Pelletier · Best practice & research. Clinical haematology 2006 · narrative review · n=?

Pathogen inactivation techniques.

Cited 120 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review synthesizing mechanisms and development of pathogen inactivation technologies without systematic synthesis or primary human trial data.

PubMed 16377551 · doi:10.1016/j.beha.2005.04.001 · record verified 2026-08-27

What was done

This narrative review summarizes pathogen-reduction technologies designed for individual blood components and whole blood. It outlines specific technologies, including solvent-detergent and methylene blue for plasma components, amotosalen (S-59 psoralen) for platelets, S-303 and Inactine (binary ethyleneimine) for red blood cells, and riboflavin (vitamin B2) for multi-component inactivation. The review examines their mechanisms of action (nucleic acid disruption versus lipid membrane dissolution), differential efficacy across bacterial and viral classes, and associated toxicological considerations.

What was found

The abstract reports no quantitative metrics, effect sizes, or specific log-reduction numbers. Qualitatively, it notes that technologies targeting nucleic acids (amotosalen, S-303, Inactine, riboflavin) prevent pathogen replication, while solvent-detergent methods disrupt lipid membranes. Inactivation efficacy varies by bacterial Gram status, sporulation, and the presence of viral envelopes. The safety and toxicology of photoproducts and chemical breakdown products were identified as major ongoing concerns.

Why it matters

Pathogen inactivation technologies aim to proactively eliminate transfusion-transmitted infections, but tailoring methods to specific blood components is required to avoid cellular toxicity and preserve component integrity.

Limits

This is a narrative review presenting no primary clinical trial data, pooled quantitative estimates, or systematic search methodology. The summary reflects the regulatory and technological landscape as of 2006, leaving current clinical implementation, efficacy benchmarks, and modern safety profiles unaddressed.

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