Cost effectiveness of quality assurance in plateletpheresis

Background and objectives: A quality assurance system (QAS) is part of mode rn blood banking facilities. Quality control of single donor platelet (SDP) concentrates includes the determination of the platelet (PLT) yield and th e white blood cell (WBC) contamination. Improvements in modern apheresis te chnology allow the collection of high PLT yields and leukoreduced products. Double dose SDPs can be split and WBC-reduced products may be labelled as leukodepleted thereby reducing costs. Material and methods: 3309 SDPs obtained with the Amicus, AS 104, AS.TEC 20 4 and MCS + blood cell separators were retrospectively analysed for their P LT yield. SDPs with greater than or equal to 4.0 x 10(11) PLTs were conside red as double dose SDPs and split. WBCs were determined microscopically in 170 SDPs. SDPs with a leukocyte content <1.0 x 10(6) were labelled as leuko depleted and no further WBC filtration was recommended. Results: PLT yield was statistically higher in SDPs from the Amicus device, 84.8% of these products could be split. Double dose concentrates were coll ected in 22.7% with the MCS + machine and in 4.8% with the AS 104/AS.TEC 20 4 blood cell separators. The savings for disposables was $150041 and for in fectious disease testing $75766. After the subtraction of the costs for PLT determinations in all SDPs $215880 could be saved. WBC contamination was s tatistically lowest in in-line filtered SDPs from the MCS + device (median 0.29 x 10(5), range 0.22-9.96 x 10(5)) and all of these products were consi dered as fulfilling the criterion of leukodepeletion so that we were able t o save $17135 for bedside filters. Median WBC content was 0.75 x 10(5) (ran ge 0.35-22.5 x 10(5)) in SDPs from the Amicus and 0.9 x 10(5) (range 0.27-9 9.8 x 10(5)) in SDPs from the AS 104/AS.TEC 204 devices, respectively. Conclusion: Blood cell separators of the newest generation allow the collec tion of leukodepleted double dose SDPs. An intensified QAS in plateletphere sis allows the decision whether a product can be split and/or released as l eukodepleted. By this means we were able to save a total of $233015 per yea r. (C) 1999 Elsevier Science Ltd. All rights reserved.