The New Zealand Experience

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Elisabeth Stone
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1 Platelet Collections using TRIMA. The New Zealand Experience Dr Anup Chand 20th November 2016

2 Disclaimer I have no financial interest in TERUMO BCT or any other company

5 Content Introduction Donor PAS The TRIMA machine IT Platelet Data

6 Te Ratonga Toto O Aotearoa Formed July 1 st 1998 Jurisdiction Gov t of New Zealand Staff 608 Website

8 1925 the first voluntary blood donations recorded in New Zealand were collected in Auckland - a panel of about 14 donors was established. For sometime only O donors.

9 1972 Herb Cullis - Apheresis machine Enables donors to donate every 2 weeks. Types of Platelets Random Donor > single > Pooled Single donor - apheresis ( 1-3 units).

10 Photo courtesy; Researchgate.net

11 COMPONENT DESCRIPTION PLATELETS APHERESIS LEUCOCYTE DEPLETED A suspension of platelets prepared from a single donor using a cell separator machine and containing less than 5 x 106 leucocytes. QUALITY SPECIFICATION Volume: mls Leucocyte Count: <5 x 106 Platelet Count: 2.4 x 1011 per unit ph at out date: (day 5) CMV Status: On demand Anticoagulant: ACD-A

12 ANNUAL NUMBER OF BLOOD COMPONENTS TRANSFUSED Blood Component % Change 2014 compared to 2010 Red Cells 123, , , , , ,718 Red Cells Neo 1,840 1,898 1,749 1,732 1,664 1,553 Total Red Cells 125, , , , , , % Platelets - APH 7,571 7,576 6,661 2, Platelets - Pooled 5,325 5,403 2, Platelets - APH PAS 774 5,354 5,627 4,033 Platelets - Pooled PAS 48 2,988 5,037 6,457 7,429 Platelets - Neo Total Platelets 13,381 13,616 13,257 13,783 13,388 12, % Fresh Frozen Plasma 19,874 17,685 16,736 16,524 13,528 13,400 Fresh Frozen Plasma Neo Total Fresh Frozen Plasma 20,001 17,872 16,863 16,724 13,703 13, % Cryoprecipitate 2,869 2,951 3,228 3,745 4,167 4, % Cryodepleted Plasma % Total Components 162, , , , , , %

13 ANNUAL NUMBER OF BLOOD COMPONENTS TRANSFUSED Blood Component % Change 2014 compared to 2010 Red Cells 123, , , , , ,718 Red Cells Neo 1,840 1,898 1,749 1,732 1,664 1,553 Total Red Cells 125, , , , , , % Platelets - APH 7,571 7,576 6,661 2, Platelets - Pooled 5,325 5,403 2, Platelets - APH PAS 774 5,354 5,627 4,033 Platelets - Pooled PAS 48 2,988 5,037 6,457 7,429 Platelets - Neo Total Platelets 13,381 13,616 13,257 13,783 13,388 12, % Fresh Frozen Plasma 19,874 17,685 16,736 16,524 13,528 13,400 Fresh Frozen Plasma Neo Total Fresh Frozen Plasma 20,001 17,872 16,863 16,724 13,703 13, % Cryoprecipitate 2,869 2,951 3,228 3,745 4,167 4, % Cryodepleted Plasma % Total Components 162, , , , , , %

14 ANNUAL RATE BLOOD COMPONENTS TRANSFUSED PER 1,000 NEW ZEALAND POPULATION Components Transfused per 1,000 Population Red Cells Platelets Fresh Frozen Plasma Cryoprecipitate All Components * Population Estimate* 4,332,100 4,373,900 4,399,400 4,425,900 4,475,800 4,553,700

15 Blood Component % Change 2014 compared to 2010 Total RBCs 125, , % -21,548 = 5387 pooled units

16 A and O group Males The Donor Females HLA negative Nomogram 650 mls Platelet count >250

18 MANAGEMENT OF PLATELET PANELS Platelet Donors shall be managed as follows: If platelet count >250, retain donor on platelet panel. If platelet count <250 but >220, retain donor on the platelet panel provided they yield two doses and the procedure time is less than 2 hours. If platelet count <220, and/or the donor does not yield a double unit and/or the procedure time is greater than 2 hours move the donor to another panel as appropriate. If platelet count <220, donors may only be retained on the platelet panel with authorisation from the MO.

19 The Machine(s) AMICUS (from Fenwal) Only for donor collection Can collect: Single or double apheresis platelet units Trima (from Terumo Medical Corporation) Only for donor collection Can collect: Single or double red blood cell units Single, double, or triple apheresis platelet units (depending on donor size, haematocrit, and platelet count) Time saved ( from over 120 mins to mins) COBE Spectra (from Terumo) Can use for both donor collection as well as for therapeutic Can collect single or double apheresis platelet units MCS+ (from Haemonetics) Can use for both donor collection as well as for therapeutic Can collect single or double apheresis platelet units.

20 Isotonic, saline Citrate: anticoagulant Acetate: fuel - platelet metabolism Platelet Additive Solution

21 Benefits of PAS Clinical benefits: Reduce plasma volume = decrease adverse events (TRALI, ABO mismatch) Compatible with Pathogen Reduction Treatment Improved bacterial detection performance Logistical benefits: Reduction of discard-rate due to expiry: compatibility with extended platelet shelf life up to 7 days Extra plasma transfuse or fractionate Compatible with whole blood and apheresis platelets).

29 Trima Software Solutions Suite Improve Your Center s Productivity and Traceability Data from procedures is available for review & analysis Cadence Data Collection System Outcome Review Productivity Reports

30 Data Transmission Cadence Data Collection System Automatic collection and transfer of Trima Accel data One way information transfer (encrypted data) No donor identifiable information transmitted Reduces machine downtime with accessibility to the run information (remote assistance) Timely troubleshooting Permits generation of comprehensive Outcome Review reports to improve operational efficiency and productivity Monitoring of procedure selection Identify re-training needs Country benchmarking

31 Consultancy Tool Outcome Review Report Raw Operational Data Actionable Information Superior Cost and Operational Efficiency Better Operational and Strategic Decisions 3 1

34 Chart Title PRE POST Chart Title Chart Title PRE POST

35 Acknowledgement You Transmedcon - Invitation Terumo BCT - Sponsorship NZBS - Presentation contains images from Google, NZBS annual report, and slides and reports presented to NZBS as part of ongoing support and service from Terumo BCT

36 QUESTIONS?

What is an Apheresis Donation?

What is an Apheresis Donation? What are Platelets? Platelets are colorless, irregularly shaped bodies found in blood. The primary role of platelets is to prevent bleeding in injured blood vessel walls by forming an aggregate at the