Keyword: Plasma

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.
Objective: This systematic review evaluated the clinical effectiveness and safety of PRT-treated platelets and plasma using studies published between 2015 and 2025.
Methods: 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.
Results: 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.
Conclusion: 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.

ABSTRACT: Gastric antral vascular ectasia (GAVE), also known as “watermelon stomach,” is a rare but clinically significant cause of chronic anemia and upper gastrointestinal bleeding, particularly in elderly patients. Although uncommon, GAVE considerably affects quality of life due to recurrent bleeding, frequent hospitalizations, and the need for blood transfusions. Diagnosis is typically based on endoscopic findings, characterized by red, radiating streaks from the pylorus or multiple punctate angioectasias in the antrum. Therapeutic approaches include various endoscopic methods, most notably argon plasma coagulation (APC) and endoscopic band ligation (EBL), each with specific advantages and limitations. Recent studies have emphasized the benefits of combining these two modalities to achieve more effective and durable hemostasis.
This case report presents a 79-year-old female patient with GAVE syndrome, manifested by chronic iron-deficiency anemia. Initially, the patient underwent APC, which provided temporary improvement but failed to achieve complete resolution. On follow-up endoscopy, persistent angioectatic lesions prompted a second-stage procedure using a combined treatment strategy: three elastic bands were applied to the most prominent vascular areas, followed by APC on residual superficial lesions. Over the next three months, the patient underwent regular endoscopic surveillance and laboratory monitoring. Follow-up assessments revealed significant clinical and endoscopic improvement, including normalization of hemoglobin levels and regression of vascular malformations, with no signs of recurrent anemia or bleeding.
This clinical case highlights the effectiveness and safety of combined endoscopic therapy using EBL and APC in patients with refractory or recurrent GAVE. The synergistic action of both techniques allows for comprehensive treatment of both superficial and deeper vascular lesions, improving long-term outcomes and reducing the need for repeated interventions. Combined therapy may be considered the treatment of choice in complex GAVE cases, offering a promising strategy in routine endoscopic practice.