Preparation of blood products for transfusion: is there a best method?

There are a number of possible methods for the preparation of blood components. These vary with respect to risks and benefits to the blood system operation, to the donor and to the recipient. An understanding of these risks is necessary when deciding what component production strategies to pursue. This manuscript reviews the elements that should be considered when choosing which components to produce. The two broad schemas for component production are apheresis and the production of components from whole blood donations. The development of apheresis technologies brought significant benefits to the patient including improving the access to specialty products such as HLA-matched platelets. Benefits to blood centers include the collection of multiple transfusion doses from a single collection procedure. The challenges include the cost of the technology and a small increased risk to donors. Whole blood component preparation offers two main forms of technology: platelet rich plasma, and buffy coat, both of which are driven by platelet production. The two have different risk profiles, with overall benefits being more favorable to buffy coat production methods particularly with respect to improved process control. Issues such as donor variability affect all production methods and require further research.