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No use, distribution or reproduction is permitted which does not comply with these terms. Transfusions of platelets are an important cornerstone of medicine; however, recipients may be subject to risk of adverse events associated with the potential transmission of pathogens, especially bacteria. Pathogen inactivation PI technologies based on ultraviolet illumination have been developed in the last decades to mitigate this risk.
This review discusses studies of platelet concentrates treated with the current generation of PI technologies to assess their impact on quality, PI capacity, safety, and clinical efficacy. Improved safety seems to come with the cost of reduced platelet functionality, and hence transfusion efficacy.
In order to understand these negative impacts in more detail, several molecular analyses have identified signaling pathways linked to platelet function that are altered by PI. Because some of these biochemical alterations are similar to those seen arising in the context of routine platelet storage lesion development occurring during blood bank storage, we lack a complete picture of the contribution of PI treatment to impaired platelet functionality.
A model generated using data from currently available publications places the signaling protein kinase p38 as a central player regulating a variety of mechanisms triggered in platelets by PI systems. Platelets play an essential role in hemostasis, fibrinolysis, and vascular integrity, which are critical physiological processes to prevent and control bleeding 1 β 3. Platelet concentrates PCs are transfused to treat bleeding in thrombocytopenic, trauma, or surgery patients 4 β 6 as well as for prophylactic treatment of patients with hypoproliferative thrombocytopenia 7 , 8.
