Quality Parameters of Platelet Concentrate at Kenyatta National Hospital's Blood Transfusion Unit

Abstract

Background and objective: Platelet rich plasma-platelet concentrate (PRP-PC), were prepared and their quality parameters were assessed. Materials and methods: This was a prospective cross-sectional study carried out from February 2010 and May 2010 to study various quality determinants of platelets prepared at the Kenyatta National Hospital. The objectives were to assess their quality using the following parameters: swirling, volume of the platelet concentrate, platelet count, WBC count and pH. Results: A total of 78 platelet concentrates were analyzed. The majority 54, (69.2%) were group O RhD+, Group O RhD- was the least frequent blood group at 1.3%. A total of 77, (98.7%) of all concentrates were RhD positive. Centrifugation of whole blood was performed according to set specifications for all (100% n=78) concentrates. Separation was achieved using a separator but there was a prolonged delay of more than 1 hour before separation. Storage for all concentrates (100%, n=78) was in ambient temperature without temperature regulation. Agitation for all the concentrates (100%, n=78) was by circular motion in the horizontal plane. Only 51% (40) of all concentrates fulfilled the minimum specification for platelet count of >5.5 x 1010; the mean SD for platelet count was 6.63 ± 4.73 x 1010 with a median of 5.58 x 1010 and a range of 0.89 - 21.50 x 1010. None of the concentrates fulfilled specification for residual WBC count, (Mean + SD, Median and range of residual WBC count are 545 ± 429, 4.40 and 0.08 – 18.9(106) respectively) whereas 91% (71) and 95% (74) of the concentrates fulfilled the standards for volume and pH respectively. Forty (40) representing 51% of the coincentrates recorded a platelet count of 5.5 x 1010. The mean volume of PRP-PC was 74.6 ± 10.7 ml, with a median of 72.6 mlk and ranged from 49.8 – 97.2 ml. Their mean pH was 7.160 ± 0.426 and ranged from 6.0 – 7.8. Only 6 (7.6%) of the concentrates did not have red cell contamination. A total of 61 (78%) of the concentrates were issued on day 1, 8 (10%) on day 2 and 9 (12%) on day 3. All the concentrates were issued within three days of processing. Conclusion: The processes used in the preparation of platelets did not conform to the standards prescribed by NBTS resulting in only half of platelet concentrates fulfilling minimum specifications set by NBTS for platelet counts and none meeting the criteria for residual WBC count although they met the criteria for volume and pH. There is therefore need to strengthen the quality assurance program for preparation of platelet concentrates at KNH BTU and it is recommended that all platelet concentrates prepared at KNH be subjected to platelet count before issue so that only those concentrates that meet quality standards are issued.