Evaluation of Mirasol Pathogen Reduction Technology and its effects on platelet viability and plasma integrity in blood units

Authors

DOI:

https://doi.org/10.65166/y1cm1p28

Keywords:

transfusion-transmitted infection, pathogen reduction technology, blood transfusion, colony forming unit, platelet concentrates

Abstract

Bacterial contamination in blood components carries a fatal risk in blood transfusion. Despite efforts in preventing transfusion-transmitted bacterial infections, it remains associated with transfusion morbidity and mortality. This study was carried out to evaluate the effectiveness of the Mirasol Pathogen Reduction Technology (MPRT) in platelets and plasma in eliminating bacterial growth by inoculating platelet concentrates with a clinically significant load of Staphylococcus aureus to determine its effect on platelet count, pH, and coagulation factors such as plasma activated prothrombin time, partial thromboplastin time and fibrinogen. For the 10 pooled platelet concentrates samples, the observed mean pH value before MPRT treatment was 7.20, and 7.10, and 6.8 after treatment on both Day 3 and Day 7, respectively. For platelet count, the resulting mean was1296.6 x 103/ul which decreased to 1199 x 103/ul, 1120 x 103/ul, 879.4 x 103/ul on Day 0, Day 3, and Day 7, respectively after MPRT. Also, no aggregates of bacteria were seen on 9 platelet concentrates samples after MPRT. For PT and aPTT, the mean average values of 12.63 seconds and 33.46 seconds were observed after MPRT, while fibrinogen’s mean average value dropped to 1.45g/L and maintained stability at a frozen state with 1.56g/L after 30 days post storage after MPRT treatment. Therefore, MPRT can preserve platelet viability with 90% effectiveness in eliminating bacterial contamination in platelet concentrates, even when changes in pH and platelet count occur through storage. Moreover, plasma integrity can also be preserved with the use of MPRT. This extends the expiry of platelet concentrates from 5 days to 7 days, thus, minimizing the blood wastage yet increasing platelet inventory.

Downloads

Download data is not yet available.

References

Agey, A., Reddoch-Cardenas, K., McIntosh, C., Sharma, U., Cantu, C., Cap, A., & Bynum, J. (2020). Effects of Intercept pathogen reduction treatment on extended cold storage of apheresis platelets. Transfusion, 61(1), 167–177. https://doi.org/10.1111/trf.16096

Aliaga, A., Ayerra, I., Cardoso, M., Puente, F., Aranda, A., Domingo, J., & Plantagenet-Whyte, R. (2024). An ecosystem of interconnected technologies to increase efficiencies in blood establishments: The example of the Blood and Tissue Bank of Aragón, Spain. Vox Sanguinis, 120(1), 32–38. https://doi.org/10.1111/vox.13752

Atento, A. G., & Atento, R. G. (2025). A Case Study of Mercury Drug Corporation: Strategic Adaptation to Universal Healthcare and Digital Disruption in the Philippines. International Journal of Health & Business Analytics, 1(1). https://doi.org/10.65166/zhw7dd39

Atento, R. G., Quinto, L., & Espelita, C. A. M. (2025b). Bridging Global Health Workforce Gaps 2050: A Multilevel Analysis of Global Demand, Philippine Supply Fragilities, and Competency Alignment. International Journal of Health & Business Analytics, 1(2). https://doi.org/10.65166/kgbpey79

Atento, R. G., Quinto, L., Espelita, C. A. M., & Castaneda, C. (2025a). Integrating Business and Health Analytics: A Conceptual Framework for Dual Outcomes in Healthcare. International Journal of Health & Business Analytics, 1(1). https://doi.org/10.65166/04pdc866

Atento, R. G., Quinto, L., Espelita, C. A. M., & San Juan, F. M. (2025c). Narrative health analytics: Integrating empathy, data, and ethics in patient-centered healthcare. International Journal of Health & Business Analytics, 1(2). https://doi.org/10.65166/yxgx8e59

Barham, M., Odenthal, T., Picker, S., Grandoch, A., Gathof, B., & Neiss, W. (2025). Ultrastructure of human platelet concentrates after treatment with pathogen reduction technologies for prolonged storage. Frontiers in Medicine, 12. https://doi.org/10.3389/fmed.2025.1682909

Blake, J., McTaggart, K., & Couture, C. (2021). Estimating the impact on the inventory of implementing pathogen‐reduced platelets in Canada. Transfusion, 61(11), 3150–3160. https://doi.org/10.1111/trf.16691

