Clinical Indications for Aph and Whole Blood pooled plts
-685800-81026016687806548120-6832606547485-68580049091859144001028700CLINICAL INDICATIONS FOR APHERESIS AND WHOLE BLOOD POOLED PLATELETSA National Statement November 201500CLINICAL INDICATIONS FOR APHERESIS AND WHOLE BLOOD POOLED PLATELETSA National Statement November 2015Contents TOC \o "1-3" \h \z \u SUMMARY PAGEREF _Toc399921099 \h 4Background PAGEREF _Toc399921100 \h 6Product comparison PAGEREF _Toc399921101 \h 7Points to consider PAGEREF _Toc399921103 \h 10Platelet content and quality PAGEREF _Toc399921104 \h 10Efficacy PAGEREF _Toc399921105 \h 11Acute non-haemolytic transfusion reactions PAGEREF _Toc399921106 \h 11Transfusion transmissible infections (TTI) PAGEREF _Toc399921107 \h 11Alloimmunisation and platelet refractoriness PAGEREF _Toc399921108 \h 12Statements PAGEREF _Toc399921109 \h 14Consensus Statement 1 PAGEREF _Toc399921110 \h 14Consensus Statement 2 PAGEREF _Toc399921111 \h 14Consensus Statement 3 PAGEREF _Toc399921112 \h 15Consensus Statement 4 PAGEREF _Toc399921113 \h 15Bibliography PAGEREF _Toc399921114 \h 17Version control:NumberDateDescription of changesCreated/Changed by1November 2013First DraftPlatelet consensus group2April 2014Formatting for consultation and endorsementsNational Blood Authority3June 2014Incorporating comments from JBC Platelets /CMV Working GroupNational Blood Authority4August 2014Feedback sought from consensus groupNo comments received5August 2015Feedback sought from JBC Platelets /CMV Working GroupPlatelet consensus groupSUMMARYOnce a decision has been made to prescribe a platelet transfusion, this document provides information regarding the selection of either apheresis platelets or whole blood pooled platelets. Absolute and relative indications for particular platelet types have been determined by literature search and expert consensus.DefinitionsAn absolute indication is one where evidence is available that either confirms or is indicative of additional clinical benefit with the prescription of a particular type of platelet component. Absolute indications will influence the supply plan for the particular type of platelet component.A relative indication is one where there is a theoretical clinical benefit or other benefit for the prescription of a particular type of platelet component, however available evidence is currently lacking. A relative indication will influence the prioritisation of the particular type of platelet component, when available.StatementsConsensus Statement 1Once it has been determined that a platelet transfusion is required for a particular patient, the absolute indications for apheresis platelets are:Patients who require HLA compatible and/or HPA matched platelets , such as:Patients with platelet refractoriness due to the presence of HLA and/or HPA antibodiesPatients with neonatal alloimmune thrombocytopenia (NAIT)Patients who require IgA deficient platelets i.e. IgA deficient patients with anti-IgA and a history of an anaphylactic transfusion reaction.Consensus Statement 2Once it has been determined that a platelet transfusion is required for a particular patient, the relative indications for apheresis platelets in preference to whole blood pooled platelets are:Neonates and small children whose platelet dose requirement can be met by a split apheresis component, thereby avoiding wastage of the unused part of the whole blood pooled platelet component Consensus Statement 3Once it has been determined that a platelet transfusion is required for a particular patient, there are no absolute indications for whole blood pooled platelets in preference to apheresis platelets.Consensus Statement 4Once it has been determined that a platelet transfusion is required for a particular patient, the relative indications for whole blood pooled platelets in preference to apheresis platelets are:Non-ABO-identical transfusions, especially for children, as the pooling process and lower plasma content reduces the risk of haemolysis associated with any potentially present high titre anti-A and/or anti-B BackgroundIn 1999, the Australian Red Cross Blood Service (Blood Service) identified its plan to supply 90% of its platelets as apheresis, as part of its original strategy for the implementation of universal leucodepletion of fresh components. At that time, platelets were mostly manufactured by the platelet rich plasma (PRP) method which gave a component of lower yield and quality and did not lend itself easily to leucodepletion.By 2004, approximately 25% of platelets supplied nationally were provided as apheresis platelets increasing to 37% in 2008/09 with wide variation amongst the jurisdictions. Apheresis platelets made up 88% of platelets manufactured in WA but only 18% in NSW.Since the late 1990s, there have been considerable advances in platelet collection, processing and testing which have had a significant impact on platelet quality and safety. These advances include:National implementation of buffy coat processing (completed 2007)Implementation of nucleic acid testing (NAT) for hepatitis C, HIV (2000) and hepatitis B (2010)Leucodepletion of all platelet components (2007)100% bacterial contamination screening (BCS) (2008)As such, the quality and safety considerations prompting the original 90% target had been mitigated to some extent by 2009. As a result, after review of the available evidence at the time and consultation with external clinicians, including the National Blood Transfusion Committee, the Blood Service recommended that 60% of platelets be produced by apheresis. This recommendation was made on the basis that haematology and oncology patients, who currently receive 50 – 60% of platelets issued, as well as paediatric patients were likely to derive the greatest benefit from apheresis platelets as a consequence of the lower donor exposure. In order to plan for future demand trends for platelets and determine the most appropriate split between apheresis and whole blood pooled platelets, the National Blood Authority (NBA) requested: A review of the clinical indications for each type of platelet component based on current evidence and expert opinion taking into account relevant Patient Blood Management (PBM) guidelines Based on the indications for