Platelet Concentrate Preparations, Brief Comparison

When platelets are in demand, the options are:

1. Random Donor Platelets RDPc.
2. Single Donor Platelets SDPc-A (automated apheresis or cell separator processed)
3. Single Donor Platelets SDPc-M (manual apheresis)
4. Pooled Buffy Coat Platelets (PBCPc)

There is little doubt that quality-wise the Single Donor Platelet concentrates win hands down over the other options both for quality of product and safety. However, in the automated process (using cell separators) cost can be a major inhibiting factor, especially in developing countries. Now, with the US dollar on the rise against most currencies, this becomes an even bigger problem as both the equipment and the single use disposables costs have jumped upwards between 15% to 20% just over the last 6 months. In Pakistan a kit can cost 15,000, while in India it's typically 12,000, for one popular brand.

Manually processed single donor platelets are now a good option to explore. Of course, it is as time consuming (and labor intensive) as the automated process, and the most platelets one can hope to harvest will be equivalent to 2 RDPc at one donor sitting. Still, the safety of the single donor approach is maintained, and costs can come down to INR 500 to 1,000 for these 2 units together (depending on the pricing structure for platelets) as it only requires the use of 2 double bags per session, and double bags are relatively inexpensive. [Of course, as the platelets are collected in 'ordinary' double bags, there is no question of storing for longer than a day. It is a major factor in significantly reducing the cost. A note added after the initial posting]

For diseases like dengue where pediatric cases are more common, SDPc-M (harvesting 2 RDPc units worth of platelets a day) can be more than sufficient to maintain minimum platelet counts, while harvesting a lot of platelets SDPc-A (using a cell separator) may lead to a lot of wastage and may compromise the donors' abilities to maintain healthy platelet counts over the period of 1-2 weeks when the disease is at its most critical.

	Platelet Concentrate Product	Total Plt Counts	Typical Volume	Plt/mL	Typical Process
1	Random Donor Platelets RDPc	4.5x10(10) or 45x10(9)	50 mL to 70 mL	6.5x10(8)	Manual, triple bags
2	Single Donor Platelets SDPc-A	3x10(11) or 300x10(9)	300 ml	1x10(9)	Automated apheresis/cell separator
3	Single Donor Platelets SDPc-M 2 units	9x10(10) or 90x10(9)	100 mL	9x10(8)	Manual, double bags
4	Pooled Buffy Coat Platelets PBCPc Plt from 4 units + 1 unit plasma	1.8x10(11) or 180x10(9)	250 mL	8.8x10(8)	Manual, 'top and bottom' bags

Comments please!

Some References:

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

H. Schrezenmeier, 

E. Seifried 

Vox Sanguinis 

Volume 99, Issue 1,  pages 1–15, July 2010 

2. Storage of Apheresis and Pooled Buffy-Coat Platelet Concentrates Treated 

with Pathogen Inactivation Using the INTERCEPT Blood System Peter Schlenke, Valentine Franck, Lily Lin, Holger Kirchner Presented at the XXIX International Congress of the 

International Society of Blood Transfusion (ISBT) September 2-7, 2006 http://www.interceptbloodsystem.com/poster_pdfs_2006/ISBT-2006_Schlenke.pdf

3. Canadian Blood Services Transfusionmedicine.ca Vein to Vein: Preparation of Platelets (online)

http://www.transfusionmedicine.ca/resources/books/vein-vein/donations/component-preparation/preparation-platelets