Cairo University, Department of Clinical and Chemical Pathology Cairo, Al Jizah, Egypt
Background/Case Studies: In resource-limited settings, software updates that enhance yield and minimize consumables and procedure time are particularly valuable.
Study
Design/Methods: This prospective study aimed to evaluate the impact of recent software updates on Trima and Haemonetics, specifically focusing on high yield collections (9-12 × 10¹¹ platelets) and their effect on donor counts.
Results/Findings: We evaluated 400 sessions/device (200 post, 200 pre-update). In the updated Trima, processing time predicted platelet yields ≤ 6 × 10¹¹. This resulted in a significantly lower platelet drop (20.6%) compared to yields >6-12 × 10¹¹ (37%) and >12 × 10¹¹ (38.7%). Donor weight predicted yields >12 × 10¹¹. Although not statistically significant, a trend towards higher yields was observed in donors with higher pre-session platelet counts. For donors with yields >12 × 10¹¹, we found significant differences between the device-predicted yield and the actual yield (P < 0.05).
The updated Trima system demonstrated a significant increase in platelet yields (14.8 × 10¹¹), compared to the previous version (9 × 10¹¹). This improvement was achieved while maintaining comparable processing times and blood volumes (P > 0.05).
Donors on the updated Haemonetics, with yields below 6×10¹¹ showed significantly reduced processing time, pre-session platelet counts, and body weight (P < 0.05), resulting in a significantly lower platelet drop compared to those with higher yields. Higher pre-session platelet counts predicted yields above 9×10¹¹ compared to 6−9×10¹¹ yields (P < 0.05). The >9×10¹¹ group had a significantly greater absolute platelet drop (P = 0.03), but the percentage drop was similar (P > 0.05).
Comparing the updated and previous Haemonetics software, the updated version significantly reduced the proportion of donors with yields below 6 × 10¹¹ (19% vs. 58%) (P < 0.05).
There was no significant difference in hematocrit drops between the two updated devices (median drop 3%). Despite the Trima yielding significantly more platelets, platelet drop percentages were comparable between the two updated devices (P > 0.05). Post-apheresis platelet counts for all donors remained above 130 × 10⁹/L.
Only 1% of donors on both updated devices experienced adverse events, compared with 4.3% and 2.3% with the pre-updated Haemonetics and Trima, respectively.
Conclusions: The post-update performance of the Haemonetics showed marked improvements in yield and safety, yet its overall yield did not reach Trima's level. This study powerfully illustrates the necessity of a holistic approach that weighs device cost against long-term efficiency and safety outcomes, especially in resource-limited settings. Future research should also address the potential for underestimation in Trima's predictive algorithms for higher platelet yields to ensure accurate and reliable results.
