Coagulation

Haematology analysers not needed to ensure donor platelet yields


The removal of haematology analysers from donor centres has reduced staff workload and saved millions in equipment costs without impacting on platelet yields, an analysis by the Australian Red Cross Blood Service (ARCBS) has found.

In 2015 donor centres switched to using historical platelet counts instead of Coulter haematology analysers as the basis for programming apheresis collection machines, and the process appears to have paid off, according to a study of platelet yields.

Donor centres made the switch after they noticed that platelet yields were maintained on previous occasions when haematology analysers were out of commission.  They had a target of 90% of mean historical platelet counts having  less than 20% variance from on-the-day platelet counts, and were able to surpass this when they formally investigated the impact of the changeover.

Starting in 2015, the apheresis collection machines in donot centres were programmed using the finger-prick haemoglobin level on the day of donation to estimate the haematocrit levels and also the mean of up to three historical platelet counts over the last 2 years from each donor.

In an analysis of  almost 2700 samples from 42 platelet collection donor centres  after removal of haematology analysers ARCBS researchers found that 96.6% of mean historical platelet counts  were within 20% variance of platelet counts on the day of donation. The component yield (platelet count x109 cell unit) increased slightly from 273.3 before to 282.8  after removal of analysers.

The authors of the study, led by Dr Rena Hirani of the ARCBS, Sydney, said the removal of analysers had simplified platelet collection procedures and logistics and freed up resources and time for collection centre staff.

“Furthermore the cost of installation and maintenance of the haematology analysers is substantial, with recurrent quality assurance program enrolment costs of over US$700,000  (A$904,000) for the 42 platelet collection sites around Australia [in 2015],” the authors noted.

Australia had also moved to a focus on male platelet donors of the annual 33,000 platelet donations to minimise the risk of transfusion-related acute lung injury (TRALI) and because larger platelet yields were usually obtained from males, the researchers said.

“Other countries use historical platelet counts for programming their apheresis machines when their onsite haematology analysers are non-functional.  However, the use of historical platelet counts as a replacement for in-centre full blood count testing has not been reported to have been implemented in other countries,” Dr Hirani told the limbic.

The findings are reported in Transfusion and Aphersesis Science.

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