An operations officer at a blood collection center in Southern California wonders if colleagues would share any data they might have on platelet recoveries both 'in lab' and following transfusion of volume-reduced platelets. In their blood center they are experiencing a 35% loss of platelets on average 'in lab' following plasma reduction, despite trying numerous settings on their centrifuges. The inquiring colleague did not provide data for platelet recoveries following transfusion of their volume-reduced platelets.

If other colleagues are more successful with 'in lab' platelet recoveries following volume reduction, please share your methods and data. If colleagues are seeing similar results to those reported by the Southern California colleague, please share those data, too. If colleagues are volume-reducing platelets but not measuring the platelet recoveries, how do they know the quality of the product is not significantly diminished?

The following responses have been received.

ADDENDA Nov. 17, 2003

1. Neil Blumberg MD, Director of Transfusion Medicine at the University of Rochester Medical Center (attribution used with permission) reports that at his institution, their traditional method of volume reduction is washing on a Cobe 2991 (4 or 5 whole blood-derived platelet concentrates as a pool). The loss due to leukoreduction is about 10% and the loss idue to washing is about 20%. The post-transfusion increments are about 25-30% lower with washed platelets. They report having performed a randomized trial of washed platelets compared with non-washed platelets and the incidence of minor or major bleeding was similar in both groups of about 20 patients each, each receiving hundreds of transfusions (about 5-10% of patients with one significant bleeding episode each during induction therapy for AML or ALL). Dr. Blumberg comments that his take on these data is that most platelet transfusions are prophylactic and most patients will not bleed with or without platelet transfusions. Therefore the doses of platelets given to patients are very possibly unnecessary or larger than needed in many cases.

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Ira A. Shulman, MD
CBBS e-Network Forum Editor & Moderator