from buffy coat platelets to single donor platelets – a feasibility study
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From Buffy Coat Platelets to Single Donor Platelets – A Feasibility Study. Dr. Sybesma, Sanquin Bloodbank Southeast, ‘s-Hertogenbosch, Netherlands St. Petersburg - June 9 th - 2004. Improvement of transfusion safety by reduction of donor exposure. - PowerPoint PPT PresentationTRANSCRIPT
From Buffy Coat Platelets to Single Donor Platelets – A
Feasibility Study
Dr. Sybesma, Sanquin Bloodbank Southeast,
‘s-Hertogenbosch, Netherlands
St. Petersburg - June 9th - 2004
Improvement of transfusion safety by reduction of donor exposure
• Variant Creutzfeldt-Jakob disease (Houston et al. 2000)
• Septic platelet transfusion reactions (Ness et al. 2001)
• Residual risk of viral infection (Soldan et al. 2003, Jackson et al. 2003)
• HLA - (Slichter 1998) and HPA - refractoriness
• TRALI
• Unknown agents
Donors and methods
Technical:donors selection: precount > 250, 70 kg
Trima Accel, 100 procedures
procedure time 70’
QC, splitting > 500
Economical:434 Euro* pooled and single donor
Logistical:autosufficient 2500 PLT per year
* nov 2002
TRIMA Accel
Donorselection
Distribution (%) of donors (n=105) by PLT precount and weight
5824
18
> 250 and > 70 kg
225 - 250 and 63-70 kg
< 225 and < 63 kg
Number procedures per procedure time
69
23
8
0
10
20
30
40
50
60
70
80
< 70 min 70 - 90 min > 90 min
procedure time
number proce-dures
Donor reactions
Form
289 procedures:
Citrate reactions:
Mild: 37,
Moderate: 1,
Severe: 0
Collaps: 0
Haematoma: 5
Hyperventilation: 0
Evolution - Real/Target Yield
0,8
0,82
0,84
0,86
0,88
0,9
0,92
0,94
0,96
1-50 51-100 101-150 151-200 200-245
Chronological groups of procedures
Real Y
ield
/Targ
et
Yie
ld
Evolution of split-rate (>500x10e9)
0,50,550,6
0,650,7
0,750,8
0,850,9
1-50 51-100 101-150 151-200 201-246
chronological groups procedures
% s
plt-r
ate
Chronological trending of residual WBC levels
Residual WBC levels All Product
0
0.5
1
1.5
2
2.5
3
1 8
15
22
29
36
43
50
57
64
71
78
85
92
99
10
6
11
3
12
0
Sequence number
WB
Cx
10
E6
/Un
it
Series1
Logistical feasibility
TRIMA: 6 procedures per day
50 weeks
190 donors
8 donations per year*
2600 SDP per year
18 % drop-out by out-dating
* Lazarus et al. 2001
Donor satisfaction
Economical feasibility
Cost price for SDP are less than revenues
High split rates are beneficial for economical feasibility
Revenues for SDP are higher than for BCP
Cost of SDP are higher than for BCP
Distribution of secondary costs over different components influence the cost of BCP
Conclusions Conversion is feasible economically, technically and logistically.
Adequate donor selection + high collection performence assure high split-rates in relatively short procedure time.
further research is needed on:
how to keep donormotivation at high level
donor recruitment and donor selection
possibilities to reduce drop-out by outdating
Cost / Qualy’s for pooled and apheresis PLT should be analyzed