Routine results of an algorithm for managing the production of blood components.

BACKGROUND AND OBJECTIVES: The variability in the number of donations together with a growing demand for platelet concentrates and plasma-derived medicines make us seek solutions aimed at optimizing the processing of blood. Some mathematical models to improve efficiencies in blood banking have been published. The goal of this work is to validate and evaluate an algorithm's impact in the production of blood components in the Blood and Tissues Bank of Aragon (BTBA). MATERIALS AND METHODS: A mathematical algorithm was designed, implemented and validated through simulations with real data. It was incorporated into the fractionation area, which uses the Reveos® fractionation system (Terumo BCT) to split blood into its components. After 9 months of daily routine validation, retrospective activity data from the Blood Bank and Transfusion Services before and during the use of the algorithm were compared. RESULTS: Using the algorithm, the outdating rate of platelet concentrates (PC) decreased by 87.8% in the blood bank. The average shelf life remaining of PC supplied to Transfusion Services increased by almost 1 day. As a consequence, the outdating rate in the Aragon Transfusion Network decreased by 33%. In addition, extra 100 litres of plasma were obtained in 9 months. CONCLUSIONS: The algorithm improves the blood establishment's workflow and facilitates the decision-making process in whole blood processing. It resulted in a decrease in PC outdating rate, increase in PC shelf life and finally an increase in the volume of recovered plasma, leading to significant cost savings.

Comparison of automated versus semi-automated whole blood processing systems: A systematic review.

BACKGROUND AND OBJECTIVES: Implementation of automated steps in preparing blood components for transfusion from whole blood collections has produced improvements in multiple fields. The aim of this review is to summarize data from existing literature related to automation of whole blood processing systems. MATERIALS AND METHODS: We searched MEDLINE for studies comparing semi-automated and fully automated whole blood processing systems published before 20 July 2021. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Additionally, we performed a manual search. RESULTS: We identified 500 studies, of which 459 (92%) did not meet the eligibility criteria, and finally 17 studies were included in the analysis. Manual search included six additional studies. Publication year ranged from 2004 to 2021. Automation reduced the run-time (from 92 to 76 min), improved recovery of haemoglobin in red cell concentrates (RCCs) and resulted in higher red blood cell and platelet yields. Automation also reduced discard rates due to whole blood bag ruptures (1.2%-0.1%), low volume of RCCs (<200 ml; 0.5%-0.03%) and haemolytic plasma (2.1%-0.6%). Automation could reduce the number of full-time equivalent (FTE) operators or maintain the number of FTE operators while performing additional procedures, and it reduced to 1.13 m2 the space required for the device. CONCLUSION: Automation of whole blood processing resulted in continued improvements in productivity, product quality and technical features. However, too few publications are available to reach strong conclusions. Therefore, it is necessary to expand the scientific knowledge in this field.

Improvement of Blood Processing and Safety by Automation and Pathogen Reduction Technology.

INTRODUCTION: The objective of the present study was to describe the experience of the Blood and Tissues Bank of Aragon with the Reveos® Automated Blood Processing System and Mirasol® Pathogen Reduction Technology (PRT) System, comparing retrospectively routine quality data obtained in two different observation periods. METHODS: Comparing quality data encompassing 6,525 blood components from the period 2007-2012, when the semi-automated buffy coat method was used in routine, with 6,553 quality data from the period 2014-2019, when the Reveos system and subsequently the Mirasol system were implemented in routine. RESULTS: Moving from buffy coat to Reveos led to decreased discard rates of whole blood units (1.2 to 0.1%), increased hemoglobin content (48.1 ± 7.6 to 55.4 ± 6.6 g/unit), and hematocrit (58.9 ± 6.5% to 60.0 ± 4.9%) in red blood cell concentrates. Platelet concentrates (PCs) in both periods had similar yields (3.5 ×1011). Whereas in the earlier period, PCs resulted from pooling 5 buffy coats, in the second period 25% of PCs were prepared from 4 interim platelet units. The mean level of factor VIII in plasma was significantly higher with Reveos (92.8 vs. 97.3 IU). Mirasol PRT treatment of PCs reduced expiry rates to 1.2% in 2019. One septic transmission was reported with a non-PRT treated PCs, but none with PRT-treated PCs. CONCLUSION: Automation contributed to standardization, efficiency, and improvement of blood processing. Released resources enabled the effortless implementation of PRT. The combination of both technologies guaranteed the self-sufficiency and improvement of blood safety.

Impact of implementing pathogen reduction technologies for platelets on reducing outdates.

BACKGROUND AND OBJECTIVES: Applying pathogen reduction technologies (PRT) to platelets can extend their shelf life from 5 to 7 days, but there have been few systematic studies of the repercussions of such technologies on outdate rates. MATERIAL AND METHODS: The benefits in terms of outdate rates of applying PRT to platelets are studied via a mathematical simulation. Specifically, statistical methods are used to determine the daily production rate needed to meet demand while not exceeding a maximum amount set as a result of limitations on donations and while assuring a minimum daily stock. RESULTS: The results show that a 2-day extension in the shelf life of platelet concentrates (PC) results in reductions in outdates ranging from 88·4% to 100% at the production centres analysed. It may be the case for budgetary reasons that only part of the PCs produced can be treated. This being so, we show that if the proportion treated per annum exceeds 25% the best option is to treat part of the output every day, otherwise, it is preferable to concentrate treatment on the last two production days of the week. CONCLUSIONS: Extending the shelf life of PC from five to seven days and setting up suitable production logistics can drastically reduce outdates at production centres. If only a part of all PCs is treated, the best choices are to distribute PRT overall production days or, if the percentage of PCs treated is very low, to apply PRT on the days preceding the weekend break.