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