A colleague in Palau (a country consisting of 8 islands and ~250 islets that is southeast of the Philippines) reports that they are considering the feasibility of making their own FFP and platelets instead of buying these products from an outside provider. Since they have neither a blood bag centrifuge for component production, nor a freezer for FFP production or storage, they will need to purchase these items. They have very limited space.

They have a series of questions for the e-Network Forum:

1. They would appreciate the names and email contact information of equipment vendors that sell blood bag centrifuges and freezers.
2. At what temperature do others rapid freeze FFP and at what temperature is the FFP is stored.
3. How many freezers they should purchase, if they are going to both prepare and store their own FFP.
4. They would appreciate speaking with someone who has experience in setting up this kind of blood product manufacturing to answer such questions as "What are the current recommended centrifuge times and speeds for FFP and platelet concentrates?"
5. They also requested information on the correct maximum storage time for whole blood and packed cells if collected into CPDA-1.

The following comments have been received.

ADDENDA Nov. 28, 2004

1. A Transfusion Medicine Specialist in Auckland NZ reports that setting up transfusion services in a place like Palau will naturally depend on finances and the local knowledge available. In his opinion, some such countries can make plasma simply by standing the unit of blood overnight in the refrigerator and then seperating the plasma into a satellite bag before freezing the plasma. This is simple component preparation without the need for any expensive equipment. Such plasma will of course not meet the standards required in more sophisticated countries, but in his opinion, is quite satisfactory for clinical use. It can be stored at -25C for 2 years. Whether to make platelet concentrates, that require equipment and acquired skills will depend on the urgency of the needs and the clinical understanding of the requesting physician. His experience has been that so often in developing countries blood products are ordered inappropriately (not unknown in developing countries also!) . If there are not the finances to set up good quality platelet production, and the requirements are spasmodic, then fresh (less than 24 hours old) whole blood will provide fresh platelets, sufficient for hemostasis. If the need is ongoing, ie there is a long-term continuing need for platelet concentrates, then the decision has to be made whether to make single donor pheresis platelets or make them from single units of donated blood. There are pros and cons for each that will need to be decided locally. Most will decide to use existing donor units as a source of platelets, but he believes that a good case can be made for single donor platelets if the requisite equipment (and technical support) and expertise can be made available on a long-term basis.

The other questions are best resolved by commercial tender or by negotiation with firms that offer the best technical backup in the country concerned.

Please submit comments to the e-Network Forum.

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