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Are whole blood donors the answer to your platelet inventory crisis?

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Blood centers and hospitals across the U.S. have reported chronic platelet shortages, potentially leading to delayed or canceled medical procedures and an inability to meet surge capacity during a disaster. Whole blood donors could hold a solution: Studies have shown that whole blood-derived platelets have similarities and even some advantages compared to the more commonly used apheresis platelets.

Platelet supply and demand
In an article published in Transfusion, results of a survey conducted by Pandey and colleagues (2019) showed that more than 20% of all hospitals surveyed experienced inadequate platelet supply more than once per month.1 The authors also reported that inadequate platelet supply may lead to delayed or canceled medical procedures as physicians wait for the platelet inventory to become adequate.1
 
As these platelet shortages become more widespread and persistent, blood collection establishments across the country have sounded the alarm that the current platelet production pipeline is unsustainable. The most recent National Blood Collection and Utilization Survey (NBCUS), in addition to collections data published by America’s Blood Centers (ABC), shows an increase in demand for platelet products that is not matched by an increase in platelet collections.2-5 This trajectory raises concerns over the ability to meet surge capacity in the event of a national disaster.
 
Platelet source concerns
Even in times of critical platelet shortages, the U.S. relies almost exclusively on the generosity of apheresis donors for platelet supply. The 2021 NBCUS reported that 96% of platelets distributed in the U.S. are collected by apheresis.2 Moreover, the production and distribution of whole blood-derived platelets has steadily decreased throughout the past decade, primarily due to financial constraints and hospital preference for apheresis platelet units.2,3
 
Blood centers have also indicated that their platelet supply is at risk due to the age demographic of dedicated apheresis donors. Currently, more than 40% of apheresis platelet donors are greater than 55 years of age, and there is concern that these donors will “age out” of eligibility.6
 
Whole blood-derived platelets
Given the current platelet supply and demand challenges, blood centers should consider other sources, such as whole blood-derived platelets.
 
Although apheresis platelets are preferred by many hospitals, studies have shown that whole blood-derived platelets have similar hemostatic efficacy,7 the same risk of alloimmunization,8 and the same risk of bacterial contamination as apheresis platelets.9,10 From the collections and recruitment perspective, implementation of whole blood-derived platelet programs may be advantageous because whole blood donation is faster than apheresis — 20 minutes versus 2 hours.
 
Is it time to try a new approach?
Today, most platelets collected during whole blood donations are discarded because blood centers do not have whole blood-derived platelet programs in place. However, platelets collected from whole blood donors can help supplement the current apheresis supply. If you already have whole blood donors, why not use their platelets to alleviate the strain on platelet supply and the burden on your apheresis donors?

To discuss this topic further, ​connect with one of our experts. We are here to help.

–  Information in this article was provided by Aspen King, PhD, Scientific Marketing Associate, and Kat Culhi, RN, MSN, Sr. Specialist, both of Terumo Blood and Cell Technologies​​.


1Pandey S, et al. A survey of U.S. hospitals on platelet inventory management, transfusion practice, and platelet availability. Transfusion. 2021;61(9):2611-2620.
2Free RJ, et al. Continued stabilization of blood collections and transfusions in the United States: Findings from the 2021 National Blood Collection and Utilization Survey. Transfusion. 2023;63(S4):S8-S18.
3Stubbs JR, et al. Expanding the platelet inventory to mitigate the impact of severe shortages. Hematology Am Soc Hematol Educ Program. 2022;1:424-429.
4America’s Blood Centers and the Association for Blood Donor Professionals. U.S. Blood Donation Statistics and Public Messaging Guide. Version 2.0. Accessed 10 May 2024. https://www.adrp.org/resources/U.S.%20Blood%20Donation%20Statistics%20and%20Public%20Messaging%20Guide%20Jan.%202024.pdf​.​​
5Riley W, et al. Ensuring a reliable platelet supply in the United States. N Engl J Med. 2023;388(22):2017-2019.
6Lasky B, et al. Young apheresis platelet donors show significant and sustained growth over the last decade in the U.S., 2010-2019: A favorable sign of the resiliency of the platelet supply. Transfusion. 2023;63(7):1333-1343.
7Triulzi DJ, et al. The impact of platelet transfusion characteristics on posttransfusion platelet increments and clinical bleeding in patients with hypoproliferative thrombocytopenia. Blood. 2012;119(23):5553-5562.
8TRAP Study Group. Leukocyte reduction with ultraviolet B irradiation of platelets to prevent alloimmunization and refractoriness to platelet transfusions. N Engl J Med. 1997;337:1861-1870.
9Seheult JN, et al. I am the 9%: Making the case for whole-blood platelets. Transfus Med. 2016;26:177-185.
10Schrezenme​ier H, et al. Bacterial contamination of platelet concentrates: results of a prospective multicenter study comparing whole blood-pooled platelets and apheresis platelets. Transfusion. 2007;47:644-652.

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