use of each platelet component type, a recommendation of a national target of the split between apheresis and whole blood derived platelets to meet clinical demandThe Blood Service developed a set of draft consensus statements through literature search using Medline and the Cochrane database. These draft statements, and supportive documentation, were discussed and consensus derived by an invited expert clinician panel. Initially, a paper-based consensus process was conducted. If consensus could not be reached, it was a requirement that an in-person formal consensus meeting or teleconference alternative be conducted to finalise the consensus statements. Of note, cost effectiveness analysis was out of scope for the development of the clinical indications for the use of apheresis and whole blood platelets.Product comparisonPlatelets are collected and manufactured by two distinct methods: ADDIN EN.CITE <EndNote><Cite><Author>Vassallo</Author><Year>2006</Year><RecNum>31</RecNum><DisplayText>(1)</DisplayText><record><rec-number>31</rec-number><foreign-keys><key app="EN" db-id="sawvdvzwle92x4epxvn5px9xvprx5sr552er">31</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Vassallo, R. R.</author><author>Murphy, S.</author></authors></contributors><auth-address>American Red Cross Blood Services - Penn-Jersey Region, Philadelphia, Pennsylvania 19123, USA. vassallor@usa.</auth-address><titles><title>A critical comparison of platelet preparation methods</title><secondary-title>Current opinion in hematology</secondary-title><alt-title>Curr Opin Hematol</alt-title></titles><periodical><full-title>Current opinion in hematology</full-title><abbr-1>Curr Opin Hematol</abbr-1></periodical><alt-periodical><full-title>Current opinion in hematology</full-title><abbr-1>Curr Opin Hematol</abbr-1></alt-periodical><pages>323-30</pages><volume>13</volume><number>5</number><edition>2006/08/05</edition><keywords><keyword>Blood Preservation/*methods</keyword><keyword>Canada</keyword><keyword>Humans</keyword><keyword>Platelet Count</keyword><keyword>*Platelet Transfusion/adverse effects/methods</keyword><keyword>Plateletpheresis/*methods</keyword><keyword>United States</keyword></keywords><dates><year>2006</year><pub-dates><date>Sep</date></pub-dates></dates><isbn>1065-6251 (Print)
1065-6251 (Linking)</isbn><accession-num>16888436</accession-num><work-type>Review</work-type><urls><related-urls><url>;(1)Whole blood pooled platelets Apheresis platelets Platelet concentrates derived from whole blood collections can be obtained via the buffy coat (BC) or platelet rich plasma (PRP) manufacturing process. Since Australia only produces whole blood derived platelets by the BC method, only this method of manufacture has been referred to for whole blood pooled platelets in this statement. The literature review was primarily confined to platelets manufactured by the BC method or apheresis.Whole blood pooled platelets are obtained by pooling buffy coats from four separate ABO-identical whole blood donations using a platelet additive solution (PAS). The pool is centrifuged, filtered (to remove white cells) and rested (to prevent platelet clumps) to produce a leucodepleted pooled platelet unit.Apheresis platelets are collected from a single donor by using an apheresis machine with an integrated leucoreduction system (removing ≥ 99% white cells). The machine draws blood from the donor, isolates the platelets and some plasma by centrifugation and returns the remaining blood back to the donor. Often, it is possible to collect sufficient platelets from one plateletpheresis procedure to allow the collection to be split into two adult doses of platelets. Apheresis platelets are not suspended in PAS and for this reason have a higher residual plasma content compared with whole blood pooled platelets. Apheresis platelets are significantly more costly than whole blood pooled platelets. Product prices are listed on the National Blood Authority website at .au/national-product-list.Table SEQ Table \* ARABIC 1 Typical unit content of apheresis and whole blood pooled platelets based on units tested Oct 2010 – Sept 2011 ADDIN EN.CITE <EndNote><Cite><Year>2012</Year><RecNum>56</RecNum><DisplayText>(2)</DisplayText><record><rec-number>56</rec-number><foreign-keys><key app="EN" db-id="sawvdvzwle92x4epxvn5px9xvprx5sr552er">56</key></foreign-keys><ref-type name="Pamphlet">24</ref-type><contributors><secondary-authors><author>Australian Red Cross Blood Service</author></secondary-authors></contributors><titles><title>Blood Component Information</title></titles><dates><year>2012</year><pub-dates><date>December 2011</date></pub-dates></dates><pub-location>Melbourne, Victoria, Australia</pub-location><urls></urls></record></Cite><Cite><Year>2012</Year><RecNum>56</RecNum><record><rec-number>56</rec-number><foreign-keys><key app="EN" db-id="sawvdvzwle92x4epxvn5px9xvprx5sr552er">56</key></foreign-keys><ref-type name="Pamphlet">24</ref-type><contributors><secondary-authors><author>Australian Red Cross Blood Service</author></secondary-authors></contributors><titles><title>Blood Component Information</title></titles><dates><year>2012</year><pub-dates><date>December 2011</date></pub-dates></dates><pub-location>Melbourne, Victoria, Australia</pub-location><urls></urls></record></Cite></EndNote>(2)Apheresis PlateletsWhole Blood Pooled PlateletsPlatelet additive solutionN/ANOTE: Validation of apheresis platelets in additive solution is expected to commence late 2013/early 2014.Make up approximately 70% of total component volumeLess plasma currentlyAnticoagulantACD-ACPD/CPDAVolume (mean + 1 SD)183 ± 16mL303 ± 12mLNOTE: The Blood Service implemented a new blood component expressor system, used in the processing of whole blood donations, in early 2013 which resulted in an increase in the average volume of pooled platelets to approximately 350mL per pool. However, further optimisation of the process has recently been implemented which is expected to reduce the average volume to approximately 325mL.Platelet count (mean + 1SD)301 ± 41 x109/pack300 ± 44x109/poolpH at expiry (mean + 1SD)7.1 ± 0.27.1 ± 0.1Leucocyte count (mean + 1SD)0.21 ± 0.12 x106/pack0.30 ± 0.02x106/poolShelf-life5 days at 20-240C with gentle agitation5 days at 20-240C with