Lਅਔਔਅ ਔਏ ਔਈਅ Eਉਔਏ Why are platelets the most frequently mentioned blood component in Chagas transfusion transmission reports? Beatriz Cancino-Faure 1, Roser Fisa 1, Cristina Riera 1, Ibeth Bula 1, Enrique Girona-Llobera 2,3, Teresa Jimenez-Marco 2,3 1
Laboratory of Parasitology, Biology, Health and Enviroment Department, Faculty of Pharmacy, Universitat de Barcelona, Barcelona; 2"Fundació Banc de Sang i Teixits de les Illes Balears", Majorca, Balearic Islands; 3IUNICS ("Institut Universitari d'Investigació en Ciencias de la Salut"), Universitat de les Illes Balears, Majorca, Balearic Islands, Spain
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donors would, therefore, explain the higher risk of Chagas disease transmission associated with platelet transfusions. Apart from this brief comment, we would sincerely like to congratulate the authors for their excellent review on Chagas disease and transfusion medicine. The Authors declare no conflicts of interest.
References
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Dear Sir, We would like to make a brief contribution to the interesting article written by Angheben et al., which was recently published in Blood Transfusion1. The authors provide a comprehensive and well-updated review of Chagas disease, focusing on transfusion medicine and the current strategies for preventing disease transmission in non-endemic areas. In the section of the article dealing with transfusiontransmitted Chagas disease, the authors state that all blood components, except plasma derivatives, are theoretically capable of transmitting the disease, since their storage conditions allow the parasite to survive. Although Angheben et al. also mention that platelets are the blood component most often associated with reported cases of transfusion-related transmission, they do not specify why this is so. Cancino-Faure et al. investigated the reason why platelets carry such a high risk of transmitting Chagas disease via transfusion and their findings were recently published in the article, "Evidence of meaningful levels of Trypanosoma cruzi in platelet concentrates from seropositive blood donors"2. Using a quantitative real-time polymerase chain reaction, these authors studied the T. cruzi parasite load in peripheral whole blood, platelets and plasma collected from chronic chagasic blood donors through apheresis donations. They reported that 100% of platelet components of all blood donors were positive for T. cruzi DNA, with a parasitic load 5 times higher than in peripheral whole blood, whereas parasite DNA was undetectable in the plasma component. This finding was attributed to the size and specific gravity3 of the trypomastigote form of T. cruzi, which is very similar to that of platelets and leucocytes. Thus, during the whole blood processing to obtain blood components, T. cruzi concentrates in the platelet fraction and leucocytes, rather than in the plasma fraction. The higher parasitic load found in platelet components, compared to plasma and peripheral whole blood, collected from Chagas-infected blood
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Angheben A, Boix L, Buonfrate D, et al. Chagas disease and transfusion medicine: a perspective from non-endemic countries. Blood Transfus 2015; 13: 540-50. Cancino-Faure B, Fisa R, Riera C, et al. Evidence of meaningful levels of Trypanosoma cruzi in platelet concentrates from seropositive blood donors. Transfusion 2015; 55: 1249-55. Amato Neto V, Matsubara L, Bustos Lanura PN. [An evaluation of the quantitative buffy coat system (QBC) in the laboratory diagnosis of Trypanosoma cruzi infection: a study in an experimental murine model.] Rev Soc Bras Med Trop 1996; 29: 59-61. [In Portuguese.]
Arrived: 23 October 2015 - Revision accepted: 2 November 2015 Correspondence: Roser Fisa Laboratory of Parasitology, Faculty of Pharmacy Universitat de Barcelona Av. Joan XXIII s.n. E-08028 Barcelona, Spain e-mail: [email protected]
Blood Transfus 2016; 14: 515 DOI 10.2450/2016.0280-15 © SIMTI Servizi Srl
515 All rights reserved - For personal use only No other use without premission
Laboratory of Parasitology, Biology, Health and Enviroment Department, Faculty of Pharmacy, Universitat de Barcelona, Barcelona; 2"Fundació Banc de Sang i Teixits de les Illes Balears", Majorca, Balearic Islands; 3IUNICS ("Institut Universitari d'Investigació en Ciencias de la Salut"), Universitat de les Illes Balears, Majorca, Balearic Islands, Spain
iz i
Sr l
donors would, therefore, explain the higher risk of Chagas disease transmission associated with platelet transfusions. Apart from this brief comment, we would sincerely like to congratulate the authors for their excellent review on Chagas disease and transfusion medicine. The Authors declare no conflicts of interest.
References
Se rv
Dear Sir, We would like to make a brief contribution to the interesting article written by Angheben et al., which was recently published in Blood Transfusion1. The authors provide a comprehensive and well-updated review of Chagas disease, focusing on transfusion medicine and the current strategies for preventing disease transmission in non-endemic areas. In the section of the article dealing with transfusiontransmitted Chagas disease, the authors state that all blood components, except plasma derivatives, are theoretically capable of transmitting the disease, since their storage conditions allow the parasite to survive. Although Angheben et al. also mention that platelets are the blood component most often associated with reported cases of transfusion-related transmission, they do not specify why this is so. Cancino-Faure et al. investigated the reason why platelets carry such a high risk of transmitting Chagas disease via transfusion and their findings were recently published in the article, "Evidence of meaningful levels of Trypanosoma cruzi in platelet concentrates from seropositive blood donors"2. Using a quantitative real-time polymerase chain reaction, these authors studied the T. cruzi parasite load in peripheral whole blood, platelets and plasma collected from chronic chagasic blood donors through apheresis donations. They reported that 100% of platelet components of all blood donors were positive for T. cruzi DNA, with a parasitic load 5 times higher than in peripheral whole blood, whereas parasite DNA was undetectable in the plasma component. This finding was attributed to the size and specific gravity3 of the trypomastigote form of T. cruzi, which is very similar to that of platelets and leucocytes. Thus, during the whole blood processing to obtain blood components, T. cruzi concentrates in the platelet fraction and leucocytes, rather than in the plasma fraction. The higher parasitic load found in platelet components, compared to plasma and peripheral whole blood, collected from Chagas-infected blood
1) 2)
©
SI M
TI
3)
Angheben A, Boix L, Buonfrate D, et al. Chagas disease and transfusion medicine: a perspective from non-endemic countries. Blood Transfus 2015; 13: 540-50. Cancino-Faure B, Fisa R, Riera C, et al. Evidence of meaningful levels of Trypanosoma cruzi in platelet concentrates from seropositive blood donors. Transfusion 2015; 55: 1249-55. Amato Neto V, Matsubara L, Bustos Lanura PN. [An evaluation of the quantitative buffy coat system (QBC) in the laboratory diagnosis of Trypanosoma cruzi infection: a study in an experimental murine model.] Rev Soc Bras Med Trop 1996; 29: 59-61. [In Portuguese.]
Arrived: 23 October 2015 - Revision accepted: 2 November 2015 Correspondence: Roser Fisa Laboratory of Parasitology, Faculty of Pharmacy Universitat de Barcelona Av. Joan XXIII s.n. E-08028 Barcelona, Spain e-mail: [email protected]
Blood Transfus 2016; 14: 515 DOI 10.2450/2016.0280-15 © SIMTI Servizi Srl
515 All rights reserved - For personal use only No other use without premission
