Sustainable plateletapheresis in a LMIC blood service: Namibia's five-year experience with the Trima Accel™ Automated...

The Namibia Blood Transfusion Service (NAMBTS) is the sole provider of blood components in Namibia, including platelets for transfusion, which are critical for various healthcare disciplines. Rising demand and limited donor availability necessitated strategies to enhance apheresis productivity and reduce collection costs.

Beginning in 2021, the NAMBTS implemented a targeted donor-selection strategy (pre-donation platelet count ≥230 × 10^3/µL⁾ and dedicated the use of the Trima Accel™ Automated Blood Collection System (Trima; Terumo BCT) for all plateletapheresis procedures. A preliminary device comparison (n = 47) evaluated output concentration and procedure time between a legacy device (Brand A) and Trima. The five-year study (2021 - 2025) tracked performance efficiency by monitoring split-rate (proportion of donations producing two adult doses of ≥3.0 × 10¹¹ each), collection procedure time, and cost per dose.

Device comparison indicated that the Trima offered a higher mean platelet output (1370 ×10^3/µL vs 1224 ×10³/µL, p = 0.0040) and shorter mean procedure time (63 vs 70 min, p = 0.0084) compared to Brand A. Over five years (2021-2025), the study achieved an average five-year split-rate of 70 %, meeting and surpassing interim targets in 2023-2024. Cumulative cost savings exceeded USD 672,378, with reduced donor burden and improved product availability. Monthly monitoring and adaptive management underpinned sustained gains.

Data-driven donor selection and exclusive use of Trima markedly improved plateletapheresis in Namibia. These practical, evidence-based, low-resource methods are transferable to comparable LMIC settings seeking a sustainable platelet supply.