gentle agitationModifications availableCMV seronegative, irradiated, HLA-compatible, HPA-matched, IgA deficient, low anti-A,BCMV seronegative, irradiatedTable SEQ Table \* ARABIC 2 Clinical considerations for transfusion of apheresis and whole blood pooled platelets Corrected Count Increment (CCI) 1 hour and 18-24 hoursNo significant difference between apheresis and BC pooled platelets PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5IZWRkbGU8L0F1dGhvcj48WWVhcj4yMDA4PC9ZZWFyPjxS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 EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5IZWRkbGU8L0F1dGhvcj48WWVhcj4yMDA4PC9ZZWFyPjxS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 EN.CITE.DATA (3, 4).Prevention of haemorrhageNo significant difference, but both studies compared apheresis with pooled platelets-PRP method PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5HdXJrYW48L0F1dGhvcj48WWVhcj4yMDA3PC9ZZWFyPjxS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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5HdXJrYW48L0F1dGhvcj48WWVhcj4yMDA3PC9ZZWFyPjxS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ADDIN EN.CITE.DATA (5, 6).In-vitro haemostatic potentialSimilar overall. Circulating recovery (5 days) is similar; hypotonic shock recovery slightly favours apheresis; ADP-, collagen- and epinephrine-induced aggregation is similar; pH is similar; activation marker CD62P is similar. (3, 5, 7, 8).Alloimmunisation and platelet refractorinessNo significant difference if components are all leucodepleted PEVuZE5vdGU+PENpdGU+PFllYXI+MTk5NzwvWWVhcj48UmVjTnVtPjQ3PC9SZWNOdW0+PERpc3Bs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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PFllYXI+MTk5NzwvWWVhcj48UmVjTnVtPjQ3PC9SZWNOdW0+PERpc3Bs
YXlUZXh0PigxMSk8L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PHJlYy1udW1iZXI+NDc8L3JlYy1udW1i
ZXI+PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJzYXd2ZHZ6d2xlOTJ4NGVweHZu
NXB4OXh2cHJ4NXNyNTUyZXIiPjQ3PC9rZXk+PC9mb3JlaWduLWtleXM+PHJlZi10eXBlIG5hbWU9
IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxjb250cmlidXRvcnM+PC9jb250cmlidXRv
cnM+PHRpdGxlcz48dGl0bGU+TGV1a29jeXRlIHJlZHVjdGlvbiBhbmQgdWx0cmF2aW9sZXQgQiBp
cnJhZGlhdGlvbiBvZiBwbGF0ZWxldHMgdG8gcHJldmVudCBhbGxvaW1tdW5pemF0aW9uIGFuZCBy
ZWZyYWN0b3JpbmVzcyB0byBwbGF0ZWxldCB0cmFuc2Z1c2lvbnMuIFRoZSBUcmlhbCB0byBSZWR1
Y2UgQWxsb2ltbXVuaXphdGlvbiB0byBQbGF0ZWxldHMgU3R1ZHkgR3JvdXA8L3RpdGxlPjxzZWNv
bmRhcnktdGl0bGU+VGhlIE5ldyBFbmdsYW5kIGpvdXJuYWwgb2YgbWVkaWNpbmU8L3NlY29uZGFy
eS10aXRsZT48YWx0LXRpdGxlPk4gRW5nbCBKIE1lZDwvYWx0LXRpdGxlPjwvdGl0bGVzPjxwZXJp
b2RpY2FsPjxmdWxsLXRpdGxlPlRoZSBOZXcgRW5nbGFuZCBqb3VybmFsIG9mIG1lZGljaW5lPC9m
dWxsLXRpdGxlPjxhYmJyLTE+TiBFbmdsIEogTWVkPC9hYmJyLTE+PC9wZXJpb2RpY2FsPjxhbHQt
cGVyaW9kaWNhbD48ZnVsbC10aXRsZT5UaGUgTmV3IEVuZ2xhbmQgam91cm5hbCBvZiBtZWRpY2lu
ZTwvZnVsbC10aXRsZT48YWJici0xPk4gRW5nbCBKIE1lZDwvYWJici0xPjwvYWx0LXBlcmlvZGlj
YWw+PHBhZ2VzPjE4NjEtOTwvcGFnZXM+PHZvbHVtZT4zMzc8L3ZvbHVtZT48bnVtYmVyPjI2PC9u
dW1iZXI+PGVkaXRpb24+MTk5OC8wMS8wNzwvZWRpdGlvbj48a2V5d29yZHM+PGtleXdvcmQ+QWRv
bGVzY2VudDwva2V5d29yZD48a2V5d29yZD5BZHVsdDwva2V5d29yZD48a2V5d29yZD5BZ2VkPC9r
ZXl3b3JkPjxrZXl3b3JkPkFnZWQsIDgwIGFuZCBvdmVyPC9rZXl3b3JkPjxrZXl3b3JkPkFudGln
ZW5zLCBIdW1hbiBQbGF0ZWxldC9pbW11bm9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPkJsb29kIENv
bXBvbmVudCBSZW1vdmFsPC9rZXl3b3JkPjxrZXl3b3JkPkJsb29kIEdyb3VwIEluY29tcGF0aWJp
bGl0eS9wcmV2ZW50aW9uICZhbXA7IGNvbnRyb2w8L2tleXdvcmQ+PGtleXdvcmQ+Qmxvb2QgUGxh
dGVsZXRzLyppbW11bm9sb2d5L3JhZGlhdGlvbiBlZmZlY3RzPC9rZXl3b3JkPjxrZXl3b3JkPkRv
dWJsZS1CbGluZCBNZXRob2Q8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxlPC9rZXl3b3JkPjxrZXl3
b3JkPkZpbHRyYXRpb248L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3Jk
Pklzb2FudGlib2RpZXMvKmJsb29kPC9rZXl3b3JkPjxrZXl3b3JkPkxldWtlbWlhLCBNeWVsb2lk
L2NvbXBsaWNhdGlvbnMvaW1tdW5vbG9neS9tb3J0YWxpdHk8L2tleXdvcmQ+PGtleXdvcmQ+TGV1
a29jeXRlcy8qaW1tdW5vbG9neS9yYWRpYXRpb24gZWZmZWN0czwva2V5d29yZD48a2V5d29yZD5M
eW1waG9jeXRlcy9pbW11bm9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtl
eXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+TXVsdGl2YXJpYXRlIEFuYWx5c2lz
PC9rZXl3b3JkPjxrZXl3b3JkPlBsYXRlbGV0IFRyYW5zZnVzaW9uLyphZHZlcnNlIGVmZmVjdHM8
L2tleXdvcmQ+PGtleXdvcmQ+VGhyb21ib2N5dG9wZW5pYS9ldGlvbG9neS90aGVyYXB5PC9rZXl3
b3JkPjxrZXl3b3JkPipVbHRyYXZpb2xldCBSYXlzPC9rZXl3b3JkPjwva2V5d29yZHM+PGRhdGVz
Pjx5ZWFyPjE5OTc8L3llYXI+PHB1Yi1kYXRlcz48ZGF0ZT5EZWMgMjU8L2RhdGU+PC9wdWItZGF0
ZXM+PC9kYXRlcz48aXNibj4wMDI4LTQ3OTMgKFByaW50KSYjeEQ7MDAyOC00NzkzIChMaW5raW5n
KTwvaXNibj48YWNjZXNzaW9uLW51bT45NDE3NTIzPC9hY2Nlc3Npb24tbnVtPjx3b3JrLXR5cGU+
Q2xpbmljYWwgVHJpYWwmI3hEO0NvbXBhcmF0aXZlIFN0dWR5JiN4RDtNdWx0aWNlbnRlciBTdHVk
eSYjeEQ7UmFuZG9taXplZCBDb250cm9sbGVkIFRyaWFsJiN4RDtSZXNlYXJjaCBTdXBwb3J0LCBV
LlMuIEdvdiZhcG9zO3QsIFAuSC5TLjwvd29yay10eXBlPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVy
bD5odHRwOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzk0MTc1MjM8L3VybD48L3JlbGF0
ZWQtdXJscz48L3VybHM+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwNTYvTkVKTTE5OTcx
MjI1MzM3MjYwMTwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PGxhbmd1YWdlPmVuZzwvbGFuZ3Vh
Z2U+PC9yZWNvcmQ+PC9DaXRlPjwvRW5kTm90ZT4A
ADDIN EN.CITE.DATA (9).Acute non-haemolytic transfusion reactionsNo significant difference (3, 9-12).Confirmed positive bacterial contamination screening ratesBoth low.Blood Service data:Apheresis 0.04% vs Pooled 0.12% (Apr 2008 – Apr 2013)International data:Apheresis 0.09% vs Pooled 0.06% PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TY2hyZXplbm1laWVyPC9BdXRob3I+PFllYXI+MjAwNzwv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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TY2hyZXplbm1laWVyPC9BdXRob3I+PFllYXI+MjAwNzwv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ADDIN EN.CITE.DATA (13) transfusion transmissible infectionsBoth low, but no comparable studies available. TRALINo comparable studies available of apheresis platelets and BC pooled platelets in platelet additive solution. No difference between TRALI risk in two studies that compared pooled PRP platelets and apheresis platelets (14, 15) and one study that compared BC pooled platelets in plasma and apheresis platelets (16).Points to considerPlatelet content and qualitySimilar platelet content in apheresis platelets and