filtration and treated with riboflavin and UV light. The level of pathogen reduction was quantified by a real-time polymerase chain reaction (qPCR) and a real-time reverse transcription-polymerase chain reaction (RT-qPCR) as a viability assay. RESULTS: The RNA (cDNA) quantification of the parasites showed a more than 99% reduction of viable T. cruzi parasites after leukoreduction and a complete reduction (100%) after the riboflavin and UV light treatment. CONCLUSION: Riboflavin and UV light treatment and leukoreduction used in conjunction appears to eliminate significant amounts of viable T. cruzi in whole blood. Both strategies could complement other blood bank measures already implemented to prevent the transmission of T. cruzi via blood transfusion.

Collection, storage, inspection and quality control of platelet concentrates obtained by apheresis: The situation in Spain.

BACKGROUND: Diverse variables are involved in apheresis platelet collection, processing and storage. This survey shows how these are realized in Spain. METHOD: An analysis of collected data was performed in a questionnaire completed by ten Transfusion Centers (TC) which perform between 50 and 520 apheresis procedures per month. This information comprises the procedures used to collect, inspect and store apheresis platelet concentrates (PC), and quality control data. RESULTS: Macroscopic inspection of PC is performed in all TC, especially during the first few hours post-collection and before distribution. The type of processor, duration of post-collection resting periods and temperature from the time of collection until distribution are similar in all TC. In 80% of TC, PC with small and scarce aggregates are distributed to transfusion services. The presence of clumps is influenced by type of processor, female donor, cold ambient temperature and collection of hyperconcentrated platelets, and is often recurrent in the same donor, although some TC have not found any influential variables. Overall, no objective inspection methods are followed, although there are exceptions. The degree of compliance with quality control parameters, such as the number of units studied, mean platelet yield, residual leukocyte counts and pH at expiry date, is acceptable in all TC. Compliance in terms of number of microbiological culture samples is variable. DISCUSSION: The usual practice in Spanish TC with respect to the collection, post-collection handling and storage of apheresis PC can be considered uniform, although some specific aspects of analyses should follow more objective methods.

Where do Trypanosoma cruzi go? The distribution of parasites in blood components from fractionated infected whole blood.

BACKGROUND: Platelets (PLTs) are the blood component most frequently involved in Trypanosoma cruzi transfusion transmission cases reported in the literature, although whole blood (WB) and red blood cells (RBCs) have also been incriminated. However, there is little knowledge of the parasite distribution among blood components. STUDY DESIGN AND METHODS: The aim of this study was to investigate in which blood component T. cruzi parasites concentrate the most, after fractionating artificially T. cruzi-infected WB. The T. cruzi parasite load was studied by a specific quantitative real-time polymerase chain reaction (qPCR) in WB, buffy coat (BC), PLT concentrates, RBCs before and after leukoreduction, and plasma (PL). RESULTS: The parasite load in WB experimentally infected with 1.5 × 10(6) parasites (2.78 × 10(3) parasite equivalents/mL) was unevenly distributed among the separated blood components. The highest level was found in the BC (6.94 × 10(3) parasite equivalents/mL) and RBCs before leukoreduction by filtration (2.51 × 10(3) parasite equivalents/mL), after which RBCs presented a 99.9% reduction in parasite levels. Both PL and PLTs, partially leukoreduced by centrifugation but nonfiltered, had low parasite levels, the lowest concentration being in PL. CONCLUSIONS: The highest parasite concentration was detected in the BC, followed by RBCs before leukoreduction. There is a notable risk of transfusion-transmitted Chagas disease associated with nonleukoreduced RBCs. Leukoreduction may be an effective prevention strategy for transfusion-transmitted T. cruzi infection, especially in endemic countries and in nonendemic countries with a high rate of immigration from Latin America.

Transfusion-transmitted leishmaniasis: a practical review.

In the Balearic Islands, as in other areas in southern Europe, there are a significant proportion of asymptomatic Leishmania infantum-infected blood donors. Theoretically, these donors may represent an important challenge for blood transfusion safety. However, despite an active search of multiply transfused patients, there have been, so far, no cases of transfusion-transmitted leishmaniasis (TTL) in our region. On the other hand, there is scarce evidence of the TTL in the literature. A review of asymptomatic Leishmania-infected blood donors' studies in endemic areas and TTL reports published in the English literature were performed, to ascertain the factors that determine the real risk of transfusion transmission of Leishmania.

Evidence of meaningful levels of Trypanosoma cruzi in platelet concentrates from seropositive blood donors.

