Background - In France, a standardized procedure has been introduced in which 5 units of plasma derived from whole blood are pooled into two equal volumes for pathogen reduction treatment (PRT). This method produces 6 fresh frozen plasmas treated with Amotosalen and Ultraviolet A (UVA) (FFP-A/UVA) from 5 native plasmas, reducing treatment time and disposable set costs, standardizing products, and decreasing adverse events by diluting allergens, cytokines, and antibodies.
Materials and methods - This study aimed i) to compare concentrations of Factor VIII, fibrinogen, and soluble inflammatory factors in ABO-isogroup or universal plasma pools with or without A/UVA PRT, and ii) to evaluate the profile and standardization of plasma units in mini-pools (5 units) and maxi-pools (10 units). We analyzed three types of parameters: soluble inflammatory biomarkers (sCD40L, IFN-alpha, IFN-beta, IFN-gamma, IL-1 beta, IL-6, IL-8, IL-10, IL-18, TNF-alpha), fibrinogen and Factor VIII, and circulating immune complexes. The pilot study used samples from untreated and PRT-treated apheresis plasma units.
Results - Factor VIII levels remained stable while fibrinogen levels significantly decreased in PRT-plasma, though still above 2 g/L. sCD40L significantly increased in individual PRT-treated plasma, while IL-18 levels were unchanged. Our results highlight the impact of the blood group distribution in the plasma mini and max pools on the concentrations of factor VIII and IL-18, but not on fibrinogen and sCD40L. We observed no circulating immune complexes and strong inter-individual variations in inflammatory molecules and significant reduction in variation in ABO-isogroup or universal plasma pools.
Discussion - This study suggests to use the mini-pool approach to produce universal plasma or expanding it to larger volume mixtures. Blood group distribution is crucial, as sCD40L and IL-18 influence immune responses, potentially reducing allergic reactions post-transfusion with PRT-treated plasma. Further research, including post-transfusion follow-up, is necessary to explore the clinical relevance of these findings.
Fabrice Cognasse
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Etienne, France; Université Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 Sainbiose, 42023, Saint-Étienne, France
https://orcid.org/0000-0001-8041-928X
Anne-Claire Duchez
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Etienne, France; Université Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 Sainbiose, 42023, Saint-Étienne, France
https://orcid.org/0000-0001-5654-4320
Marco Heestermans
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Etienne, France; Université Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 Sainbiose, 42023, Saint-Étienne, France
https://orcid.org/0000-0002-5788-6653
Marie-Ange Eyraud
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Etienne, France; Université Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 Sainbiose, 42023, Saint-Étienne, France
Charles-Antoine Arthaud
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Etienne, France; Université Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 Sainbiose, 42023, Saint-Étienne, France
Amélie Prier
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Etienne, France; Université Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 Sainbiose, 42023, Saint-Étienne, France
https://orcid.org/0000-0003-0977-3010
Stéphane Paul
- Department of Immunology, CIC1408, GIMAP U1111/UMR5308 INSERM-UJM-UCBL-ENS de Lyon-CNRS, University Hospital of Saint-Etienne, Saint-Etienne, France
https://orcid.org/0000-0002-8830-4273
Anne-Emmanuelle Berger
- Department of Immunology, CIC1408, GIMAP U1111/UMR5308 INSERM-UJM-UCBL-ENS de Lyon-CNRS, University Hospital of Saint-Etienne, Saint-Etienne, France
Béatrice Belcour
- Etablissement Français du Sang Grand-Est, Nancy, France
Sandrine Rochette-Eribon
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Etienne, France
Patricia Chavarin
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Etienne, France
Hind Hamzeh-Cognasse
- Université Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 Sainbiose, 42023, Saint-Étienne, France
https://orcid.org/0000-0001-8041-928X
, Anne-Claire Duchez
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