Background/Case Studies: In Brazil, the cost of high-quality hemotherapy often compromises access for patients in the public health system. The incorporation of Platelet Additive Solution (PAS) in platelet concentrates is a crucial strategy for transfusion services, optimizing patient management and blood stock. By reducing plasma volume to 35% and adding 65% Intersol (PAS), double platelet collection becomes possible, minimizing donor reactions during the procedure and lowering isoagglutinin titers in platelet concentrates. This enables the availability of non-group-matched O-type platelet products and reduces immediate and delayed transfusion reactions in recipients.However, the higher operational costs associated with Intersol use limit its feasibility in Brazil’s public health system. Reducing these costs is essential to ensure transfusion safety and equitable patient access.For the first time in Brazil’s Central-West region, this methodology will be implemented in a transfusion service, providing 100% coverage for public health patients. This milestone represents a significant advancement in transfusion safety and equitable access to high-quality care.
Study
Design/Methods: Between March and May 2024, 104 platelet apheresis collections were performed using Amicore equipment. Donors were selected based on a body surface area >1.7 m² and a platelet count >200,000/µl, following Brazilian clinical criteria, and were voluntary and regular. The protocol adjusted the platelet yield based on the equipment time during collection and reinfusion (max 120 minutes). A preservative solution—65% Intersol platelet additive and 35% autologous plasma—was added to the concentrate. Yield analysis used a binomial distribution to achieve 99% confidence that concentrates exceeded 6×10^11 platelets/unit. Operational costs included donor tests, the disposable kit, 700 ml Intersol, 500 ml each of anticoagulant and saline, platelet counts, and the blood culture of the collected bag.
Results/Findings: Of the 104 collections performed, based on the predefined adjustments, it was possible to obtain 208 platelet concentrates within the expected quality standard, as the average collection efficiency was 71%. The average yield obtained was 6.1×10^11 platelets per unit, with a 99% confidence interval where sample variation ranged between 6×10^11 and 6.2×10^11 platelets per unit.
Conclusions: The study demonstrated that an optimized donor selection protocol and equipment adjustments are effective strategies to reduce platelet collection operational costs by 50% while maintaining high-quality platelet concentrates.The cost reduction associated with this process enables broader access to high-quality platelets for public health patients, promoting equity in care and driving significant advancements in national hemotherapy services.