pooled plateletsi.e. 301 ± 41 x109/pack vs 300 ± 44x109/pool ADDIN EN.CITE <EndNote><Cite><Year>2012</Year><RecNum>56</RecNum><DisplayText>(2)</DisplayText><record><rec-number>56</rec-number><foreign-keys><key app="EN" db-id="sawvdvzwle92x4epxvn5px9xvprx5sr552er">56</key></foreign-keys><ref-type name="Pamphlet">24</ref-type><contributors><secondary-authors><author>Australian Red Cross Blood Service</author></secondary-authors></contributors><titles><title>Blood Component Information</title></titles><dates><year>2012</year><pub-dates><date>December 2011</date></pub-dates></dates><pub-location>Melbourne, Victoria, Australia</pub-location><urls></urls></record></Cite></EndNote>(2).Similar number of residual white cells are found i.e. 0.21 ± 0.12 x106/apheresis unit vs 0.30 ± 0.02x106/pooled platelet unit.A review of in vitro and in vivo studies by Schrezenmeier comparing platelet survival, activation and clot formation did not demonstrate that one method of preparation is consistently superior to the other; however noted that, due to inter-donor variability, pooled platelets may lead to a reduction in component variation ADDIN EN.CITE <EndNote><Cite><Author>Schrezenmeier</Author><Year>2010</Year><RecNum>37</RecNum><DisplayText>(13)</DisplayText><record><rec-number>37</rec-number><foreign-keys><key app="EN" db-id="sawvdvzwle92x4epxvn5px9xvprx5sr552er">37</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Schrezenmeier, H.</author><author>Seifried, E.</author></authors></contributors><auth-address>Red Cross Blood Service Baden-Wurttemberg-Hessen, Germany. h.schrezenmeier@blutspende.de</auth-address><titles><title>Buffy-coat-derived pooled platelet concentrates and apheresis platelet concentrates: which product type should be preferred?</title><secondary-title>Vox Sanguinis</secondary-title><alt-title>Vox Sang</alt-title></titles><periodical><full-title>Vox Sanguinis</full-title></periodical><pages>1-15</pages><volume>99</volume><number>1</number><edition>2010/01/12</edition><keywords><keyword>*Blood Donors/ethics</keyword><keyword>Blood Platelets/cytology/*physiology</keyword><keyword>Humans</keyword><keyword>Platelet Activation</keyword><keyword>Platelet Transfusion/adverse effects/ethics/methods</keyword><keyword>Plateletpheresis/ethics/*methods</keyword></keywords><dates><year>2010</year><pub-dates><date>Jul 1</date></pub-dates></dates><isbn>1423-0410 (Electronic)
0042-9007 (Linking)</isbn><accession-num>20059760</accession-num><work-type>Review</work-type><urls><related-urls><url>;(7).EfficacyCorrected count increment (CCI) is often used as a surrogate marker of platelet efficacy.1 hour and 18-24 hour CCI are no different between apheresis platelets and pooled platelets produced by the BC method ADDIN EN.CITE <EndNote><Cite><Author>Heddle</Author><Year>2008</Year><RecNum>44</RecNum><DisplayText>(5)</DisplayText><record><rec-number>44</rec-number><foreign-keys><key app="EN" db-id="sawvdvzwle92x4epxvn5px9xvprx5sr552er">44</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Heddle, N. M.</author><author>Arnold, D. M.</author><author>Boye, D.</author><author>Webert, K. E.</author><author>Resz, I.</author><author>Dumont, L. J.</author></authors></contributors><auth-address>The Department of Medicine and the Department of Molecular Medicine and Pathology, McMaster University, Hamilton, Ontario, Canada. heddlen@mcmaster.ca</auth-address><titles><title>Comparing the efficacy and safety of apheresis and whole blood-derived platelet transfusions: a systematic review</title><secondary-title>Transfusion</secondary-title><alt-title>Transfusion</alt-title></titles><periodical><full-title>Transfusion</full-title><abbr-1>Transfusion</abbr-1></periodical><alt-periodical><full-title>Transfusion</full-title><abbr-1>Transfusion</abbr-1></alt-periodical><pages>1447-58</pages><volume>48</volume><number>7</number><edition>2008/05/17</edition><keywords><keyword>Blood Component Removal/adverse effects/*methods/statistics & numerical data</keyword><keyword>Humans</keyword><keyword>Platelet Transfusion/adverse effects/*methods/statistics & numerical data</keyword><keyword>Randomized Controlled Trials as Topic</keyword></keywords><dates><year>2008</year><pub-dates><date>Jul</date></pub-dates></dates><isbn>0041-1132 (Print)
0041-1132 (Linking)</isbn><accession-num>18482183</accession-num><work-type>Comparative Study
Research Support, Non-U.S. Gov't
Review</work-type><urls><related-urls><url>;(3). In AML patients undergoing myeloablative transplant, both types of platelets (pooled PRP and apheresis) were just as effective in preventing haemorrhage PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5HdXJrYW48L0F1dGhvcj48WWVhcj4yMDA3PC9ZZWFyPjxS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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5HdXJrYW48L0F1dGhvcj48WWVhcj4yMDA3PC9ZZWFyPjxS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ADDIN EN.CITE.DATA (5) using time to red cell transfusion as a surrogate. There is also no difference in Grade ≥2 bleeding in haematology/oncology patients transfused with apheresis or pooled platelets PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Ucml1bHppPC9BdXRob3I+PFllYXI+MjAxMjwvWWVhcj48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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Ucml1bHppPC9BdXRob3I+PFllYXI+MjAxMjwvWWVhcj48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ADDIN EN.CITE.DATA (6).Acute non-haemolytic transfusion reactionsThe most common adverse reaction to platelets is febrile non haemolytic transfusion reaction (FNHTR) and the rate does not differ between apheresis platelets and whole blood pooled platelets as long as they are leucodepleted PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5IZWRkbGU8L0F1dGhvcj48WWVhcj4yMDAyPC9ZZWFyPjxS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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5IZWRkbGU8L0F1dGhvcj48WWVhcj4yMDAyPC9ZZWFyPjxS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ADDIN EN.CITE.DATA (9-11). Further trials have also indicated that the incidence of severe platelet reactions including bronchospasm and extensive urticaria does not differ PEVuZE5vdGU+PENpdGU+PFllYXI+MTk5NzwvWWVhcj48UmVjTnVtPjQ3PC9SZWNOdW0+PERpc3Bs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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PFllYXI+MTk5NzwvWWVhcj48UmVjTnVtPjQ3PC9SZWNOdW0+PERpc3Bs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ADDIN EN.CITE.DATA (9).Currently, there is no convincing data to suggest that the rate of transfusion-related acute lung injury (TRALI) is different between apheresis and whole blood pooled platelets, despite pooled platelets containing the least plasma (14-16). TRALI has still been reported even with transfusions of small volumes of plasma PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5XaW48L0F1dGhvcj48WWVhcj4yMDA4PC9ZZWFyPjxSZWNO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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5XaW48L0F1dGhvcj48WWVhcj4yMDA4PC9ZZWFyPjxSZWNO
