Clinical Effectiveness and Safety of Pathogen-Reduction Technologies for Platelets and Plasma: A Systematic Review

Abstract

Pathogen-reduction technologies (PRTs) methods for platelet and plasma are increasingly being relied on to inactivate a broad spectrum of pathogens to ensure safety in transfusion. However, there is continuing debate about the impact of such technology on clinical effectiveness, bleeding outcomes, and transfusion-related adverse events.<br /> <b>Objective:</b> This systematic review evaluated the clinical effectiveness and safety of PRT-treated platelets and plasma using studies published between 2015 and 2025.<br /> <b>Methods: </b>Following PRISMA 2020 guidelines, major databases including PubMed, Scopus, Embase, Web of Science, and Google Scholar were searched for studies published between 2015 and 2025. Eligible studies included human studies, platelet and/or plasma products that have been treated with specific PRT technology.  A total of 1256 records were identified. Findings were synthesized narratively and presented descriptively.<br /> <b>Results:</b> Fifteen qualifying studies utilizing pathogen-reduced platelets and plasma from various areas were included.  In randomized trials, platelets treated with PRT consistently exhibited decreased CCI at both 1 hour and 24 hours compared to conventional platelets, with certain studies indicating greater platelet use.  Even though the platelet increments were lower, most trials did not report any significant rise in WHO grade ≥2 clinical bleeding, and the hemostatic efficacy was still satisfactory.  Safety outcomes were relatively good: datasets showed that transfusion-reaction rates were low (<1%) and major adverse events were not so common.  PRT systems showed strong pathogen-inactivation abilities, including the ability to effectively inactivate clinically important viruses such as hepatitis viruses, dengue, and Japanese encephalitis virus.  Different technologies had different results, and UVC-based systems sometimes showed smaller increases after transfusions.<br /> <b>Conclusion:</b> Platelets and plasma treated with PRT are still clinically useful and very safe. They also greatly lower the risk of infections that can be spread by transfusions.  Even though there are fewer laboratory increments and more platelet use, these changes don't seem to affect clinical hemostasis. Strengthening implementation methods, inventory planning, and hemovigilance systems alongside continuing evaluation of performance will enable safer transfusion procedures and safeguard vulnerable patient groups globally.

Affiliated Institutions

• Presbyterian University, Ghana GH
• University of Ibadan NG
• University of Port Harcourt NG
• University of Vermont Medical Center US
• Kingston University GB
• University of North Carolina at Greensboro US

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