Transfusion Systems Transfusion Business CompanyTRANSFUSION CONGRESS Opatia, Croatia June 10-11,...

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Transfusion Systems

Transfusion Business Company

TRANSFUSION CONGRESS Opatia, Croatia June 10-11, 2005

CONFIDENTIAL

Programme:

- Introduction

- How to define logistics of bloodprocessing

- Priority of components

- Influence of regulations

- Influence of staff related regulations

- Influence of platelets production

- Example of optimised logistics

- TSF separation and bloodbank logistics

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CONFIDENTIAL

Define priority of bloodcomponents

Optimalisation of blood components:

Production of ALL components in MOST excellent quality is NOT possible, define priority:

- Plasma; quick separation, fast freezing to optimise quality. Freezing < 3 hr after separation

- Platelets, storage for 4 – 24 hours, optimal recovery of platelets, high quality.

-This choice of most important component together with method of preparation defines basic algoritms of processing, find acceptable consensus for all components.

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Influencing the logistics of blood processing

External regulations:

- Fractionater; max. delay of freezing 3 hr

- GMP; different staf for different departments

Internal influences:

- Organisational priorities; lab and processing

- waste costs;

- work during late evening/night; personal costs

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Parameters effecting logistics: method of preparation and choice of bag system.

Different Reduction in Lymphocyte and Granulocyte content by removal of BC from fresh and O/N stored blood. (Z.Rácz, Hungary 1997)

- Results of separation: Manual (Q), Separator 1 =TACE(Q) and Separator 2=OPTIPRESS) were compaired with these variabels:

- Fresh blood and stored (O/N)

- Different sizes of BC taken

- Distribution of Lymphocytes/Granulocytes were investigated.

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Top and Bottom separation:

- Simultanious transfer of Plasma and Red Cells.

- Buffycoat is NOT transferred

- Hard spin for maximal Plasma recovery, up to 4700g for 15 minutes.

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Conventional Quadruple bag:

- Removal of plasma and BC from top of primairy bag.

- Transfer of SAGM through same tube.

- Quality of components influenced by storage of blood

- Platelet production with pooled Single BC or single Dilted BC

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Results of the study:

- Stored blood gives better removal of leukocytes with equal volume of BC removed.

- 20-30 ml BC: Fresh Stored

- Manual Q: 45% 70%

- Auto Q: 60% 78%

- Auto TAB: 71% 82%

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Platelet production

Platelet production from whole blood:

Triple bag conventional: Platelet Rich Plasma, to be separated by an additional spin in PC and PPP.

Quadruple bag conventional:

A: Diluted buffy coat to be separated by additional spin in PC and a waste residual BC.

B: 4 – 6 single buffycoats to be pooled together with a plasma (or additive solution), to produce a pooled random platelet concentrate. Buffycoats to be pooled within 24 HOURS

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Basic Processing procedures

Platelet production from whole blood:

Quadruple TAB bag :

Diluted buffycoat to be separated by additional spin in PC and a waste BC. Better results as quadruple Dil BC

Triple TAB bag:

Single buffy coat to be pooled together with 4-6 and a plasma (PAS etc), to produce a pooled random platelet concentrate. Buffycoats to be pooled within 24 HOURS

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CONFIDENTIAL

Basic Processing procedures

PERFORMANCE OF SEPARATION

TAB CONV Q Triple PRP

Plasma recovery +++ ++ -

L-reduction RCC +++ ++/+ -

Platelet recovery +++ ++ +

Separation time 2 – 7 min 2 – 3 min 2 Spin

Syphonage effect yes no no

Disposable cost +++ ++ +

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RBC Q PL Q PL VOL PLT Q PLT AMTRIPLE PRP 1-2 1 5 3 3QUAD BC DIL 2-3 2-3 3-5 3 4QUAD BC POOLED 2-3 4 3-5 5 5QUAD TAB 5 5 5 3 4TRIPLE TAB 5 5 5 5 5TSF TRIPLE 6 4 6 6 6

EXCELLENT 5POOR 1

QUALITY OF DIFFERENT COMPONENTS

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Optimal separation logistics in Rotterdam (NL).

- Collection of blood: every day from 09:00 untill 21:00. The collected blood is stored O/N in a incubator of 22°C.

- Test samples of blood are tested during the night from 00:00 untill 07:00.

-Test results are used to release the collected blood before the processing starts at 08:00.

- Unsafe blood is processed separate of safe blood.

- Pooling of Buffycoats is always done with safe products, no waste of pools due to positive test results.

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Alternative for platelet production:

Terumo Saving Platelet filter

3 leukodepleted products RBC, PLASMA, PLTS in 1

LGF version: results in small “BC”

Some recent tests done:

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Results of TSF:

Elverum; Norway (5000 col year)

Pool of 4, with T-SOL (BC 24hr old)

Buffycoat: weight is 62-65 gr netto. Redcell loss: 20- 22 ml in BC. Diluted BC 10 ml plasma.

Pool: Volume of 514- 520 ML, HcT= 21 – 23 %

(recovery of pooling: 97%)

Results: Pooled 6 pools,

Plt recovery: 294 – 356 x 109 unit

Recovery of second separation: 75 – 93% of pool

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Results of TSF:

Maribor, Slovenia: 9 – 13 May 2005.

Pool of 5 BC with PLASMA

Buffycoat: weight is 62-65 gr netto. Redcell loss: 20- 22 ml in BC. Diluted BC 10 ml plasma.

Pooled buffycoats of different ages:

-Overnight stored

-Two days stored (aggitated)

-Three and four days stored (aggitated)

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Results of TSF:

Maribor, Slovenia: 9 – 13 May 2005.

Fresh pooled: (O/N): 240 – 380

Day 2: 342 and 348

Day 3: 332 and 93 (cherry coloured BC’s!!)

Day 4: still under investigation.

Recovery of pooling: 99%

Recovery of sec separation:

75% (1950 rpm 4 m 30 sec)

91- 94 % (1300 rpm for 7 min, acc 8, brake 1)

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CONFIDENTIAL

New posibility for TSF saving Platelets

Small centres, willing to pool BC, allowing them to have prestorage filtering conditions with pooling untill day 3 (or more) to optimise the logistics of the platelets.

Transfusion Systems Transfusion Business CompanyTRANSFUSION CONGRESS Opatia, Croatia June 10-11,...

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