dW0+NTQ8L1JlY051bT48RGlzcGxheVRleHQ+KDE0KTwvRGlzcGxheVRleHQ+PHJlY29yZD48cmVj
LW51bWJlcj41NDwvcmVjLW51bWJlcj48Zm9yZWlnbi1rZXlzPjxrZXkgYXBwPSJFTiIgZGItaWQ9
InNhd3Zkdnp3bGU5Mng0ZXB4dm41cHg5eHZwcng1c3I1NTJlciI+NTQ8L2tleT48L2ZvcmVpZ24t
a2V5cz48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRy
aWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPldpbiwgTi48L2F1dGhvcj48YXV0aG9yPkNoYXBtYW4s
IEMuIEUuPC9hdXRob3I+PGF1dGhvcj5Cb3dsZXMsIEsuIE0uPC9hdXRob3I+PGF1dGhvcj5HcmVl
biwgQS48L2F1dGhvcj48YXV0aG9yPkJyYWRsZXksIFMuPC9hdXRob3I+PGF1dGhvcj5FZG1vbmRz
b24sIEQuPC9hdXRob3I+PGF1dGhvcj5XYWxsaXMsIEouIFAuPC9hdXRob3I+PC9hdXRob3JzPjwv
Y29udHJpYnV0b3JzPjxhdXRoLWFkZHJlc3M+UmVkIENlbGwgSW1tdW5vbG9neSBEZXBhcnRtZW50
LCBOYXRpb25hbCBCbG9vZCBTZXJ2aWNlLCBUb290aW5nIENlbnRyZSwgTG9uZG9uLiBuYXkud2lu
QG5oc2J0Lm5ocy51azwvYXV0aC1hZGRyZXNzPjx0aXRsZXM+PHRpdGxlPkhvdyBtdWNoIHJlc2lk
dWFsIHBsYXNtYSBtYXkgY2F1c2UgVFJBTEk/PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPlRyYW5z
ZnVzaW9uIG1lZGljaW5lPC9zZWNvbmRhcnktdGl0bGU+PGFsdC10aXRsZT5UcmFuc2Z1cyBNZWQ8
L2FsdC10aXRsZT48L3RpdGxlcz48cGVyaW9kaWNhbD48ZnVsbC10aXRsZT5UcmFuc2Z1c2lvbiBt
ZWRpY2luZTwvZnVsbC10aXRsZT48YWJici0xPlRyYW5zZnVzIE1lZDwvYWJici0xPjwvcGVyaW9k
aWNhbD48YWx0LXBlcmlvZGljYWw+PGZ1bGwtdGl0bGU+VHJhbnNmdXNpb24gbWVkaWNpbmU8L2Z1
bGwtdGl0bGU+PGFiYnItMT5UcmFuc2Z1cyBNZWQ8L2FiYnItMT48L2FsdC1wZXJpb2RpY2FsPjxw
YWdlcz4yNzYtODA8L3BhZ2VzPjx2b2x1bWU+MTg8L3ZvbHVtZT48bnVtYmVyPjU8L251bWJlcj48
ZWRpdGlvbj4yMDA4LzEwLzIyPC9lZGl0aW9uPjxrZXl3b3Jkcz48a2V5d29yZD5BY3V0ZSBMdW5n
IEluanVyeS8qZXRpb2xvZ3kvcHJldmVudGlvbiAmYW1wOyBjb250cm9sPC9rZXl3b3JkPjxrZXl3
b3JkPkFkb2xlc2NlbnQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZCwgODAgYW5kIG92ZXI8L2tleXdv
cmQ+PGtleXdvcmQ+Qmxvb2QgRG9ub3JzPC9rZXl3b3JkPjxrZXl3b3JkPkVyeXRocm9jeXRlIFRy
YW5zZnVzaW9uLyphZHZlcnNlIGVmZmVjdHM8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxlPC9rZXl3
b3JkPjxrZXl3b3JkPkhMQSBBbnRpZ2Vucy8qaW1tdW5vbG9neTwva2V5d29yZD48a2V5d29yZD5I
aXN0b2NvbXBhdGliaWxpdHkgVGVzdGluZzwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdv
cmQ+PGtleXdvcmQ+SXNvYW50aWJvZGllcy8qYWR2ZXJzZSBlZmZlY3RzL2Jsb29kL2ltbXVub2xv
Z3k8L2tleXdvcmQ+PGtleXdvcmQ+TGV1a29jeXRlcy8qaW1tdW5vbG9neTwva2V5d29yZD48a2V5
d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2VkPC9rZXl3b3JkPjxrZXl3b3Jk
PlBsYXNtYS8qaW1tdW5vbG9neTwva2V5d29yZD48a2V5d29yZD5QbGF0ZWxldCBUcmFuc2Z1c2lv
bi8qYWR2ZXJzZSBlZmZlY3RzPC9rZXl3b3JkPjwva2V5d29yZHM+PGRhdGVzPjx5ZWFyPjIwMDg8
L3llYXI+PHB1Yi1kYXRlcz48ZGF0ZT5PY3Q8L2RhdGU+PC9wdWItZGF0ZXM+PC9kYXRlcz48aXNi
bj4xMzY1LTMxNDggKEVsZWN0cm9uaWMpJiN4RDswOTU4LTc1NzggKExpbmtpbmcpPC9pc2JuPjxh
Y2Nlc3Npb24tbnVtPjE4OTM3NzMzPC9hY2Nlc3Npb24tbnVtPjx3b3JrLXR5cGU+Q2FzZSBSZXBv
cnRzPC93b3JrLXR5cGU+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHA6Ly93d3cubmNiaS5u
bG0ubmloLmdvdi9wdWJtZWQvMTg5Mzc3MzM8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGVs
ZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjExMTEvai4xMzY1LTMxNDguMjAwOC4wMDg4NS54PC9l
bGVjdHJvbmljLXJlc291cmNlLW51bT48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48L3JlY29yZD48
L0NpdGU+PC9FbmROb3RlPn==
ADDIN EN.CITE.DATA (18). Blood Service data shows that platelets implicated in TRALI investigations are normally transfused with other blood components. In these situations, it can be difficult to distinguish which components are implicated.Transfusion transmissible infections (TTI)One of the strongest rationales for advocating the use of apheresis platelets is that the risk for TTI is higher with increased donor exposure. However, with ongoing improvements in donor screening, collection, manufacture and testing some of these risks have been mitigated.Bacterial infectionSince April 2008, all platelet units supplied by the Blood Service have undergone pre-release bacterial contamination screening. Several international studies including a large prospective study comparing contamination rates in more than 15,000 apheresis platelets and 37,000 whole blood pooled platelets found equal rates of confirmed positives in both platelet types PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TY2hyZXplbm1laWVyPC9BdXRob3I+PFllYXI+MjAwNzwv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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TY2hyZXplbm1laWVyPC9BdXRob3I+PFllYXI+MjAwNzwv
WWVhcj48UmVjTnVtPjI5PC9SZWNOdW0+PERpc3BsYXlUZXh0Pig0KTwvRGlzcGxheVRleHQ+PHJl
Y29yZD48cmVjLW51bWJlcj4yOTwvcmVjLW51bWJlcj48Zm9yZWlnbi1rZXlzPjxrZXkgYXBwPSJF
TiIgZGItaWQ9InNhd3Zkdnp3bGU5Mng0ZXB4dm41cHg5eHZwcng1c3I1NTJlciI+Mjk8L2tleT48
L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5
cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPlNjaHJlemVubWVpZXIsIEguPC9hdXRo
b3I+PGF1dGhvcj5XYWx0aGVyLVdlbmtlLCBHLjwvYXV0aG9yPjxhdXRob3I+TXVsbGVyLCBULiBI
LjwvYXV0aG9yPjxhdXRob3I+V2VpbmF1ZXIsIEYuPC9hdXRob3I+PGF1dGhvcj5Zb3VuaXMsIEEu
PC9hdXRob3I+PGF1dGhvcj5Ib2xsYW5kLUxldHosIFQuPC9hdXRob3I+PGF1dGhvcj5HZWlzLCBH
LjwvYXV0aG9yPjxhdXRob3I+QXNtdXMsIEouPC9hdXRob3I+PGF1dGhvcj5CYXVlcmZlaW5kLCBV
LjwvYXV0aG9yPjxhdXRob3I+QnVya2hhcnQsIEouPC9hdXRob3I+PGF1dGhvcj5EZWl0ZW5iZWNr
LCBSLjwvYXV0aG9yPjxhdXRob3I+Rm9yc3RlbWFubiwgRS48L2F1dGhvcj48YXV0aG9yPkdlYmF1
ZXIsIFcuPC9hdXRob3I+PGF1dGhvcj5Ib2Noc21hbm4sIEIuPC9hdXRob3I+PGF1dGhvcj5LYXJh
a2Fzc29wb3Vsb3MsIEEuPC9hdXRob3I+PGF1dGhvcj5MaWVic2NoZXIsIFUuIE0uPC9hdXRob3I+
PGF1dGhvcj5TYW5nZXIsIFcuPC9hdXRob3I+PGF1dGhvcj5TY2htaWR0LCBNLjwvYXV0aG9yPjxh
dXRob3I+U2NodW50ZXIsIEYuPC9hdXRob3I+PGF1dGhvcj5TaXJlaXMsIFcuPC9hdXRob3I+PGF1
dGhvcj5TZWlmcmllZCwgRS48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGF1dGgt
