Alternative Platelet Options Offered by Carter BloodCare
Carter BloodCare is continually exploring opportunities to improve our blood inventory and meet the needs of our community. We plan to increase our availability of both low-yield and pooled platelets in the coming months and years. While we typically think of these platelets as “alternative” platelet options, many countries use pooled platelets with lower yields as their conventional platelet dose. Thus, raising the question if we should continue consider these platelets as “alternative.”
Both pooled and apheresis platelets are pre-storage leukocyte reduced, bacterially tested, have 7-day storage and meet the same platelet yield criteria – thus making these equivalent products. The previously published TRAP study¹ shows that pooled platelets have similar rates of HLA alloimmunization to single donor apheresis platelets. The main factor in reducing HLA alloimmunization is leukocyte filtration, which applies to both. Additionally, pooled platelets have been shown to have advantages over apheresis platelets. Studies have shown that transfusion recipients have decreased rates of adverse reactions after receiving pooled platelets vs apheresis platelets². A small retrospective trial showed that the use of pooled platelets was associated with a greater platelet count increment in platelet refractory patients when compared to apheresis platelets³.
While low-yield platelets do not have the same platelet yield as traditional platelets, all other specifications (i.e. bacterial testing, shelf life, etc.) are satisfied. On September 10, 2024, Carter BloodCare will adjust our low-yield minimum platelet count from 2.8 x 10¹¹ to 2.5 x 10¹¹ platelets per bag. U.S. and International literature support the use of low-yield platelets with this new minimum yield. A large U.S. trial showed that low dose platelets with yields even lower than 2.5 X 10¹¹ did not affect bleeding incidence in study participants. Additionally, other countries and even U.S. hospitals have published their experiences in using low-yield platelets, with no noticeable increase in platelet usage⁵˒⁶.
In summary, these “alternative” platelet options will help stabilize the platelet supply. Reach out to us to learn more at hospitalrelations@carterbloodcare.org.
References:
1. TRAP Study Group. Leukocyte reduction and ultraviolet B irradiation of platelets to prevent alloimmunization and refractoriness to platelet transfusions. New England Journal of Medicine 1997; 337(26):1861-1869.
2. Daurat A, C Roger, JC Gris et al. Apheresis platelets are more frequently associated with adverse reactions than pooled platelets both in recipients and in donors: a study from French hemovigilance data. Transfusion 2016; 56; 1295–1303
3. Chu Y, W Rose, W Nawrot, T Raife. Pooled platelet concentrates provide a small benefit over single-donor platelets for patients with platelet refractoriness of any etiology. Journal of International Medical Research 2021: 49(5) 1–8
4. Slichter SJ, Kaufman RM, Assmann SF, et al. Dose of prophylactic platelet transfusions and prevention of hemorrhage. N Engl J Med. 2010; 362(7):600-613.
5. Devine DV. Impact of product platelet count reduction on platelet demand in Canada. Transfusion. 2022; 62: 481–2.
6. Tang MS, Shu E, Sussman H, Virk M, Pandey S, Shan H, et al. Transfusion outcomes between regular and low yield pathogen reduced platelets across different patient populations in a single institution. Transfusion. 2022; 62 (10): 2012–9.