Platelet concentrates from buffy coats: improved conditions for preparation and evaluation in routine clinical use.

Since 1990, platelet concentrates prepared by soft centrifugation of buffy-coat pools diluted with a glucose-free, commercially available crystalloid solution (BC-PC) are the first choice product for all platelet recipients in our institution. Numerous in vitro and in vivo observations from our own and other laboratories indicate that BC-PC compare favorably to PC prepared from platelet-rich plasma (PRP). In the present in vitro study we evaluated traditional and bottom-and-top bags and modified centrifugation conditions with the aim of increasing in vitro platelet yield in BC-PC. This was 14-18% higher compared with our previous protocol when prolonged centrifugation and bottom-and-top bags were used. In addition, we evaluated post-transfusion platelet count increments in 42 unselected adult hematological patients routinely transfused with 703 1-5 day-old BC-PC pools. Transfusion data were managed with PLATELET, an MS-DOS compatible program which includes automated calculation of transfusion efficacy and periodic patient reports. Mean pre-, 1 h and 24 h post-transfusion platelet counts were 16, 38 and 28x10 9/L, respectively. Mean 1 h and 24 h post-transfusion platelet count increments, expressed as percentage of expected, were 40 and 24%, respectively. These data were similar to those obtained previously in 189 unselected hematological patients given 2432 PRP-PC transfusions (mean 1 h post-transfusion increment 46% of expected). The present in vitro study confirms that similar platelet yields can be obtained with the BC and PRP methods. In vivo findings show that also in routine conditions post-transfusion increments of PRP-PC and BC-PC are similar.(ABSTRACT TRUNCATED AT 250 WORDS)

A computer planning model for blood platelet production and distribution.

We consider a class of policies for stocking hospital blood banks with units of random donor platelet concentrate ('Platelets') based upon scheduled daily deliveries from a regional blood center to replenish the platelet inventory to a fixed 'base stock' level. The measures of interest are the 'shortage rate' (the proportion of days for which the on-hand inventory at the hospital blood bank is insufficient to meet the demand) and the 'outdate rate' (the proportion of total units shipped which are not transfused within the usable life span of 5 days). Our principal results give a predictive model which relates the base stock level to the shortage rate and outdate rate. Our model uses only the mean daily demand as a parameter. It provides a basis to unify the results from other studies which have demonstrated improvements in platelet inventory management in particular hospitals and blood centers.