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High-yield platelet concentrates attainable by continuous quality improvement reduce platelet transfusion cost and
D L Kelley1, R L Fegan, A T Ng
1Department of Pathology, Ohio State University Medical Center, American Red Cross Blood Services, Central Ohio Region, USA.
Background:
Donor exposure risk and cost in platelet transfusion practice can be limited by increasing the recovery of platelets from donor units.
Study Design And Methods:
This study presents results of continuous quality improvement efforts in platelet production and compares the in vivo therapeutic efficacy of currently produced platelet concentrates (PCs) with that of apheresis platelets. Production quality improvement measures included optimization of instrument performance (rotor speed trials), process (massaging whole-blood units, using cup liners, limiting spin-expression time, and refining plasma expression technique), and staff (intensive training with observation and ongoing quality control data feedback). Corrected count increments and increments per kg were calculated for transfusions of 4 pooled PCs and apheresis platelets over a 30-day period.
Results:
The mean number of platelets per PC increased from 5.5 x 10(10) in 1975 to 9.69 x 10(10) in 1994. The mean platelet dose was 3.78 x 10(11) for 4 PCs and 4.17 x 10(11) for apheresis platelets. A total of 34 pooled PCs and 17 apheresis platelets was transfused to 21 patients. The mean increment, the increment per kg, and the corrected count increment were, respectively, 31 x 10(3) per microL, 4.8 x 10(2) per microL, and 14,700 for 4 PCs and 35.4 x 10(3) per microL, 5.4 x 10(2) per microL, and 14,700 for apheresis platelets. Differences were not significant.
Conclusion:
Therapeutic efficacy comparable to that of apheresis platelets can be obtained with 4 high-yield PCs.