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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
Transfusion Systems
Transfusion Business Company
TRANSFUSION CONGRESS Opatia, Croatia June 10-11, 2005
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.
Transfusion Systems
Transfusion Business Company
TRANSFUSION CONGRESS Opatia, Croatia June 10-11, 2005
CONFIDENTIAL
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
Transfusion Systems
Transfusion Business Company
TRANSFUSION CONGRESS Opatia, Croatia June 10-11, 2005
CONFIDENTIAL
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.
Transfusion Systems
Transfusion Business Company
TRANSFUSION CONGRESS Opatia, Croatia June 10-11, 2005
CONFIDENTIAL
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.
Transfusion Systems
Transfusion Business Company
TRANSFUSION CONGRESS Opatia, Croatia June 10-11, 2005
CONFIDENTIAL
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
Transfusion Systems
Transfusion Business Company
TRANSFUSION CONGRESS Opatia, Croatia June 10-11, 2005
CONFIDENTIAL
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%
Transfusion Systems
Transfusion Business Company
TRANSFUSION CONGRESS Opatia, Croatia June 10-11, 2005
CONFIDENTIAL
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
Transfusion Systems
Transfusion Business Company
TRANSFUSION CONGRESS Opatia, Croatia June 10-11, 2005
CONFIDENTIAL
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
Transfusion Systems
Transfusion Business Company
TRANSFUSION CONGRESS Opatia, Croatia June 10-11, 2005
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 +++ ++ +
Transfusion Systems
Transfusion Business Company
TRANSFUSION CONGRESS Opatia, Croatia June 10-11, 2005
CONFIDENTIAL
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
Transfusion Systems
Transfusion Business Company
TRANSFUSION CONGRESS Opatia, Croatia June 10-11, 2005
CONFIDENTIAL
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.
Transfusion Systems
Transfusion Business Company
TRANSFUSION CONGRESS Opatia, Croatia June 10-11, 2005
CONFIDENTIAL
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:
Transfusion Systems
Transfusion Business Company
TRANSFUSION CONGRESS Opatia, Croatia June 10-11, 2005
CONFIDENTIALCONFIDENTIAL
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
Transfusion Systems
Transfusion Business Company
TRANSFUSION CONGRESS Opatia, Croatia June 10-11, 2005
CONFIDENTIALCONFIDENTIAL
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)
Transfusion Systems
Transfusion Business Company
TRANSFUSION CONGRESS Opatia, Croatia June 10-11, 2005
CONFIDENTIALCONFIDENTIAL
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)
Transfusion Systems
Transfusion Business Company
TRANSFUSION CONGRESS Opatia, Croatia June 10-11, 2005
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.