platelet collections using trima. the new zealand experience · i have no financial interest in...
TRANSCRIPT
Platelet Collections Platelet Collections Platelet Collections Platelet Collections Platelet Collections Platelet Collections Platelet Collections Platelet Collections
using TRIMA.using TRIMA.using TRIMA.using TRIMA.using TRIMA.using TRIMA.using TRIMA.using TRIMA.
The New Zealand ExperienceThe New Zealand ExperienceThe New Zealand ExperienceThe New Zealand ExperienceThe New Zealand ExperienceThe New Zealand ExperienceThe New Zealand ExperienceThe New Zealand Experience
Dr Anup Chand20th November 2016
The New Zealand ExperienceThe New Zealand ExperienceThe New Zealand ExperienceThe New Zealand ExperienceThe New Zealand ExperienceThe New Zealand ExperienceThe New Zealand ExperienceThe New Zealand Experience
Disclaimer
I have no financial interest in TERUMO BCT or any other company
Content
• Introduction• Donor• PAS• PAS• The TRIMA machine• IT• Platelet Data
Te Ratonga Toto O Aotearoa
Formed July 1st 1998
Jurisdiction Gov’t of New Zealand
Staff 608
Website www.nzblood.co.nz
• 1925 – the first voluntary blood donations recorded in New Zealand were collected in Auckland - a panel of about 14 donors was established.established.
• For sometime only O donors.
• 1972 – Herb Cullis - Apheresis machine
• Enables donors to donate every 2 weeks.• Types of Platelets
– Random Donor > single– Random Donor > single> Pooled
– Single donor - apheresis ( 1-3 units).
Photo courtesy; Researchgate.net
PLATELETS APHERESISLEUCOCYTE DEPLETED
COMPONENT DESCRIPTION• A suspension of platelets prepared from a single donor using a cell
separator• machine and containing less than 5 x 106 leucocytes.QUALITY SPECIFICATION• Volume: 180 - 400 mls• Volume: 180 - 400 mls• Leucocyte Count: <5 x 106• Platelet Count: 2.4 x 1011 per unit• pH at out date: 6.4 – 7.4 (day 5)• CMV Status: On demand• Anticoagulant: ACD-A
ANNUAL NUMBER OF BLOOD COMPONENTSTRANSFUSED 2009 – 2014
Blood Component
2009 2010 2011 2012 2013 2014
% Change2014 compared
to2010
Red Cells 123,979 122,745 116,071 113,014 103,565 102,718
Red Cells Neo 1,840 1,898 1,749 1,732 1,664 1,553
Total Red Cells 125,819 124,643 117,820 114,746 105,229 1 04,271 -16.3%
Platelets - APH 7,571 7,576 6,661 2,117 487 523
Platelets - Pooled 5,325 5,403 2,349 614 0 0
Platelets - APH PAS 774 5,354 5,627 4,033
Platelets - Pooled PAS 48 2,988 5,037 6,457 7,429Platelets - Pooled PAS 48 2,988 5,037 6,457 7,429
Platelets - Neo 485 589 485 661 817 616
Total Platelets 13,381 13,616 13,257 13,783 13,388 12,601 -7.5%
Fresh Frozen Plasma 19,874 17,685 16,736 16,524 13,528 13,400
Fresh Frozen Plasma Neo 127 187 127 200 175 151
Total Fresh Frozen Plasma 20,001 17,872 16,863 16,724 13 ,703 13,551 -24.2%
Cryoprecipitate 2,869 2,951 3,228 3,745 4,167 4,198 42.3%
Cryodepleted Plasma 517 486 751 670 508 514 5.8%
Total Components 162,587 159,568 151,919 149,668 136,995 135,135 -15.3%
ANNUAL NUMBER OF BLOOD COMPONENTSTRANSFUSED 2009 – 2014
Blood Component
2009 2010 2011 2012 2013 2014
% Change2014 compared
to2010
Red Cells 123,979 122,745 116,071 113,014 103,565 102,718
Red Cells Neo 1,840 1,898 1,749 1,732 1,664 1,553
Total Red Cells 125,819 124,643 117,820 114,746 105,229 1 04,271 -16.3%
Platelets - APH 7,571 7,576 6,661 2,117 487 523
Platelets - Pooled 5,325 5,403 2,349 614 0 0
Platelets - APH PAS 774 5,354 5,627 4,033
Platelets - Pooled PAS 48 2,988 5,037 6,457 7,429Platelets - Pooled PAS 48 2,988 5,037 6,457 7,429
Platelets - Neo 485 589 485 661 817 616
Total Platelets 13,381 13,616 13,257 13,783 13,388 12,601 -7.5%
Fresh Frozen Plasma 19,874 17,685 16,736 16,524 13,528 13,400
Fresh Frozen Plasma Neo 127 187 127 200 175 151
Total Fresh Frozen Plasma 20,001 17,872 16,863 16,724 13 ,703 13,551 -24.2%
Cryoprecipitate 2,869 2,951 3,228 3,745 4,167 4,198 42.3%
Cryodepleted Plasma 517 486 751 670 508 514 5.8%
Total Components 162,587 159,568 151,919 149,668 136,995 135,135 -15.3%