YWRkcmVzcz5JbnN0aXR1dGUgZm9yIENsaW5pY2FsIFRyYW5zZnVzaW9uIE1lZGljaW5lIGFuZCBJ
bW11bm9nZW5ldGljcyBVbG0sIFJlZCBDcm9zcyBCbG9vZCBEb25vciBTZXJ2aWNlIEJhZGVuLVd1
cnR0ZW1iZXJnLUhlc3NpYSwgYW5kIEluc3RpdHV0ZSBvZiBUcmFuc2Z1c2lvbiBNZWRpY2luZSwg
VW5pdmVyc2l0eSBvZiBVbG0sIFVsbSwgR2VybWFueS4gaC5zY2hyZXplbm1laWVyQGJsdXRzcGVu
ZGUuZGU8L2F1dGgtYWRkcmVzcz48dGl0bGVzPjx0aXRsZT5CYWN0ZXJpYWwgY29udGFtaW5hdGlv
biBvZiBwbGF0ZWxldCBjb25jZW50cmF0ZXM6IHJlc3VsdHMgb2YgYSBwcm9zcGVjdGl2ZSBtdWx0
aWNlbnRlciBzdHVkeSBjb21wYXJpbmcgcG9vbGVkIHdob2xlIGJsb29kLWRlcml2ZWQgcGxhdGVs
ZXRzIGFuZCBhcGhlcmVzaXMgcGxhdGVsZXRzPC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPlRyYW5z
ZnVzaW9uPC9zZWNvbmRhcnktdGl0bGU+PGFsdC10aXRsZT5UcmFuc2Z1c2lvbjwvYWx0LXRpdGxl
PjwvdGl0bGVzPjxwZXJpb2RpY2FsPjxmdWxsLXRpdGxlPlRyYW5zZnVzaW9uPC9mdWxsLXRpdGxl
PjxhYmJyLTE+VHJhbnNmdXNpb248L2FiYnItMT48L3BlcmlvZGljYWw+PGFsdC1wZXJpb2RpY2Fs
PjxmdWxsLXRpdGxlPlRyYW5zZnVzaW9uPC9mdWxsLXRpdGxlPjxhYmJyLTE+VHJhbnNmdXNpb248
L2FiYnItMT48L2FsdC1wZXJpb2RpY2FsPjxwYWdlcz42NDQtNTI8L3BhZ2VzPjx2b2x1bWU+NDc8
L3ZvbHVtZT48bnVtYmVyPjQ8L251bWJlcj48ZWRpdGlvbj4yMDA3LzAzLzI3PC9lZGl0aW9uPjxr
ZXl3b3Jkcz48a2V5d29yZD5CYWN0ZXJpYS9ncm93dGggJmFtcDsgZGV2ZWxvcG1lbnQvKmlzb2xh
dGlvbiAmYW1wOyBwdXJpZmljYXRpb248L2tleXdvcmQ+PGtleXdvcmQ+QmFjdGVyaWFsIEluZmVj
dGlvbnMvKmJsb29kL2V0aW9sb2d5L3ByZXZlbnRpb24gJmFtcDsgY29udHJvbDwva2V5d29yZD48
a2V5d29yZD5CbG9vZCBQbGF0ZWxldHMvKm1pY3JvYmlvbG9neTwva2V5d29yZD48a2V5d29yZD5C
bG9vZCBQcmVzZXJ2YXRpb24vbWV0aG9kcy9zdGFuZGFyZHM8L2tleXdvcmQ+PGtleXdvcmQ+Q29s
b255IENvdW50LCBNaWNyb2JpYWw8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxr
ZXl3b3JkPlBsYXRlbGV0IFRyYW5zZnVzaW9uL2FkdmVyc2UgZWZmZWN0cy8qc3RhdGlzdGljcyAm
YW1wOyBudW1lcmljYWwgZGF0YTwva2V5d29yZD48a2V5d29yZD5QbGF0ZWxldHBoZXJlc2lzPC9r
ZXl3b3JkPjxrZXl3b3JkPlByb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+Umlz
ayBGYWN0b3JzPC9rZXl3b3JkPjwva2V5d29yZHM+PGRhdGVzPjx5ZWFyPjIwMDc8L3llYXI+PHB1
Yi1kYXRlcz48ZGF0ZT5BcHI8L2RhdGU+PC9wdWItZGF0ZXM+PC9kYXRlcz48aXNibj4wMDQxLTEx
MzIgKFByaW50KSYjeEQ7MDA0MS0xMTMyIChMaW5raW5nKTwvaXNibj48YWNjZXNzaW9uLW51bT4x
NzM4MTYyMzwvYWNjZXNzaW9uLW51bT48d29yay10eXBlPkNvbXBhcmF0aXZlIFN0dWR5JiN4RDtN
dWx0aWNlbnRlciBTdHVkeSYjeEQ7UmVzZWFyY2ggU3VwcG9ydCwgTm9uLVUuUy4gR292JmFwb3M7
dDwvd29yay10eXBlPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwOi8vd3d3Lm5jYmkubmxt
Lm5paC5nb3YvcHVibWVkLzE3MzgxNjIzPC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxlbGVj
dHJvbmljLXJlc291cmNlLW51bT4xMC4xMTExL2ouMTUzNy0yOTk1LjIwMDcuMDExNjYueDwvZWxl
Y3Ryb25pYy1yZXNvdXJjZS1udW0+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PC9yZWNvcmQ+PC9D
aXRlPjwvRW5kTm90ZT4A
ADDIN EN.CITE.DATA (13). Blood Service data, from commencement of bacterial contamination screening (BCS) until April 2013, indicates that the confirmed positive rate for apheresis platelets was 0.04% vs 0.12% for whole blood pooled platelets. Almost 80% of bacteria identified were Propionibacterium species which is a common skin commensal and is considered nonpathogenic to non-immunocompromised patients. The remaining 20% of bacterial contaminants mainly consisted of other skin flora like Coagulase negative staphylococcus and Staphylococcus epidermidis. Approximately half of the platelets found to be BCS positive (either initial machine positive or confirmed positive) had already been transfused at the time of the initial machine positive flag and, in all cases, no evidence of transfusion-associated sepsis was reported. Therefore, although the rate of confirmed positive bacterial contamination is higher for whole blood pooled platelets, this may not translate into higher infection rates. Since the implementation of routine bacterial contamination screening of platelets, the Blood Service has only received three reports of confirmed transfusion-transmitted bacterial infection; two cases associated with red cell transfusions and one case associated with a whole blood pooled platelet transfusion.Viral infectionThe introduction of nucleic acid testing (NAT) for hepatitis C and HIV in 2000 and for hepatitis B in 2010 has further reduced the window period for viral detection, thereby reducing the infectious risk of contracting these viruses via a blood transfusion. The Blood Service TTI residual risk estimates, based on data from 1 January 2011 and 31 December 2012, are approximately 1 in 26 million for HIV, 1 in 26 million for hepatitis C and 1 in 538 000 for hepatitis B. No cases of transfusion transmitted hepatitis C have been reported in Australia since 1991, none for HIV since 1998 and three probable cases of hepatitis B in the 2005-2011 period ADDIN EN.CITE <EndNote><Cite><Author>Lucky</Author><Year>2012</Year><RecNum>62</RecNum><DisplayText>(15)</DisplayText><record><rec-number>62</rec-number><foreign-keys><key app="EN" db-id="sawvdvzwle92x4epxvn5px9xvprx5sr552er">62</key></foreign-keys><ref-type name="Government Document">46</ref-type><contributors><authors><author>Lucky, Tarana</author><author>Seed, Clive</author></authors><secondary-authors><author>Australian Red Cross Blood Service </author></secondary-authors></contributors><titles><title>Transfusion- transmissible Infections in Australia 2012 Surveillance Report</title></titles><dates><year>2012</year></dates><urls></urls></record></Cite></EndNote>(19). Although, theoretically, the risk of transmission of infectious agents would be expected to be higher in whole blood pooled platelets, no epidemiological studies or clinical trials have demonstrated this.The introduction of 100% leucodepletion has also reduced the risk of transmission of CMV which is located primarily in the white cells. The recent SaBTO guidelines ADDIN EN.CITE <EndNote><Cite><Year>2012</Year><RecNum>63</RecNum><DisplayText>(16)</DisplayText><record><rec-number>63</rec-number><foreign-keys><key app="EN" db-id="sawvdvzwle92x4epxvn5px9xvprx5sr552er">63</key></foreign-keys><ref-type name="Government Document">46</ref-type><contributors><secondary-authors><author>Advisory Committee on the Safety of Blood, Tissues and Organs</author></secondary-authors></contributors><titles><title>SaBTO report of the CMV Steering Group</title></titles><dates><year>2012</year></dates><urls></urls><custom1>SaBTO</custom1></record></Cite></EndNote>(20) from the UK state that the rates of transfusion-transmitted CMV are very low with both leucocyte