Technical Director Carter BloodCare Bedford, Texas, United States
Background/Case Studies: This blood center is an independent, community blood center providing transfusion resources to more than 200 hospitals across 50-plus counties in North, Central and East Texas, serving a population base of 8 million. Maintaining adequate platelet inventories at hospitals has been a challenge. This has become more acute due to increasing demand, a consequence of Texas’ maternal levels of care designation, the massive transfusion protocol and support to seven Level 1 trauma centers, and aging of the apheresis platelet donor base. To transform these challenges into opportunities, an FDA variance to store platelets at 1-6 °C for 14 days was submitted in July 2020. The FDA approved the variance in July 2021. The blood center kept hospital clients abreast of FDA status and the expected implementation. This was accomplished proactively via client emails, virtual Q&A sessions, and educational FAQs. Clients had access to the blood centers team of medical directors for additional consultations.
Study
Design/Methods: Our goals included honoring the donors, maintaining prices at a competitive level, and, most importantly, meeting platelet transfusion needs as requested. One approach to achieving these goals was to process and distribute 14 – day cold stored platelets (CSP) – instead of 7-day LVDS room-temperature (RT) platelets – to health care facilities. Those facilities that historically had elected to store an inventory of apheresis platelets on-site and whose historical monthly usage was < 30% were automatically enrolled in the cold-stored platelets program. Twenty-four hospitals were identified for automatic enrollment; of these, six maintained two or more units of platelets onsite, with 18 stocking only one unit each of RT LVDS platelets.
Results/Findings: Initially, the blood center team enrolled two hospitals on a trial basis in November 2021; this strategically enabled identification and resolution of any issues prior to program rollout to all eligible clients in January 2022. Table 1 Platelet Shipments and Usage Conclusions: By onboarding these identified hospitals to be supplied with CSP onsite rather than RT LVDS, the blood center efficiently reduced the quantity of platelets shipped YoY by 50%. Also, usage percentage increased from 25% to 49% YoY referenced by Table 1. Furthermore, platelets needed to treat patients prophylactically were more readily available, with limited need to increase platelet collections. Consistent communication with hospital partners contributed to the success of this initiative.
Importance of research: Donor recruitment is challenging especially associated with apheresis platelet donations. Our center continues to see the platelet donor base aging without new younger donors being added. CSPs allowed us to fulfill our mission to meet patient needs while honoring the donor's gift of life and still meet hospital needs to maintain a platelet onsite without having to increase collections. It is important to communicate with hospitals during the process to ensure understanding and cooperation.
