Background: Extracorporal photopheresis (ECP) is an immunosuppressive treatment that involves leukocyte apheresis, psoralen und UV light treatment, and susequent reinfusion. Patients treated with ECP are usually immunosuppressed. Bacterial contamination therefore poses a much unwanted risk, but incidence data are lacking.
Patients and Methods: We screened all 1922 consecutive ECP procedures scheduled within a roughly 3-year period for eligibility. Those with missing data on ECP method (inline or offline) or type of enous access (peripheral or central) were excluded. ECPs with complete aerobic and anearobic microbial testing of baseline patient blood samples (n=1637) and of ECP cell concentrtes (n=1814) were included in the analysis.
Results: A test for microbial contamination was positive for 1,82% of the cell concentrates, with central venous accesss was the most significant risk factor for the contamination (odds ration = 19). Patient blood samples were positive in 3,85% of cases, but no patients became septic. Staphylococcus spp. were most abundant, and products with bacterial contamination did not cause side effects after reinfusion. There were no signifacant differences in contamination rates between inline and offline ECP.
Conclusion: These findings stress the importance of sterile procedures and the benefits of using peripheral over central venous access for reducing the risk of bacterial contamination in ECP
