Platelet Collections using TRIMA. The New Zealand Experience Dr Anup Chand 20th November 2016
Disclaimer I have no financial interest in TERUMO BCT or any other company
Content Introduction Donor PAS The TRIMA machine IT Platelet Data
Te Ratonga Toto O Aotearoa Formed July 1 st 1998 Jurisdiction Gov t of New Zealand Staff 608 Website www.nzblood.co.nz
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.
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).
Photo courtesy; Researchgate.net
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: 180-400 mls Leucocyte Count: <5 x 106 Platelet Count: 2.4 x 1011 per unit ph at out date: 6.4 7.4 (day 5) CMV Status: On demand Anticoagulant: ACD-A
ANNUAL NUMBER OF BLOOD COMPONENTS TRANSFUSED 2009 2014 Blood Component 2009 2010 2011 2012 2013 2014 % Change 2014 compared to 2010 Red Cells 123,979 122,745 116,071 113,014 103,565 102,718 Red Cells Neo 1,840 1,898 1,749 1,732 1,664 1,553 Total Red Cells 125,819 124,643 117,820 114,746 105,229 104,271-16.3% Platelets - APH 7,571 7,576 6,661 2,117 487 523 Platelets - Pooled 5,325 5,403 2,349 614 0 0 Platelets - APH PAS 774 5,354 5,627 4,033 Platelets - Pooled PAS 48 2,988 5,037 6,457 7,429 Platelets - Neo 485 589 485 661 817 616 Total Platelets 13,381 13,616 13,257 13,783 13,388 12,601-7.5% Fresh Frozen Plasma 19,874 17,685 16,736 16,524 13,528 13,400 Fresh Frozen Plasma Neo 127 187 127 200 175 151 Total Fresh Frozen Plasma 20,001 17,872 16,863 16,724 13,703 13,551-24.2% Cryoprecipitate 2,869 2,951 3,228 3,745 4,167 4,198 42.3% Cryodepleted Plasma 517 486 751 670 508 514 5.8% Total Components 162,587 159,568 151,919 149,668 136,995 135,135-15.3%
ANNUAL NUMBER OF BLOOD COMPONENTS TRANSFUSED 2009 2014 Blood Component 2009 2010 2011 2012 2013 2014 % Change 2014 compared to 2010 Red Cells 123,979 122,745 116,071 113,014 103,565 102,718 Red Cells Neo 1,840 1,898 1,749 1,732 1,664 1,553 Total Red Cells 125,819 124,643 117,820 114,746 105,229 104,271-16.3% Platelets - APH 7,571 7,576 6,661 2,117 487 523 Platelets - Pooled 5,325 5,403 2,349 614 0 0 Platelets - APH PAS 774 5,354 5,627 4,033 Platelets - Pooled PAS 48 2,988 5,037 6,457 7,429 Platelets - Neo 485 589 485 661 817 616 Total Platelets 13,381 13,616 13,257 13,783 13,388 12,601-7.5% Fresh Frozen Plasma 19,874 17,685 16,736 16,524 13,528 13,400 Fresh Frozen Plasma Neo 127 187 127 200 175 151 Total Fresh Frozen Plasma 20,001 17,872 16,863 16,724 13,703 13,551-24.2% Cryoprecipitate 2,869 2,951 3,228 3,745 4,167 4,198 42.3% Cryodepleted Plasma 517 486 751 670 508 514 5.8% Total Components 162,587 159,568 151,919 149,668 136,995 135,135-15.3%
ANNUAL RATE BLOOD COMPONENTS TRANSFUSED PER 1,000 NEW ZEALAND POPULATION 2009 2014 Components Transfused per 1,000 Population 2009 2010 2011 2012 2013 2014 Red Cells 29.0 28.5 26.8 25.9 23.5 22.9 Platelets 3.1 3.1 3.0 3.1 3.0 2.8 Fresh Frozen Plasma 3.1 3.1 3.0 3.1 3.0 2.8 Cryoprecipitate 0.7 0.7 0.7 0.8 0.9 0.9 All Components 37.5 36.5 34.5 33.8 30.6 29.7 *www.stats.govt.nz Population Estimate* 4,332,100 4,373,900 4,399,400 4,425,900 4,475,800 4,553,700
Blood Component 2009 2014 % Change 2014 compared to 2010 Total RBCs 125,819 104,271-16.3% -21,548 = 5387 pooled units
A and O group Males The Donor Females HLA negative Nomogram 650 mls Platelet count >250
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.
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 80-90 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.
Isotonic, saline Citrate: anticoagulant Acetate: fuel - platelet metabolism Platelet Additive Solution
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).
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
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
Consultancy Tool Outcome Review Report Raw Operational Data Actionable Information Superior Cost and Operational Efficiency Better Operational and Strategic Decisions 3 1
500 400 300 200 100 0 300 250 200 150 100 50 0 Chart Title PRE POST 450 400 350 300 250 200 150 100 50 Chart Title Chart Title 0 16-01-2015 16-02-2015 16-03-2015 16-04-2015 16-05-2015 16-06-2015 16-07-2015 16-08-2015 16-09-2015 16-10-2015 16-11-2015 16-12-2015 16-01-2016 16-02-2016 16-03-2016 16-04-2016 16-05-2016 16-06-2016 16-07-2016 16-08-2016 16-09-2016 PRE POST
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
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