Whole blood–derived platelets: keeping our platelet inventory whole

Abstract

Whole blood-derived platelet (WBDP) distribution has declined dramatically in the United States from 32.3% in 2001 to only 7.6% in 2013.1 This national trend is not reflected in the greater Seattle area where WBDPs still account for approximately 30% of platelet (PLT) distribution. The figures show our technique for manual extraction of plasma from the PLT button created after hard spin of PLT-rich plasma. Applying the Lean manufacturing premise of "right the first time," our product manufacturing department drilled two screws into each manual extractor and determined optimal positioning of these screws to leave approximately 55 mL of plasma in each WBDP (see figure, left). Furthermore, the satellite bag is placed on a raised shelf behind the plasma extractors to allow controlled flow of extracted plasma (see figure, middle). With this technique, one employee can make at least 12 WBDPs at once (see figure, right). The Acrodose PL system is then used to create leukoreduced prestorage PLT pools (PSPPs) composed of five WBDPs. The PSPPs provide equivalent PLT dose, bacterial contamination testing, and rapidity of issue as apheresis PLTs (APs). Data have also shown that leukoreduced WBDPs have similar hemostatic efficacy and HLA alloimmunization rate compared to leukoreduced APs and that both products carry a low risk of transfusion-related adverse events in the era of viral nucleic acid testing and bacterial testing. 2 With increased regulations and national trends of decreased donations and increased PLT usage, maintenance of an adequate PLT supply is becoming more challenging. WBDPs maximize the whole blood donor's gift and may help mitigate PLT shortages.