Buffy-coat-derived pooled platelet concentrates and apheresis platelet concentrates: which product type should be preferred?

Abstract

There is an ongoing debate whether platelet concentrates (PCs) prepared from either whole-blood donations or by plateletpheresis are superior. Usage of these two product types varies greatly between countries and individual institutions. Some use mainly apheresis PCs; others prefer pooled PCs which are produced from whole-blood donations. This review summarizes the existing information on these product types. In the first part data on quality, efficacy and safety are reviewed. It is important to note that the issue cannot be answered just by comparing 'the' apheresis platelet concentrate versus 'the' pooled platelet concentrate. Other factors which determine the quality of a product, e.g. residual leukocyte count, plasma content, additive solution or storage period may be even more important. The focus of the debate should be shifted. It is much more needed to further improve the overall quality of PCs and to optimize treatment of thrombocytopenic patients than to concentrate on a single-edged view on just the preparation method. In the second part of this review we compare the product types from the donor's point of view. If PCs which are equally safe and effective can be obtained by various methods, ethics and the safety of the healthy volunteer donor tips the scales. The decision on the use of a particular product type should take into account all aspects of efficacy, side effects and availability of the product as well as the donor's perspective and the commitment to maximize the use of the valuable whole-blood donation.

Supportive care in severe and very severe aplastic anemia

“…56 In the case of inadequate increments in platelet count after platelet transfusion, screening for HLA-Abs should be performed. If no HLA-Abs can be detected, a screening for HPA Abs should be performed.…”

Wissenschaftliche Erläuterungen zur Stellungnahme „Bewertung von Apherese- und Pool-Thrombozytenkonzentraten“ des AK Blut vom 31.03.2015

“…Der gewonnene BC wird anschließend langsam zentrifugiert und das TK wird aus dem Überstand gewonnen. Alternativ wird die Vollblutspende langsam zentrifugiert und bei der Komponentenauftrennung wird ein plättchenreiches Plasma (PRP) gewonnen, das wiederum durch schnelle Zentrifugation und Resuspension der Thrombozyten zum TK wird [6,7]. Die in Deutschland eingesetzten PTK werden ausschließlich mit der BC-Methode hergestellt, in den USA wird die Plätt-chenreiches-Plasma-(PRP) Methode bevorzugt [8].…”

“…Um eine therapeutische Einheit mit den erforderlichen aktuellen Spezifikationen zu erhalten, werden in Deutschland in aller Regel die Thrombozyten von vier Spenden für ein nicht-pathogeninaktiviertes PTK gepoolt [6]. Nur eine Einrichtung hat aktuell eine Zulassung für PTK, hergestellt aus 5 Vollblutspenden.…”

Blood Product Supply in Germany: The Impact of Apheresis and Pooled Platelet Concentrates

“…ii) Four WBDs are needed for the production of 4 buffy coats to obtain 1 PPC [15][16][17]. iii) During buffy coat-derived PPC production from WBDs, a proportion of erythrocytes is lost or damaged.…”

“…The following assumptions were made: i) There is no difference reported between PPCs and APCs concerning clinical efficacy [1,2,8,15]. ii) Four WBDs are needed for the production of 4 buffy coats to obtain 1 PPC [15][16][17].…”