Buffy coat platelets coming to America: Are we ready?

BACKGROUND: Buffy coat (BC) platelets (PLTs) have been used globally for many years. In 2004 Canadian Blood Services (CBS) made the decision to transition from PLT-rich plasma (PRP) to BC PLTs. We reviewed the benefits and manufacture process of BC and the implementation challenges involved. STUDY DESIGN AND METHODS: A literature review was performed in the following areas: BC efficacy, donor population shifts, production and good stewardship of PLTs, logistic considerations with overnight holds, advantages of the overnight hold, the CBS experience, licensure and standards, and changes needed to produce BC PLTs in the United States. The aim was to analyze current practice and identify possible actions for blood centers and hospitals. RESULTS: Implementation of BC would offer an additional source of PLTs to address the growing elderly population and the declining apheresis donor base. Substantial logistic, operational, and financial benefits were seen when CBS transitioned to BC with overnight hold. CONCLUSIONS: Buffy coat blood products are widely used throughout the world. Recent conversion from PRP to BC by CBS showed that conversion can be accomplished with planning, communication, and partnership from all stakeholders. In conclusion, BC PLTs are worth serious consideration in the United States, but regulatory barriers in the United States will need to be addressed.

[Platelet-washing solution optimization]. / Optimisation des solutions de lavage pour déplasmatiser des concentrés de plaquettes.

Different washing and homogénéisation solutions are hereby analysed by comparing the evolution of functional indicators during the preservation of washed aphaeresis platelet concentrates: physiological pH 4.5 and 6 solutions, buffered physiological pH 6.8 glucose solution, and two physiological pH 7 citrate solutions with acetate. Prior acidification of platelet concentrates proved to be essential. Two washings with manual or automated technique, guarantee residual proteins at a level of less than 0.5 g. Solutions T-Sol Baxter or SSP Macopharma allow us to obtain a product that meet the PSL specifications. Routine since June 2004, washings are done with a physiological pH 6 solution, then homogeneised with T-Sol solution. Platelet recovery, swirling phenomenon, lack of agrgegates, pH maintenance, low increase in the platelet average volume and maintenance of intra-cell potassium level, suggest that platelet entirety is preserved beyond the product's expiration date. The platelet transfusion yield of these products is satisfactory.

[Concentration of platelets from apheresis: methods of preparation]. / Les concentrés de plaquettes d'aphérèse: méthodes de préparation.

Apheresis platelet concentrates are platelet suspension obtained by apheresis from a blood cell separator. These techniques are now 20 years old. They are best way to collect great quantities of platelets from only one donor. These blood cell separators (discontinuous or continuous flow), realise extracorporeal circuit in which the blood in mixed with an anticoagulant (mainly citrate). All the procedures used are automatic and adapted with the donor parameters. The platelet donor is between 18 and 60 years old and can give 5 times per year. The platelet concentration in the product is divided into 3 classes (1 = 2 - 4 x 10(11) - 2 = 4 - 6 x 10(11) - 3 > 6 x 10(11)). Each category has a special price. Actually, we can store these platelets only 5 days. In the future, we need new studies and new directions (additive solution, new plastic) to propose a better viability and a longer storage.