depletion and serology screening and that the two techniques are probably equivalent. Hence, for all patient groups, including those undergoing haematopoietic stem cell transplant and solid organ transplant, CMV seronegative blood products can be replaced with leucodepleted blood components. However, it recommends that CMV seronegative blood products should be provided for intrauterine transfusions (IUT), pregnant women and neonates, up to 28 days post expected date of delivery, because of the potential severity of the consequences of CMV infections and the difficulty in monitoring neonates for infection. There is no published evidence to support that, with universal leucodepletion, whole blood pooled platelets have a higher risk of CMV TTI compared to apheresis platelets.Emerging infections There are, however, other TTIs for which the Blood Service does not currently test and, as such, there remains a theoretically higher risk of TTIs with whole blood pooled platelet transfusions due to the higher donor exposure. Alloimmunisation and platelet refractorinessThe other frequently cited indication for favouring apheresis platelets is the lower risk of alloimmunisation, and subsequent development of platelet refractoriness, because of the reduction in donor exposures. With the introduction of 100% leucodepletion, this risk is now substantially mitigated. The Trial to Reduce Alloimmunisation to Platelet study group (TRAP) showed that the rate of formation of HLA and HPA antibodies were similar in leucocyte filtered whole blood pooled platelets and apheresis platelets and, hence, both were equally effective in preventing alloimmune platelet refractoriness; the alloimmunisation rate being 7% (4-13%) for filtered whole blood pooled platelets and 8% (4-14%) for filtered apheresis platelets PEVuZE5vdGU+PENpdGU+PFllYXI+MTk5NzwvWWVhcj48UmVjTnVtPjQ3PC9SZWNOdW0+PERpc3Bs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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PFllYXI+MTk5NzwvWWVhcj48UmVjTnVtPjQ3PC9SZWNOdW0+PERpc3Bs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ADDIN EN.CITE.DATA (9). More recently Heddle et al (3) conducted a systematic review in 2008 which evaluated 10 RCTs. There have also been some non-randomised studies (21, 22). Whilst these studies found an increase in refractoriness and alloimmunisation with the use of WB derived platelets compared with apheresis platelets, not all studies included prestorage leucodepleted components and there was significant variation in how platelet refractoriness was defined. Heddle noted that the included studies were not powered for equivalence and RCTs should be conducted. One hour and 18-24 hour CCI are no different between apheresis platelets and pooled platelets produced by the BC method ADDIN EN.CITE <EndNote><Cite><Author>Heddle</Author><Year>2008</Year><RecNum>44</RecNum><DisplayText>(5)</DisplayText><record><rec-number>44</rec-number><foreign-keys><key app="EN" db-id="sawvdvzwle92x4epxvn5px9xvprx5sr552er">44</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Heddle, N. M.</author><author>Arnold, D. M.</author><author>Boye, D.</author><author>Webert, K. E.</author><author>Resz, I.</author><author>Dumont, L. J.</author></authors></contributors><auth-address>The Department of Medicine and the Department of Molecular Medicine and Pathology, McMaster University, Hamilton, Ontario, Canada. heddlen@mcmaster.ca</auth-address><titles><title>Comparing the efficacy and safety of apheresis and whole blood-derived platelet transfusions: a systematic review</title><secondary-title>Transfusion</secondary-title><alt-title>Transfusion</alt-title></titles><periodical><full-title>Transfusion</full-title><abbr-1>Transfusion</abbr-1></periodical><alt-periodical><full-title>Transfusion</full-title><abbr-1>Transfusion</abbr-1></alt-periodical><pages>1447-58</pages><volume>48</volume><number>7</number><edition>2008/05/17</edition><keywords><keyword>Blood Component Removal/adverse effects/*methods/statistics & numerical data</keyword><keyword>Humans</keyword><keyword>Platelet Transfusion/adverse effects/*methods/statistics & numerical data</keyword><keyword>Randomized Controlled Trials as Topic</keyword></keywords><dates><year>2008</year><pub-dates><date>Jul</date></pub-dates></dates><isbn>0041-1132 (Print)
0041-1132 (Linking)</isbn><accession-num>18482183</accession-num><work-type>Comparative Study
Research Support, Non-U.S. Gov't
Review</work-type><urls><related-urls><url>;(3). The available evidence confirms that apheresis platelets have a lower adverse reaction rate and a higher platelet increment when compared with nonleucodepleted whole blood derived platelets. However overall, there is no evidence that apheresis platelets and whole blood pooled platelets have a clinically significant difference in their rates of alloimmunisation providing they have been leucodepleted. For patients who are predicted to require long term platelet support, most commonly haematology and oncology patients (utilising 60% of the current total platelet supply) and patients with congenital platelet disorders, avoidance of alloimmunisation is desirable. Efficacy of leucodepletion rather than number of donor exposures is now understood to be critical to alloimmunisation prevention. Studies have not yet been performed to compare long term risk between transfusion with apheresis and whole blood pooled platelets in patient groups who receive multiple platelet transfusions.Statements Consensus Statement 1Once it has been determined that a platelet transfusion is required for a particular patient, the absolute indications for apheresis platelets are:Patients who require HLA compatible and/or HPA matched platelets , such as:Patients with platelet refractoriness due to the presence of HLA and/or HPA antibodiesPatients with neonatal alloimmune thrombocytopenia (NAIT)Patients who require IgA deficient platelets i.e. IgA deficient patients with anti-IgA and a history of an anaphylactic transfusion reaction.Brief DescriptionThere is no current evidence of different rates of TTI, alloimmunisation (and hence platelet refractoriness), acute reactions or clinical efficacy in terms of prevention or treatment of bleeding between apheresis platelets and