Supply with Platelet Concentrates from the Point of View of a Blood Donation Service of the Bavarian Red Cross

Abstract

Background: It is known that pooled platelet concentrates derived from buffy coat (PCs) have several disadvantages compared to platelet concentrates produced by platelet apheresis (APCs). Therefore, all blood products issued by the Bavarian Red Cross blood banks (BSD/BRK) (18,000 products/year) were produced by single donor apheresis. The main reason not to produce PCs was the elevated viral and bacterial infection risk during the last decade. But also the four-fold increased exposition to HLA and PLA antigens and the poor quality (in the sense of white and red cell contamination) of PCs (especially the ones produced with the platelet-rich plasma method) played a role to abstain from these products. Material and Methods: We performed a risk assessment to evaluate both products with regard to the actual testing and production methods, considering recently published data. However, a statistical calculation of the risks associated with the use of PCs or APCs with regard to different infectious agents with various prevalences was not done. Results: The dramatically reduced risk for the transmission of HIV, HBV or HCV accompanying the implementation of improved antibody tests and of NAT minipool testing, the introduction of 100% leukocyte filtration, the conversion of PC production from the platelet-rich to the buffy coat method, and recent data on the risk of transmission of bacterial infections resulted in a equal assessment of APCs and PCs. Conclusion: As a consequence of this revised risk assessment, we supply our hospitals with both products APCs and buffy coat-derived PCs (pools of 4 donors). For clinical use we considered both products as equally effective, except for patients who have multiple antibodies and need HLA-typed platelets.