Pathogen reduction/inactivation of products for the treatment of bleeding disorders:what are the processes and what should we say to patients?

Patients with blood disorders (including leukaemia, platelet function disorders and coagulation factor deficiencies) or acute bleeding receive blood-derived products, such as red blood cells, platelet concentrates and plasma-derived products. Although the risk of pathogen contamination of blood products has fallen considerably over the past three decades, contamination is still a topic of concern. In order to counsel patients and obtain informed consent before transfusion, physicians are required to keep up to date with current knowledge on residual risk of pathogen transmission and methods of pathogen removal/inactivation. Here, we describe pathogens relevant to transfusion of blood products and discuss contemporary pathogen removal/inactivation procedures, as well as the potential risks associated with these products: the risk of contamination by infectious agents varies according to blood product/region, and there is a fine line between adequate inactivation and functional impairment of the product. The cost implications of implementing pathogen inactivation technology are also considered

4303020001 Основы медицинских знаний 2015

This practical manual, written by well-known experts, reviews current indications for the use of IgG concentrates and some other modern immunomodulators and provides fundamental information on present-day immunomodulation in patients (and mice). The book opens by tracing the transition from IgG substitution to IgG immunomodulation and providing expert updates on immunomodulatory indications in autoimmune and inflammatory disorders, including hematologic, neurologic, dermatologic, and other diseases. Basic aspects of IgG concentrates, including methods of production, safety, currently available products, and mechanisms of action, are then discussed. An entire chapter is devoted to the different aspects of immunomodulatory IgG treatment in the bleeding disorder immune thrombocytopenia (ITP). Finally, the transition from polyclonal to monoclonal antibody (mAb) treatment is addressed in detail, covering mAb development, methods, mechanisms of action, adverse effects, and more. Particular attention is paid to the example of anti-CD20 (B-cell) antibody