Bloch, E., Marshall, C., Boyd, J., Shifflett, L., Tobian, A., Gehrie, E., & Ness, P. (2018). Implementation of secondary bacterial culture testing of platelets to mitigate residual risk of septic transfusion reactions. Transfusion, 58(7). https://doi.org/10.1111/trf.14618

Brixner, V., Bug, G., Pohler, P., Krämer, D., Metzner, B., Voss, A., Casper, J., Ritter, U., Klein, S., Alakel, N., Peceny, R., Derigs, H., Stegelmann, F., Wolf, M., Schrezenmeier, H., Thiele, T., Seifried, E., Kapels, H., Döscher, A., … Seltsam, A. (2021). Efficacy of UVC-treated, pathogen-reduced platelets versus untreated platelets: a randomized controlled non-inferiority trial. Haematologica, 106(4), 1086–1096. https://doi.org/10.3324/haematol.2020.260430

Cheng, A., Das, A., Chaw, K., Dennington, P., Styles, C., & Gosbell, I. (2023). Safety Analysis of Extended Platelet Shelf-Life with Large-Volume Delayed Sampling on BACT/ALERT® VIRTUO® in Australia. Microorganisms, 11(9). https://doi.org/10.3390/microorganisms11092346

Cid, J., Charry, P., & Lozano, M. (2024). Therapeutic efficacy and safety of pathogen‐reduced platelet components: Results of a meta‐analysis of randomized controlled trials. Vox Sanguinis, 119(2), 203–211. https://doi.org/10.1111/vox.13573

Cloutier, M., & De Korte, D. (2022). Residual risks of bacterial contamination for pathogen‐reduced platelet components. Vox Sanguinis, 117(7), 879–886. https://doi.org/10.1111/vox.13272

Diallo, I., Benmoussa, A., Laugier, J., Osman, A., Hitzler, W., & Provost, P. (2020). Platelet Pathogen Reduction Technologies Alter the MicroRNA Profile of Platelet-Derived Microparticles. Frontiers in Cardiovascular Medicine, 7. https://doi.org/10.3389/fcvm.2020.00031

Dillon, M., Vauhkonen, I., Arvas, M., Ihalainen, J., Vilkkumaa, E., & Oliveira, F. (2023). Supporting platelet inventory management decisions: What is the effect of extending platelets' shelf life?. European Journal of Operational Research, 310(2), 640–654. https://doi.org/10.1016/j.ejor.2023.03.007

Escolar, G., Díaz-Ricart, M., & McCullough, J. (2021). Impact of different pathogen reduction technologies on the biochemistry, function, and clinical effectiveness of platelet concentrates: An updated view during a pandemic. Transfusion, 62(2), 227–246. https://doi.org/10.1111/trf.16747

Fachini, R., Fontão‐Wendel, R., Achkar, R., Scuracchio, P., Brito, M., Amaral, M., & Wendel, S. (2021). The 4-Year Experience with Implementation and Routine Use of Pathogen Reduction in a Brazilian Hospital. Pathogens, 10(11). https://doi.org/10.3390/pathogens10111499

Fadeyi, E., Wagner, S., Goldberg, C., Lu, T., Young, P., Bringmann, P., Meier, N., Namen, A., Benjamin, R., & Palavecino, E. (2020). Fatal sepsis associated with a storage container leak permitting platelet contamination with environmental bacteria after pathogen reduction. Transfusion, 61(2), 641–648. https://doi.org/10.1111/trf.16210

Fridey, J., Stramer, S., Nambiar, A., Moayeri, M., Bakkour, S., Langelier, C., Crawford, E., Lu, T., Lanteri, M., Kamm, J., Miller, S., Wagner, S., Benjamin, R., & Busch, M. (2020). Sepsis from an apheresis platelet contaminated with Acinetobacter calcoaceticus/baumannii complex bacteria and Staphylococcus saprophyticus after pathogen reduction. Transfusion, 60(9), 1960–1969. https://doi.org/10.1111/trf.15951

Garban, F., Guyard, A., Labussière, H., Bulabois, C., Marchand, T., Mounier, C., Caillot, D., Bay, J., Coiteux, V., Schmidt-Tanguy, A., Niger, L., Robin, C., Ladaique, P., Lapusan, S., Deconinck, E., Rolland, C., Foote, A., François, A., Jacquot, C., … Bosson, J. (2018). Comparison of the Hemostatic Efficacy of Pathogen-Reduced Platelets vs Untreated Platelets in Patients With Thrombocytopenia and Malignant Hematologic Diseases: A Randomized Clinical Trial. JAMA Oncology, 4(4), 468–475. https://doi.org/10.1001/jamaoncol.2017.5123

