DEHP plasticizer and blood bags: challenges ahead

Abstract

The invention of the plastic container represented a major advance in haemotherapy that opened the door to blood component preparation and transfusion. Later, it was found that the plasticizer di‐2‐ethylhexyl‐phthalate ( DEHP ) used in combination with polyvinylchloride ( PVC ), leached to the blood component contained in the plastic bag and that in the case of the red blood cells, stabilized the membrane allowing the extension of storage up to 49 days, depending on the additive solution used. This extraction of the plasticizer to the components provokes that not only the recipients of transfusions are exposed to significant levels of DEHP but also plasma and platelet apheresis donors are exposed. Although clear‐cut human toxicity has not been identified, for some the precautionary principle should be evoked and in front of the current available data, particularly in neonates and children, only DEHP ‐free disposable should be used in bags containing blood components for transfusion. For platelets this has already been accomplished for most of the containers and for plasma it should not be a problem to attain it. However, for the most often transfused blood component, red blood cells concentrates, continues to be an unresolved challenge, although in recent years some new plasticizers appear to be promising safer alternatives.