Improvement of Blood Processing and Safety by Automation and Pathogen Reduction Technology

Abstract

<b><i>Introduction:</i></b> The objective of the present study was to describe the experience of the Blood and Tissues Bank of Aragon with the Reveos® Automated Blood Processing System and Mirasol® Pathogen Reduction Technology (PRT) System, comparing retrospectively routine quality data obtained in two different observation periods. <b><i>Methods:</i></b> Comparing quality data encompassing 6,525 blood components from the period 2007–2012, when the semi-automated buffy coat method was used in routine, with 6,553 quality data from the period 2014–2019, when the Reveos system and subsequently the Mirasol system were implemented in routine. <b><i>Results:</i></b> Moving from buffy coat to Reveos led to decreased discard rates of whole blood units (1.2 to 0.1%), increased hemoglobin content (48.1 ± 7.6 to 55.4 ± 6.6 g/unit), and hematocrit (58.9 ± 6.5% to 60.0 ± 4.9%) in red blood cell concentrates. Platelet concentrates (PCs) in both periods had similar yields (3.5 ×10<sup>11</sup>). Whereas in the earlier period, PCs resulted from pooling 5 buffy coats, in the second period 25% of PCs were prepared from 4 interim platelet units. The mean level of factor VIII in plasma was significantly higher with Reveos (92.8 vs. 97.3 IU). Mirasol PRT treatment of PCs reduced expiry rates to 1.2% in 2019. One septic transmission was reported with a non-PRT treated PCs, but none with PRT-treated PCs. <b><i>Conclusion:</i></b> Automation contributed to standardization, efficiency, and improvement of blood processing. Released resources enabled the effortless implementation of PRT. The combination of both technologies guaranteed the self-sufficiency and improvement of blood safety.

Comparison of automated versus semi‐automated whole blood processing systems: A systematic review

“…In addition, from the 17 publications that met the eligibility criteria and the 6 additional publications from the manual search, only 7 were comparing the semi-automated system versus the fully automated system. These comparisons were done by assessing retrospectively the data from two different time periods from the same blood bank centre [8,18] or among different centres [7], or using both processing systems simultaneously in a single blood bank centre and assessing the data afterwards [21,23,28,29]. Considering the different devices that can perform the semi-automated method, the multiple protocols and technical features that can influence whole blood processing (e.g., maximum rpm of the centrifuges, etc.…”

“…Pérez-Aliaga reported lower discard rates due to haemolysis for RBC concentrates produced with a fully automated device as compared to semi-automated processing [8].…”

“…Overall, 17 studies were included in the analysis, with publication years ranging from 2004 to 2021 [5-7, 9, 15-27]. Manual search resulted in a further six publications for inclusion [8,11,[28][29][30][31].…”

“…On the other side, all semi-automated systems require a second centrifugation to obtain platelets [18]. Furthermore, automation of whole blood processing has increased the recovery of Hb in red cell concentrates (RCCs) [8] and has shown a higher platelet yield and a smaller volume of plasma using a three-component (3C) protocol, which comprised an RCC, a plasma and a platelet unit, when compared with semi-automated processing systems [20]. In addition, automation of whole blood processing can use the same disposable bag for the two-component (2C) or threecomponent (3C) protocols and process up to four whole blood units in one run, which makes disposal management less complex and more flexible compared to the semi-automated system [8].…”

“…Third, regardless of the skill level and experience of the operator, the final quality of blood components prepared by manual methods is variable [4]. Fourth, each additional manual step introduces the potential for processing errors and increases variance, for example, processing time [5][6][7][8]. Finally, wastage of blood is more frequently reported with any preparation method that includes manual separation steps [9].…”