García-Otálora, M., McDonald, C., Bearne, J., Brown, B., Cheng, A., Humbrecht, C., Tiberghien, P., & Ramirez-Arcos, S. (2025). Platelet component safety in the era of new advancements in bacterial screening and pathogen reduction: A congress report of the 2024 ISBT Transfusion‐Transmitted Infectious Diseases Working Party, Bacteria Subgroup. Vox Sanguinis, 120(8), 846–857. https://doi.org/10.1111/vox.70053

Gorria, C., Labata, G., Lezaun, M., López, F., Aliaga, A., & Vaquero, P. (2019). Impact of implementing pathogen reduction technologies for platelets on reducing outdates. Vox Sanguinis, 115. https://doi.org/10.1111/vox.12860

Graaf, W., Spelmink, S., Heijnen, J., & Korte, D. (2021). Transfusion transmitted bacterial infections (TTBI) involving contaminated platelet concentrates: residual risk despite intervention strategies. Annals of Blood. https://doi.org/10.21037/aob-21-26

Hayashi, T., Fujimura, Y., Sakurai, Y., Masaki, M., Fuchizaki, A., Oguma, K., Hosokawa, K., Mishima, Y., Tanaka, M., Yasui, K., Kimura, T., Tani, Y., Hirayama, F., Takahashi, K., & Takihara, Y. (2025). Irradiation with 265-nm Ultraviolet Light-Emitting Diodes to Plasma: Alterations of Hemostatic Parameters and von Willebrand Factor. Transfusion Medicine and Hemotherapy, 52(4), 248–258. https://doi.org/10.1159/000546169

Hermida-Nogueira, L., Barrachina, M., Izquierdo, I., García-Vence, M., Lacerenza, S., Bravo, S., Castrillo, A., & García, Á. (2020). Proteomic analysis of extracellular vesicles derived from platelet concentrates treated with Mirasol® identifies biomarkers of platelet storage lesion. Journal of Proteomics, 210, 103529. https://doi.org/10.1016/j.jprot.2019.103529

Jacobs, M., Zhou, B., Tayal, A., & Maitta, R. (2024). Bacterial Contamination of Platelet Products. Microorganisms, 12(2), 258. https://doi.org/10.3390/microorganisms12020258

Jimenez‐Marco, T., García‐Recio, M., & Girona‐Llobera, E. (2018). Our experience in riboflavin and ultraviolet light pathogen reduction technology for platelets: from platelet production to patient care. Transfusion, 58. https://doi.org/10.1111/trf.14797

Jones, S., Jones, J., Leung, V., Nakashima, A., Oakeson, K., Smith, A., Hunter, R., Kim, J., Cumming, M., McHale, E., Young, P., Fridey, J., Kelley, W., Stramer, S., Wagner, S., West, F., Herron, R., Snyder, E., Hendrickson, J., … Basavaraju, S. (2019). Sepsis Attributed to Bacterial Contamination of Platelets Associated with a Potential Common Source — Multiple States, 2018. Morbidity and Mortality Weekly Report, 68(23), 519–523. https://doi.org/10.15585/mmwr.mm6823a2

Ketter, P., Kamucheka, R., Arulanandam, B., Akers, K., & Cap, A. (2019). Platelet enhancement of bacterial growth during room temperature storage: mitigation through refrigeration. Transfusion, 59. https://doi.org/10.1111/trf.15255

Klompas, A., Van Helmond, N., Juskewitch, J., Pruthi, R., Sexton, M., Soto, J., Klassen, S., Senese, K., Van Buskirk, C., Winters, J., Stubbs, J.,

Hammel, S., Joyner, M., & Senefeld, J. (2022). Coagulation profile of human COVID-19 convalescent plasma. Scientific Reports, 12. https://doi.org/10.1038/s41598-021-04670-1

Lachert, E., Kubis, J., Antoniewicz‐Papis, J., Rosiek, A., Woźniak, J., Piotrowski, D., Przybylska, Z., Mikołowska, A., Marschner, S., & Łętowska, M. (2018). Quality control of riboflavin-treated platelet concentrates using Mirasol® PRT system: Polish experience. Advances in Clinical and Experimental Medicine, 27(6), 765–772. https://doi.org/10.17219/acem/68901

Levy, J., Neal, M., & Herman, J. (2018). Bacterial contamination of platelets for transfusion: strategies for prevention. Critical Care, 22, 271. https://doi.org/10.1186/s13054-018-2212-9

Liu, C., Su, Y., Guo, W., & Qiao, R. (2023). The platelet storage lesion, what are we working for?. Journal of Clinical Laboratory Analysis, 38. https://doi.org/10.1002/jcla.24994