BACKGROUND: According to the reported cases of transfusion-acquired Trypanosoma cruzi infection, the risk of T. cruzi transfusion transmission appears to be higher with platelet (PLT) products than with other blood components. The aim of this study was to investigate by quantitative real-time polymerase chain reaction (qPCR) the parasitic load detected in leukoreduced plasma and PLT concentrates collected by apheresis from seropositive T. cruzi blood donors and compare them with peripheral whole blood (WB). STUDY DESIGN AND METHODS: During 2011 to 2013, a prospective study was carried out in a group of blood donors originating from Chagas-endemic areas but who are now living on the island of Majorca, Spain. Leukoreduced plasma and PLT concentrates were collected by apheresis from seropositive blood donors with detectable parasitemias in peripheral WB. RESULTS: Seropositivity was found in 23 of 1201 donors studied (1.9%), and T. cruzi DNA with less than 1 parasite equivalent/mL was detected in peripheral WB in 60.86% (14 of 23) of these. The study in blood components obtained by apheresis from these donors showed that T. cruzi DNA with a mean ± SD parasitic load of 5.33 ± 6.12 parasite equivalents/mL was detected in 100% of the PLT concentrate samples. Parasite DNA was undetectable in the extract taken from plasma collected from donors with a positive qPCR in peripheral WB. CONCLUSION: The higher parasitic load found in PLT concentrates compared to plasma and peripheral WB would explain the higher transfusion transmission risk of Chagas disease associated with PLT transfusions described in the reported cases of transfusion-acquired T. cruzi infection.

Practical issues that should be considered when planning the implementation of pathogen reduction technology for plateletpheresis.

Pathogen reduction technology (PRT) is associated with increased blood safety through the inactivation of virus, bacteria and parasites. Dilution of platelet (PLT) concentrates in platelet additive solution (PAS) is a requirement for applying PRT, and that it is associated with various practical issues: increasing PLT target yields to compensate for loss of PLTs through PRT, extended apheresis donation time due to PAS addition at the end of the procedure, and the appearance of PLT aggregates. We proposed to program higher target PLT yields for plateletpheresis donations to compensate for PLTs lost due to PRT processing. To verify the feasibility of this approach, a paired study of the Amicus 3.11 and Trima 5.22 apheresis separators was performed using 196 procedures carried out on the same 98 donors. The Amicus 3.11 presented a higher collection efficiency (CE: 78.02 vs. 69.63; p < 0.0001) and collection rate (CR: 8.3 vs. 7.00; p < 0.0001); it was also faster (56.92 vs. 62.60; p < 0.0001) than the Trima 5.22 apheresis device. However, analysis of the donor group with higher pre-procedure PLT counts showed similar productivity results for the Amicus and Trima. The percentage of PLT aggregates detected was higher with the TA than the AM (8.62% vs. 3.88%, p = 0.04). Overall, both separators are entirely suitable for collecting hyper-concentrated PLTs that are subsequently diluted in PAS for PRT, without excessively increasing the donation time. PLT aggregation can occur after apheresis collection but most of them disappear by day 1. Further investigation is needed to study the clinical impact of PLT aggregation.

Reducing the financial impact of pathogen inactivation technology for platelet components: our experience.

BACKGROUND: Pathogen inactivation (PI) technology for blood components enhances blood safety by inactivating viruses, bacteria, parasites, and white blood cells. Additionally, PI for platelet (PLT) components has the potential to extend PLT storage time from 5 to 7 days. STUDY DESIGN AND METHODS: A retrospective analysis was conducted into the percentage of outdated PLT components during the 3 years before and after the adoption of PLT PI technology in our institution. The PLT transfusion dose for both pre-PI and post-PI periods was similar. A retrospective analysis to study clinical safety and component utilization was also performed in the Balearic Islands University Hospital. RESULTS: As a result of PI implementation in our institution, the PLT production cost increased by 85.5%. However, due to the extension of PLT storage time, the percentage of outdated PLT units substantially decreased (-83.9%) and, consequently, the cost associated with outdated units (-69.8%). This decrease represented a 13.7% reduction of the initial cost increase which, together with the saving in blood transportation (0.1%), led to a saving of 13.8% over the initial cost. Therefore, the initial 85.5% increase in the cost of PLT production was markedly reduced to 71.7%. The mean number of PLT concentrates per patient was similar during both periods. CONCLUSIONS: The extension of PLT storage time can substantially contribute to reducing the financial impact of PI by decreasing the percentage of outdated PLTs while improving blood safety. Since the adoption of PI, there have been no documented cases of PLT transfusion-related sepsis in our region.