ANNUAL RATE BLOOD COMPONENTS TRANSFUSEDPER 1,000 NEW ZEALAND POPULATION 2009 – 2014
Components Transfused per 1,000 Population
2009 2010 2011 2012 2013 2014
Red Cells 29.0 28.5 26.8 25.9 23.5 22.9
Platelets 3.1 3.1 3.0 3.1 3.0 2.8Platelets 3.1 3.1 3.0 3.1 3.0 2.8
Fresh Frozen Plasma 3.1 3.1 3.0 3.1 3.0 2.8
Cryoprecipitate 0.7 0.7 0.7 0.8 0.9 0.9
All Components 37.5 36.5 34.5 33.8 30.6 29.7
Population Estimate* 4,332,100 4,373,900 4,399,400 4,425,900 4,475,800 4,553,700
*www.stats.govt.nz
Blood Component
2009 2014
% Change2014 compared
to2010
Total RBCs 125,819 104,271 -16.3%
-21,548 = 5387 pooled units
The Donor
• A and O group
• Males
• Females – HLA negative• Females – HLA negative
• Nomogram – 650 mls
• Platelet count >250
MANAGEMENT OF PLATELET PANELS
Platelet Donors shall be managed as follows:
•If platelet count >250, retain donor on platelet panel.
•If platelet count <250 but >220 , retain donor on the plateletpanel provided they yield two doses and the procedure time isless than 2 hours.less than 2 hours.
•If platelet count <220 , and/or the donor does not yield adouble unit and/or the procedure time is greater than 2 hoursmove the donor to another panel as appropriate.
•If platelet count <220 , donors may only be retained on theplatelet panel with authorisation from the MO.
AMICUS (from Fenwal )• Only for donor collection• Can collect:
• Single or double apheresis platelet units
• Trima (from Terumo Medical Corporation ) • Only for donor collection • Can collect:
• Single or double red blood cell units • Single, double, or triple apheresis platelet units
The Machine(s)
• Single, double, or triple apheresis platelet units (depending on donor size, haematocrit, and platelet count)
• Time saved ( from over 120 mins to 80-90 mins)•COBE Spectra (from Terumo)
• Can use for both donor collection as well as for therapeutic • Can collect single or double apheresis platelet units
•MCS+ (from Haemonetics )• Can use for both donor collection as well as for therapeutic • Can collect single or double apheresis platelet units.
Platelet Additive Solution
•Isotonic, saline •Citrate: anticoagulant•Acetate: fuel - platelet metabolism
Clinical benefits:• Reduce plasma volume = decrease adverse events(TRALI, ABO mismatch)• Compatible with Pathogen Reduction Treatment• Improved bacterial detection performance
Logistical benefits:
Benefits of PAS
Logistical benefits: • Reduction of discard-rate due to expiry: compatibilitywith extended platelet shelf life up to 7 days• Extra plasma – transfuse or fractionate• Compatible with whole blood and apheresis platelets).
Trima Software Solutions SuiteImprove Your Center’s Productivity and
Traceability
Data from procedures is Data from procedures is Data from procedures is Data from procedures is available for review & available for review & available for review & available for review & analysisanalysisanalysisanalysis
Outcome ReviewProductivity ReportsCadence Data
Collection System
Data TransmissionCadence Data Collection System
• Automatic collection and transfer of Trima Accel data� One way information transfer (encrypted data)� No donor identifiable information transmitted
• Reduces machine downtime with accessibility to the run information (remote assistance)– Timely troubleshooting– Timely troubleshooting
• Permits generation of comprehensive Outcome Review reports to improve operational efficiency and productivity– Monitoring of procedure selection– Identify re-training needs– Country benchmarking
Raw Operational DataActionable Information
Consultancy ToolOutcome Review Report
Better Operational and Strategic
Decisions
Superior Cost and Operational Efficiency
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Acknowledgement• You• Transmedcon - Invitation• Terumo BCT - Sponsorship• NZBS -• Presentation contains images from
Google, NZBS annual report, and slides Google, NZBS annual report, and slides and reports presented to NZBS as part of ongoing support and service from Terumo BCT
QUESTIONS ?