Cost effectiveness of quality assurance in plateletpheresis.
ABSTRACT A quality assurance system (QAS) is part of modern blood banking facilities. Quality control of single donor platelet (SDP) concentrates includes the determination of the platelet (PLT) yield and the white blood cell (WBC) contamination. Improvements in modern apheresis technology allow the collection of high PLT yields and leukoreduced products. Double dose SDPs can be split and WBC-reduced products may be labelled as leukodepleted thereby reducing costs.
3309 SDPs obtained with the Amicus, AS 104, AS.TEC 204 and MCS + blood cell separators were retrospectively analysed for their PLT yield. SDPs with > or = 4.0 x 10(11) PLTs were considered as double dose SDPs and split. WBCs were determined microscopically in 170 SDPs. SDPs with a leukocyte content < 1.0 x 10(6) were labelled as leukodepleted and no further WBC filtration was recommended.
PLT yield was statistically higher in SDPs from the Amicus device, 84.8% of these products could be split. Double dose concentrates were collected in 22.7% with the MCS + machine and in 4.8% with the AS 104/AS.TEC 204 blood cell separators. The savings for disposables was $150,041 and for infectious disease testing $75,766. After the subtraction of the costs for PLT determinations in all SDPs $215,880 could be saved. WBC contamination was statistically lowest in in-line filtered SDPs from the MCS + device (median 0.29 x 10(5), range 0.22-9.96 x 10(5)) and all of these products were considered as fulfilling the criterion of leukodepeletion so that we were able to save $17,135 for bedside filters. Median WBC content was 0.75 x 10(5) (range 0.35-22.5 x 10(5)) in SDPs from the Amicus and 0.9 x 10(5) (range 0.27-99.8 x 10(5)) in SDPs from the AS 104/AS.TEC 204 devices, respectively.
Blood cell separators of the newest generation allow the collection of leukodepleted double dose SDPs. An intensified QAS in plateletpheresis allows the decision whether a product can be split and/or released as leukodepleted. By this means we were able to save a total of $233,015 per year.
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ABSTRACT: There is almost general agreement that removal of leukocytes from blood components reduces the incidence of HLA-antibody formation and refractoriness to random platelet transfusions. Recently filters have become available, which are able to reduce leukocyte contamination in platelet suspensions with acceptable platelet loss. We evaluated a cellulose acetate (CA) and a polyester (PE) filter, and stored buffy coat-derived platelet suspensions after filtration. Both filters are effective for the removal of leukocytes to levels below 5 x 10(6) per transfusate. For the CA filter, platelet recovery was 73 +/- 13% yielding 256 +/- 53 x 10(9) platelets per transfusate from 6 donors. For the PE filter, platelet recovery was 90 +/- 9% and 327 +/- 51 x 10(9) platelets per transfusate. When a loading dose of less than 5 x 10(8) leukocytes was applied, 98% of the CA-filtered suspensions and 100% of the PE-filtered suspensions contained less than 5 x 10(6) residual leucocytes. In 123 patients transfusion results of CA-filtered platelet suspensions stored for 72 h, were compared with those obtained by non-stored, non filtered, random platelet suspensions which had been leukocyte depleted by differential centrifugation. Platelet increments 1 and 20 h after transfusion showed no statistical difference between CA-filtered platelet transfusions stored for 72 h and non-stored, non-filtered platelet transfusions. In a new cohort of 117 patients, two filters and various postfiltration storage times were compared. Using both filters, the 1-hour posttransfusion increments decreased to approximately 60% after 96 h of storage compared to results of storage periods of 72 h or less.(ABSTRACT TRUNCATED AT 250 WORDS)Vox Sanguinis 02/1992; 63(1):23-30. · 2.85 Impact Factor
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ABSTRACT: New software for the cell separators A 201 and CS 3000 Plus have been developed by Baxter. Fresenius recently offered a single needle option for the AS 104 device. The results of separation are described with respect to total platelet yield, efficiency and cell contamination of the platelet concentrate (PC). Two software programs were evaluated in both the A 201 (version 5.12 and 5.13) and AS 104 cell separators (version 4560 with different separation parameters according to protocol IV and V). With software version 5.12, the A 201 collected 2.0 +/- 0.9 x 10(11) platelets in 200 mL plasma whereas 2.3 +/- 0.7 x 10(11) platelets could be harvested with version 5.13. The separation efficiencies were 32.1 +/- 11.6 and 34.7 +/- 10.7%, respectively. The leucocyte contamination was 5.6 +/- 4.6 x 10(8) with software version 5.12 and 4.9 +/- 7.6 x 10(8) with the 5.13 version. With the CS 3000 Plus cell separator, 2.9 +/- 0.8 x 10(11) platelets (efficiency 38.4 +/- 8.2%) could be harvested in 208 +/- 2 mL plasma. The white blood cell contamination was extremely low (1.4 +/- 3.2 x 10(6). There was a high separation efficacy with the Fresenius single needle procedure of 59.1 +/- 10.6% (protocol IV) and 58.7 +/- 7.3% (protocol V), respectively. The total number of platelets sampled in 338 +/- 21 mL plasma was 3.1 +/- 0.8 x 10(11) in protocol IV.(ABSTRACT TRUNCATED AT 250 WORDS)Transfusion Science 10/1994; 15(3):313-7.
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ABSTRACT: It is necessary to protect patients from white cell (WBC)-caused side effects of platelet transfusion by reducing the WBC contamination in single-donor platelets. A new COBE Spectra WBC (leuko)-reduction system (LRS) was compared to the COBE standard plateletpheresis (standard) procedure. Each of 62 donors underwent plateletpheresis under the two protocols (LRS and standard). The collection efficiency and WBC contamination in the components collected using the techniques were compared. Platelets were counted in a cell counter and WBCs were counted using two full grids of a Nageotte chamber. The preseparation and postseparation numbers for red cells, WBCs, and platelets as well as the number of collected platelets were not different in the two techniques. Collection efficiency in the LRS procedures was 96.2 +/- 13.0 percent of that in the standard procedures. Median WBC contamination in the platelet components was 10,160 per LRS procedure and 56,500 per standard procedure. The purity of the LRS components was significantly improved (p = 0.001), as seen in a comparison of the WBC numbers in components per procedure after log10 transformation (LRS: 0.096 +/- 0.195 x 10(6); standard: 0.390 +/- 1.075 x 10(6)). These data suggest that the LRS procedure produces platelet concentrates with a collection efficiency that is comparable to that obtained with the standard technique and with a residual WBC content that satisfies even the most stringent criteria for filtered platelets. As this purity can be achieved without platelet loss or alteration, conventional fiber filtration no longer seems necessary or useful in this type of single-donor platelet component.Transfusion 11/1997; 37(10):1045-9. · 3.53 Impact Factor