血小板单采质量保证的成本效益

Institut für Transfusionsmedizin, Universitätsklinikum Essen, Germany.

Transfus Sci. 1999 Oct;21(2):141-5. doi: 10.1016/s0955-3886(99)00085-5.

BACKGROUND AND OBJECTIVES

A quality assurance system (QAS) is part of modern blood banking facilities. Quality control of single donor platelet (SDP) concentrates includes the determination of the platelet (PLT) yield and the white blood cell (WBC) contamination. Improvements in modern apheresis technology allow the collection of high PLT yields and leukoreduced products. Double dose SDPs can be split and WBC-reduced products may be labelled as leukodepleted thereby reducing costs.

MATERIAL AND METHODS

3309 SDPs obtained with the Amicus, AS 104, AS.TEC 204 and MCS + blood cell separators were retrospectively analysed for their PLT yield. SDPs with > or = 4.0 x 10(11) PLTs were considered as double dose SDPs and split. WBCs were determined microscopically in 170 SDPs. SDPs with a leukocyte content < 1.0 x 10(6) were labelled as leukodepleted and no further WBC filtration was recommended.

RESULTS

PLT yield was statistically higher in SDPs from the Amicus device, 84.8% of these products could be split. Double dose concentrates were collected in 22.7% with the MCS + machine and in 4.8% with the AS 104/AS.TEC 204 blood cell separators. The savings for disposables was $150,041 and for infectious disease testing $75,766. After the subtraction of the costs for PLT determinations in all SDPs $215,880 could be saved. WBC contamination was statistically lowest in in-line filtered SDPs from the MCS + device (median 0.29 x 10(5), range 0.22-9.96 x 10(5)) and all of these products were considered as fulfilling the criterion of leukodepeletion so that we were able to save $17,135 for bedside filters. Median WBC content was 0.75 x 10(5) (range 0.35-22.5 x 10(5)) in SDPs from the Amicus and 0.9 x 10(5) (range 0.27-99.8 x 10(5)) in SDPs from the AS 104/AS.TEC 204 devices, respectively.

CONCLUSION

Blood cell separators of the newest generation allow the collection of leukodepleted double dose SDPs. An intensified QAS in plateletpheresis allows the decision whether a product can be split and/or released as leukodepleted. By this means we were able to save a total of $233,015 per year.

背景与目的

质量保证体系（QAS）是现代血库设施的一部分。单采血小板（SDP）浓缩物的质量控制包括血小板（PLT）产量的测定和白细胞（WBC）污染情况。现代血液成分单采技术的改进使得能够采集到高产量的PLT且产品白细胞减少。双倍剂量的SDP可以拆分，白细胞减少的产品可以标记为白细胞去除，从而降低成本。

材料与方法

回顾性分析使用Amicus、AS 104、AS.TEC 204和MCS +血细胞分离机采集的3309份SDP的PLT产量。PLT≥4.0×10¹¹的SDP被视为双倍剂量SDP并进行拆分。在170份SDP中通过显微镜检测WBC。白细胞含量＜1.0×10⁶的SDP标记为白细胞去除，不建议进一步进行白细胞过滤。

结果

来自Amicus设备的SDP的PLT产量在统计学上更高，其中84.8%的产品可以拆分。使用MCS +机器采集到双倍剂量浓缩物的比例为22.7%，使用AS 104/AS.TEC 204血细胞分离机采集到的比例为4.8%。一次性用品节省了150,041美元，传染病检测节省了75,766美元。扣除所有SDP中PLT测定的成本后，可节省215,880美元。来自MCS +设备的在线过滤SDP的WBC污染在统计学上最低（中位数0.29×10⁵，范围0.22 - 9.96×10⁵），所有这些产品都被认为符合白细胞去除标准，因此我们能够节省17,135美元的床边过滤器费用。来自Amicus的SDP的WBC中位数含量为0.75×10⁵（范围0.35 - 22.5×10⁵），来自AS 104/AS.TEC 204设备的SDP的WBC中位数含量分别为0.9×10⁵（范围0.27 - 99.8×10⁵）。