Pathogen reduction (PR) systems decrease the risk of transfusion-transmitted infections (TTI), and many blood centers use PR to treat platelets stored at room temperature. In November 2017, France mandated that all platelet concentrates be treated with the InterceptTM amotosalen and UVA PR system (Ceres Corporation); in France, both apheresis and pooled whole blood-derived platelets are collected. Prior to implementation, only 7% of platelets transfused in France had been treated with PR. Initially published data on platelet transfusions in France in 2018 to 2022 showed a decrease in TTIs from bacteria (TTBIs). Newly published data extends the evaluation period through December 2024. Between January 2013 and October 2017 (before mandated PR of platelets), over 1.4 million platelet concentrates were transfused in France with a TTBI frequency of 1/97,098 transfused platelet concentrates. After PR implementation from November 2017 to 2025 in which over 2.4 million PCs were transfused, the frequency of TTBI from platelets significantly decreased to 1/787,662 transfused platelet concentrates. However, two new cases of TTBI occurred in 2023 and 2024—one caused by Bacillus mobilis (split pooled whole blood-derived platelet concentrate stored 3 days) and another linked to Staphylococcus ureilyticus (apheresis-derived PC stored 4 days). During 2023-2024, no cases of HIV, hepatitis B or C viruses, human T-cell lymphotropic virus or arboviruses TTI occurred, and no new TTIs of hepatitis E virus were associated with platelets after nucleic acid testing was implemented. PR decreases the risk of TTIs, but a persistent risk remains—notably from spore- and biofilm-forming bacteria, post-PR contamination, and non-enveloped viruses. Continued vigilance is needed as well as further research on the clinical efficacy of PR platelets.
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