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From Buffy Coat Platelets to Single Donor Platelets – A Feasibility Study Dr. Sybesma, Sanquin Bloodbank Southeast, ‘s-Hertogenbosch, Netherlands St. Petersburg.

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Presentatie over: "From Buffy Coat Platelets to Single Donor Platelets – A Feasibility Study Dr. Sybesma, Sanquin Bloodbank Southeast, ‘s-Hertogenbosch, Netherlands St. Petersburg."— Transcript van de presentatie:

1 From Buffy Coat Platelets to Single Donor Platelets – A Feasibility Study Dr. Sybesma, Sanquin Bloodbank Southeast, ‘s-Hertogenbosch, Netherlands St. Petersburg - June 9 th

2 Introduction  Pilot-study ● Donors, Methods ● Results ● Conclusions  Discussion

3 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

4 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

5 De machine: TRIMA ACCEL COBE Spectra: dubbele naald techniek: weinig comfortabel. Continue 2 stapsscheiding: WBC > 10^8 daarom grote LRS-kamer: snel, goede oogst TRIMA 4.0: enkele naald. Continue 2 stapsscheiding: WBC < 10^6 kleine LRS-kamer: snel, hoge oogst, TRIMA 5.0 (Accel): 1-staps scheiding: nog meer oogst per tijdseenheid (plaatjes collectie efficientie**), LRS-kamer van de Spectra WBC < 10^6, minder extra corpereel volume (< 200 ml), minder citraat naar donor, automatische aanpassing van draw en return: minder alarm.*** Na einde bewaartijd (5 dagen en 7 dagen) in vitro voldoende plaatjesfunctie*

6 TRIMA Accel

7 Donorselection

8 Number procedures per procedure time

9 Donor reactions n Form n 289 procedures: Citrate reactions : Mild: 37, Moderate: 1, Severe: 0 Collaps: 0 Haematoma: 5 Hyperventilation: 0

10 Predicted Procedures, DPP and SDP for predicted yield (n=100)

11 Evolution - Real/Target Yield

12 Evolution of split-rate (>500x10e9)

13 Chronological trending of residual WBC levels

14 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

15 Donor satisfaction

16 Economical feasibility Apheresis PLT: 434 €* Cost / procedure: 269 € donorrelated / manufacturing / screening and quality control / device [1.76 product / procedure] Cost / product: 152 € + Bact Alert / distribution 27 € Variable cost / product: 179 € Pooled PLT: 434 €* Cost / procedure: 62 € manufacturing / quality controle Cost / product 62 € + Bact Alert / distribution 27 € Variable cost / product: 89 € * nov 2002

17 Economical feasibility n Cost price for SDP are less than revenues n High split rates are beneficial for economical feasibility n Revenues for SDP are higher than for BCP n Cost of SDP are higher than for BCP n Distribution of secondary costs over different components influence the cost of BCP

18 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

19 Discussie Voor  zorginnovatie  gezondheidswinst*  Spin-off * vCJD / onbekende agens / TRALI / anti-HLA preventie / windowdonaties Tegen  inkomsten €

20 Hoe verder  voortgang invoering aferesetrombocyten  Werkgroep voorbereiding implementatie zuidoost plan van aanpak feb 2004 start september 2004 

21 Met dank aan Projectgroepleden Speciaal Bob en Astrid

22 Referenties n MAR: Inzake vCJD en mogelijke maatregelen mbt bloedtransfusie / Houston art. n art. P. Brown. BSE and transmission through blood The Lancet Vol 356 sept 16, 2000 n art. F. Houston et al. Transmission of BSE by blood transfusion in sheep. The Lancet vol 356 sept 16, n art. W.G. van Aken, A. Brand en C.L. van der Poel: Leukodepletie van bloedproducten: een maatregel ten behoeve van kwaliteit en veiligheid. NTVG mei;144(22) n art. H.L. Zaaijer Boviene spongiforme encephalopathie en de veiligheid van voedsel NTVG mei;144 (22) n art. H.L. Zaaijer Interpretatie van de toename van boviene spongiforme encephalopathie buiten Groot-Brittannie. NTVG april;146(16) n art. E.A. Groes et al. Ziekte van Creutzfeldt-Jakob: diagnostiek, incidentie, preventie en behandeling. NTVG april;146 (16) n art. R. Kersseboom et al. Het risico van de variant Creutzfeldt-Jakob in Nederland en het effect van preventieve maatregelen. NTVG april;146 (16) n art W.G. van Aken ‘Variant van de ziekte van Creutzfeldt-Jkob en bloedtransfuzie’;rapport van de gezondheidsraad NTVG juli;145 (30)


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