Liu, H., & Wang, X. (2021). Pathogen Reduction Technology for blood component: A promising solution for prevention of emerging infectious disease and bacterial contamination in blood transfusion services. Journal of Photochemistry and Photobiology, 8, 100079. https://doi.org/10.1016/j.jpap.2021.100079

Lu, W., & Fung, M. (2020). Platelets treated with pathogen reduction technology: current status and future direction. F1000Research, 9. https://doi.org/10.12688/f1000research.20816.1

Malvaux, N., Defraigne, F., Bartziali, S., Bellora, C., Mommaerts, K., Betsou, F., & Schuhmacher, A. (2022). In Vitro Comparative Study of Platelets Treated with Two Pathogen-Inactivation Methods to Extend Shelf Life to 7 Days. Pathogens, 11(3), 343. https://doi.org/10.3390/pathogens11030343

Marini, I., Aurich, K., Jouni, R., Nowak-Harnau, S., Hartwich, O., Greinacher, A., Thiele, T., & Bakchoul, T. (2018). Cold storage of platelets in additive solution: the impact of residual plasma in apheresis platelet concentrates. Haematologica, 104(1), 207–214. https://doi.org/10.3324/haematol.2018.195057

Matte, J., Fonseca, S., Robidoux, J., Charette, S., Cayer, M., & Brouard, D. (2025). Monitoring of Staphylococcus epidermidis biofilm formation on platelet storage bag surfaces. PLOS ONE, 20(2), e0333558. https://doi.org/10.1371/journal.pone.0333558

Mertes, P., Oulehri, W., Gomis, P., Malinovsky, J., Collange, O., Audibert, G., Kientz, D., Levy, F., Roche, A., Tacquard, C., Humbrecht, C., & Delabranche, X. (2025). Clinical impact of Amotosalen and UV-A treatment (INTERCEPT™ Blood System) for platelet concentrate preparation in cardiac surgery. Blood Transfusion, 23(6), 498–506. https://doi.org/10.2450/bloodtransfus.985

Mokhtarian, A., Melicine, S., Siguret, V., & Jourdi, G. (2025). Effect of Selective Serotonin Reuptake Inhibitors on Coagulation: Fact or Fiction?. Clinical and Translational Science, 18. https://doi.org/10.1111/cts.70164

Nguyen, J., Rioveros, J., Ziman, A., McGonigle, A., & Ward, D. (2021). How do we implement pathogen reduction technology, while maintaining an adequate platelet inventory for our patients?. Transfusion, 61(4), 1014–1022. https://doi.org/10.1111/trf.16348

O'Flaherty, N., Bryce, L., Nolan, J., & Lambert, M. (2023). Changing Strategies for the Detection of Bacteria in Platelet Components in Ireland: From Primary and Secondary Culture (2010–2020) to Large Volume Delayed Sampling (2020–2023). Microorganisms, 11(11), 2765. https://doi.org/10.3390/microorganisms11112765

Petrou, E., Nikolopoulos, G., Kriebardis, A., Pantavou, K., Loukopoulou, E., Tsantes, A., Georgatzakou, H., Maratou, E., Rapti, E., Mellou, S., Kokoris, S., Gialeraki, A., & Tsantes, A. (2021). Haemostatic profile of riboflavin-treated apheresis platelet concentrates. Blood Transfusion. https://doi.org/10.2450/2021.0089-21

Prioli, K., Karp, J., Lyons, N., Chrebtow, V., Herman, J., & Pizzi, L. (2018). Economic Implications of Pathogen Reduced and Bacterially Tested Platelet Components: A US Hospital Budget Impact Model. Applied Health Economics and Health Policy, 16(6), 889–899. https://doi.org/10.1007/s40258-018-0409-3

Ramirez‐Arcos, S., Evans, S., McIntyre, T., Pang, C., Yi, Q., DiFranco, C., & Goldman, M. (2020). Extension of platelet shelf life with an improved bacterial testing algorithm. Transfusion, 60(12), 2918–2928. https://doi.org/10.1111/trf.16112

Rebulla, P. (2019). The long and winding road to pathogen reduction of platelets, red blood cells and whole blood. British Journal of Haematology, 186. https://doi.org/10.1111/bjh.16093

Rebulla, P., & Prati, D. (2022). Pathogen Reduction for Platelets—A Review of Recent Implementation Strategies. Pathogens, 11(2), 142. https://doi.org/10.3390/pathogens11020142

Rezvany, M., Hasan-Abad, A., Sobhani-Nasab, A., & Esmaili, M. (2024). Evaluation of bacterial safety approaches of platelet blood concentrates: bacterial screening and pathogen reduction. Frontiers in Medicine, 11. https://doi.org/10.3389/fmed.2024.1325602

