Transfusions in Resource Poor Settings Can Become Safer With UV-Based Pathogen Inactivation Interview with:

Prof Jean-Pierre Allain Principal Investigator, Department of Haematology University of Cambridge, Cambridge Blood Centre Cambridge UK

Prof. Jean Pierre Allain

Prof Jean-Pierre Allain
Principal Investigator, Department of Haematology
University of Cambridge, Cambridge Blood Centre
Cambridge UK What is the background for this study? What are the main findings?

Prof. Allain: In sub-Saharan Africa (SSA), 70% of the transfusions are in the form of  whole blood units (generally 1 or 2). Lack of resources limit the safety
measures to donor questionnaire, viral/bacterial testing (HIV, HCV, HBV
and Syphilis). Other measures used in rich countries i.e. nucleic acid
testing, filtration, bacterial culture etc. are not done because of cost.
Pathogen reduction would be an effective way to overcome these issues as
it is able to inactivate viruses, bacteria, parasites and nucleated
cells in one go, provided it is applied to whole blood and affordable.

The study consisted in assessing the efficacy of such a method (Mirasol
using riboflavin and UV illumination) taking inactivation of plasmodium
as major endpoint of a randomised controlled clinical trial called AIMS
(African Investigation of Mirasol System). What should clinicians and patients take away from your report?

Prof. Allain: Mirasol-treated whole blood is largely effective to inactivate
plasmodium and to prevent transfusion-transmitted malaria in highly
endemic areas where the whole adult population is semi-immune. Efficacy
observed in vivo closely reproduces what was predicted by in vitro
laboratory studies. It can therefore be implied that this treatment
would be equally effective against other infectious agents demonstrated
as inactivated in vitro such as HIV, HBV, HCV, bacteria, nucleated
blood cells and provide a major advancement in blood safety in
sub-Saharan Africa and other developing countries. What recommendations do you have for future research as a result of this study?

Prof. Allain: The efficacy and safety of the treated whole blood being demonstrated by
the study, the system should be applied clinically first to young
children and pregnant women (the most at risk populations) and
secondarily to the whole blood supply in one blood centre first (Kumasi,
Ghana where the study was conducted) followed by other blood services in
Ghana and other sub-Saharan Africa countries. Is there anything else you would like to add?

Prof. Allain: This study opens new avenues for blood safety in developing countries.
The question is in part technical: to implement the method but mostly
economic. The price offered by the manufacturer should be affordable in
sub-Saharan Africa.


Shirley Owusu-Ofori, MD et al. Effect of Plasmodium inactivation in whole blood on the incidence of blood transfusion-transmitted malaria in endemic regions: the African Investigation of the Mirasol System (AIMS) randomised controlled trial. The Lancet, April 2016 DOI: 10.1016/S0140-6736(16)00581-X

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Last Updated on April 23, 2016 by Marie Benz MD FAAD