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Comparative evaluation of blood component preparation with the top-and-top and top-and-bottom methods: A change in
Natalia Méndez Acosta1, Gabriela Rivas Alén1, Ismael Rodriguez Grecco1
1Hospital Clinicas "Dr. Manuel Quintela", UDELAR, Montevideo, Uruguay.
Background:
Hospital de Clínicas, in conjunction with the Universidad de la República UDELAR in Uruguay, evaluated the quality of blood components after separation with a top-and-bottom (TB) system, comparing it with the top-and-top (TT) system and verifying compliance with local and international standards.
Study Design And Methods:
Whole blood (WB) was collected using TB (n = 150) and TT (n = 130). TB units were processed with MacoPress Smart, obtaining red cell concentrate (RCC), plasma (PL), and buffy coat (BC). After 2 h, BC had a soft spin centrifugation for a single unit of platelet concentrate (SUPC). TT bags were managed on day 0 (up to 8 h of collection) with manual press obtaining RCC and platelet-rich plasma units (PRP). PRP had hard spin centrifugation and was separated again with the manual press to collect PL and SUPC.
Results:
TB system produced RCC with higher haemoglobin concentration and Haematocrit but with lower volume and Hb/unit (p < 0.001). The TB system produced RCC with lower leukocytes and residual platelet levels (p < 0.001). SUPC showed fewer residual leukocytes and red cell levels with TB (p < 0.001), but TT produced a higher mean platelet count than the TB system (p < 0.001). During this evaluation, there was no significant difference in the mean plasma volume (p = 0.178).
Conclusion:
The analysis favors the implementation of TB in the HC Blood Bank, improving the quality and safety of the transfusion service.
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