Richard, P., Pouchol, E., Sandid, I., Aoustin, L., Lefort, C., Chartois, A., Baima, A., Malard, L., Bacquet, C., Ferrera-Tourenc, V., Gallian, P., Laperche, S., Bliem, C., Morel, P., & Tiberghien, P. (2023). Implementation of amotosalen plus ultraviolet A‐mediated pathogen reduction for all platelet concentrates in France: Impact on the risk of transfusion‐transmitted infections. Vox Sanguinis, 119(3), 212–218. https://doi.org/10.1111/vox.13574

Rosell-Valle, C., Martín-López, M., Campos, F., Chato‐Astrain, J., Campos-Cuerva, R., Alaminos, M., & González, M. (2022). Inactivation of human plasma alters the structure and biomechanical properties of engineered tissues. Frontiers in Bioengineering and Biotechnology, 10. https://doi.org/10.3389/fbioe.2022.908250

Rozhkov, E., Kozhemiako, O., Rozhkova, N., Kurmanova, O., Davidovich, M., Pokhabov, D., & Madzaev, S. (2023). Storage of pathogen-reduced platelets. Russian Journal of Hematology and Transfusiology. https://doi.org/10.35754/0234-5730-2023-68-2-195-201

Salunkhe, V., De Cuyper, I., Papadopoulos, P., Van Der Meer, P., Daal, B., Villa-Fajardo, M., De Korte, D., Van Den Berg, T., & Gutiérrez, L. (2019). A comprehensive proteomics study on platelet concentrates: Platelet proteome, storage time and Mirasol pathogen reduction technology. Platelets, 30(3), 368–379. https://doi.org/10.1080/09537104.2018.1447658

Sherstyukova, E., Semenova, J., Kandrashina, S., Bogdanova, A., Vinogradov, I., Inozemtsev, V., Shvedov, M., Grechko, A., Dokukin, M., Kuzovlev, A., Klychnikova, E., Bulanov, A., Kostin, A., & Sergunova, V. (2025). Pathogen-Reduced Low-Titer Group O Whole Blood for Managing Massive Blood Loss in Prehospital and Early Hospital Settings: An In Vitro Study. Journal of Clinical Medicine, 14(17), 6292. https://doi.org/10.3390/jcm14176292

Shu, E., Batilo, C., Sussmann, H., Owen, B., Belanger, G., Pandey, S., & Pham, T. (2022). Implementation strategy for complete pathogen reduction technology treated apheresis platelet inventory. Transfusion, 62(11), 2108–2116. https://doi.org/10.1111/trf.17081

Stewart, C., McGoldrick, P., Anderson, J., MacGregor, S., Atreya, C., & Maclean, M. (2024). Microbial reduction of prebagged human plasma using 405 nm light and its effects on coagulation factors. AMB Express, 14. https://doi.org/10.1186/s13568-024-01725-0

Valsami, S., Grouzi, E., Mochandreou, D., Pouliakis, A., Piroula-Godoy, M., Kokori, S., Pittaras, T., Raikou, A., & Politou, M. (2022). Effect of mirasol pathogen reduction technology system on immunomodulatory molecules of apheresis platelets. Transfusion and Apheresis Science, 61(4), 103523. https://doi.org/10.1016/j.transci.2022.103523

Van Der Meer, P., Ypma, P., Van Geloven, N., Van Hilten, J., Van Wordragen-Vlaswinkel, R., Eissen, O., Zwaginga, J., Trus, M., Beckers, E., Boekhorst, P., Tinmouth, A., Lin, Y., Hsia, C., Lee, D., Norris, P., Goodrich, R., Brand, A., Hervig, T., Heddle, N., … Kerkhoffs, J. (2018). Hemostatic efficacy of pathogen-inactivated vs untreated platelets: a randomized controlled trial. Blood, 132(2), 223–231. https://doi.org/10.1182/blood-2018-02-831289

Wasiluk, T., Rogowska, A., Boczkowska-Radziwon, B., Żebrowska, A., Bołkun, L., Piszcz, J., & Radziwon, P. (2020). Maintaining plasma quality and safety in the state of ongoing epidemic – The role of pathogen reduction. Transfusion and Apheresis Science, 60(3), 102953. https://doi.org/10.1016/j.transci.2020.102953

Zhang, C., Ayer, T., White, C., Bodeker, J., & Roback, J. (2022). Inventory Sharing for Perishable Products: Application to Platelet Inventory Management in Hospital Blood Banks. Operations Research, 71(5), 1756–1776. https://doi.org/10.1287/opre.2022.2410

Downloads

Published

2026-03-22