What is the solvent-detergent method used to prevent transfusion-transmitted diseases?

Updated: Jan 15, 2017
  • Author: Mudassar Zia, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Answer

The solvent-detergent method is used to disrupt membranes of lipid-enveloped viruses without affecting the majority of plasma proteins, except protein S, antitrypsin, and antiplasmin. Hence, the method is effective in destroying HIV, HTLV, Epstein-Barr virus (EBV), HBV, and HCV. It is not effective against HAV and parvovirus; consequently, the blood product is tested for these 2 agents if the solvent-detergent method is used.

Once the blood product is prepared, the solvent-detergent chemicals must be removed by extraction, using oils and chromatography. This method can be employed in the preparation of coagulation factors. [80, 81]

Loss of protein S, antitrypsin, and antiplasmin may occur during processes involving the removal of residual solvent detergent. This has been concerning in patients with hyperfibrinolysis, which occurs, for example, during the reperfusion stage of liver transplantation. Clustered deaths in such patients in the United States were the reason that the solvent-detergent method fell out of favor in North America. This technique is still widely used in Europe, however, where alternative methods are employed to remove residual solvent detergent in order to minimize the loss of these 3 proteins. [82]


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