whole blood pooled platelets. Patients who have developed HLA or HPA antibodies due to previous transfusions or pregnancy may have very poor platelet increments to random donor platelets and need platelets collected by apheresis from HLA compatible or HPA matched donors. Neonatal alloimmune thrombocytopenia (NAIT) is a life-threatening condition where maternal HPA antibodies cross the placenta and cause immune thrombocytopenia in the foetus and newborn. Platelets that do not possess the relevant HPA antigen obtained from typed apheresis donors are indicated for treatment of this condition. However, good responses to random donor platelets by neonates affected by NAIT have also been reported PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LaWVmZWw8L0F1dGhvcj48WWVhcj4yMDA2PC9ZZWFyPjxS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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LaWVmZWw8L0F1dGhvcj48WWVhcj4yMDA2PC9ZZWFyPjxS
ZWNOdW0+NjA8L1JlY051bT48RGlzcGxheVRleHQ+KDE3KTwvRGlzcGxheVRleHQ+PHJlY29yZD48
cmVjLW51bWJlcj42MDwvcmVjLW51bWJlcj48Zm9yZWlnbi1rZXlzPjxrZXkgYXBwPSJFTiIgZGIt
aWQ9InNhd3Zkdnp3bGU5Mng0ZXB4dm41cHg5eHZwcng1c3I1NTJlciI+NjA8L2tleT48L2ZvcmVp
Z24ta2V5cz48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNv
bnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktpZWZlbCwgVi48L2F1dGhvcj48YXV0aG9yPkJh
c3NsZXIsIEQuPC9hdXRob3I+PGF1dGhvcj5Lcm9sbCwgSC48L2F1dGhvcj48YXV0aG9yPlBhZXMs
IEIuPC9hdXRob3I+PGF1dGhvcj5HaWVycywgRy48L2F1dGhvcj48YXV0aG9yPkRpdG9tYXNzbywg
Si48L2F1dGhvcj48YXV0aG9yPkFsYmVyLCBILjwvYXV0aG9yPjxhdXRob3I+QmVybnMsIE0uPC9h
dXRob3I+PGF1dGhvcj5XaWViZSwgQi48L2F1dGhvcj48YXV0aG9yPlF1ZW56ZWwsIEUuIE0uPC9h
dXRob3I+PGF1dGhvcj5Ib2NoLCBKLjwvYXV0aG9yPjxhdXRob3I+R3JlaW5hY2hlciwgQS48L2F1
dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGF1dGgtYWRkcmVzcz5EZXBhcnRtZW50IG9m
IFRyYW5zZnVzaW9uIE1lZGljaW5lLCBVbml2ZXJzaXR5IG9mIFJvc3RvY2ssIEVybnN0LUhleWRl
bWFubi1TdHJhc3NlIDYsIEQtMTgwNTcgUm9zdG9jaywgR2VybWFueS4gdm9sa2VyLmtpZWZlbEBt
ZWQudW5pLXJvc3RvY2suZGU8L2F1dGgtYWRkcmVzcz48dGl0bGVzPjx0aXRsZT5BbnRpZ2VuLXBv
c2l0aXZlIHBsYXRlbGV0IHRyYW5zZnVzaW9uIGluIG5lb25hdGFsIGFsbG9pbW11bmUgdGhyb21i
b2N5dG9wZW5pYSAoTkFJVCk8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+Qmxvb2Q8L3NlY29uZGFy
eS10aXRsZT48YWx0LXRpdGxlPkJsb29kPC9hbHQtdGl0bGU+PC90aXRsZXM+PHBlcmlvZGljYWw+
PGZ1bGwtdGl0bGU+Qmxvb2Q8L2Z1bGwtdGl0bGU+PC9wZXJpb2RpY2FsPjxhbHQtcGVyaW9kaWNh
bD48ZnVsbC10aXRsZT5CbG9vZDwvZnVsbC10aXRsZT48L2FsdC1wZXJpb2RpY2FsPjxwYWdlcz4z
NzYxLTM8L3BhZ2VzPjx2b2x1bWU+MTA3PC92b2x1bWU+PG51bWJlcj45PC9udW1iZXI+PGVkaXRp
b24+MjAwNi8wMS8xMzwvZWRpdGlvbj48a2V5d29yZHM+PGtleXdvcmQ+Qmxvb2QgRG9ub3JzPC9r
ZXl3b3JkPjxrZXl3b3JkPkJsb29kIFBsYXRlbGV0cy9pbW11bm9sb2d5PC9rZXl3b3JkPjxrZXl3
b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+SW5m
YW50LCBOZXdib3JuPC9rZXl3b3JkPjxrZXl3b3JkPklzb2FudGlib2RpZXMvYmxvb2Q8L2tleXdv
cmQ+PGtleXdvcmQ+SXNvYW50aWdlbnMvYmxvb2Q8L2tleXdvcmQ+PGtleXdvcmQ+TWFsZTwva2V5
d29yZD48a2V5d29yZD5NYXRlcm5hbC1GZXRhbCBFeGNoYW5nZS9pbW11bm9sb2d5PC9rZXl3b3Jk
PjxrZXl3b3JkPlBsYXRlbGV0IENvdW50PC9rZXl3b3JkPjxrZXl3b3JkPipQbGF0ZWxldCBUcmFu
c2Z1c2lvbjwva2V5d29yZD48a2V5d29yZD5QcmVnbmFuY3k8L2tleXdvcmQ+PGtleXdvcmQ+UmV0
cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlRocm9tYm9jeXRvcGVuaWEvYmxv
b2QvY29uZ2VuaXRhbC8qaW1tdW5vbG9neS8qdGhlcmFweTwva2V5d29yZD48L2tleXdvcmRzPjxk
YXRlcz48eWVhcj4yMDA2PC95ZWFyPjxwdWItZGF0ZXM+PGRhdGU+TWF5IDE8L2RhdGU+PC9wdWIt
ZGF0ZXM+PC9kYXRlcz48aXNibj4wMDA2LTQ5NzEgKFByaW50KSYjeEQ7MDAwNi00OTcxIChMaW5r
aW5nKTwvaXNibj48YWNjZXNzaW9uLW51bT4xNjQwMzkxNjwvYWNjZXNzaW9uLW51bT48d29yay10
eXBlPk11bHRpY2VudGVyIFN0dWR5JiN4RDtSZXNlYXJjaCBTdXBwb3J0LCBOb24tVS5TLiBHb3Ym
YXBvczt0PC93b3JrLXR5cGU+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHA6Ly93d3cubmNi
aS5ubG0ubmloLmdvdi9wdWJtZWQvMTY0MDM5MTY8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+
PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjExODIvYmxvb2QtMjAwNS0wNi0yMjM1PC9lbGVj
dHJvbmljLXJlc291cmNlLW51bT48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48L3JlY29yZD48L0Np
dGU+PC9FbmROb3RlPn==
ADDIN EN.CITE.DATA (23). IgA deficient platelets are provided for individuals with anti-IgA and a history of an anaphylactic transfusion reaction. IgA deficient platelets are only collected by apheresis.In 2012, the supply of HLA compatible/HPA matched platelets to Australian states and territories ranged from 1% -5.1% of all platelets supplied, which overall, represents only a small proportion of platelet supply. In 2012, only 0.09% of all platelets supplied were IgA deficient.Consensus Statement 2Once it has been determined that a platelet transfusion is required for a particular patient, the relative indications for apheresis platelets in preference to whole blood platelet pools are:Neonates and small children whose platelet dose requirement can be met by a split apheresis component, thereby avoiding wastage of the unused part of the whole blood pooled platelet component Brief DescriptionThe Blood Service is unable to produce a leucodepleted platelet component from a single whole blood donation. For this reason, options for paediatric transfusion support are split apheresis platelets (one apheresis component can support repeated transfusions over a few days) or part of a pooled platelet component. In this scenario, the unused part of the pooled platelet component would be discarded.CMV seronegative platelets are collected through both apheresis (51%) and whole blood pooled platelets (49%) and therefore both types of platelets could potentially be used for IUT, neonates and pregnant women. As one apheresis bag may be split into four paediatric bags for neonates and small children needing platelet support over a few days (dose of platelets is 5-10ml/kg), apheresis platelets are generally preferred in the paediatric setting, primarily to avoid component wastage. It is also relevant to consider that the volume of plasma is greater in apheresis platelets compared with whole blood platelet pools (which are suspended in additive solution) and for this reason there is also a theoretical increased risk of TRALI, allergic type reactions and, if crossing ABO groups, haemolysis from apheresis platelets. The Blood Service will commence validation of apheresis platelets in additive solution in 2014.Consensus Statement 3Once it has been determined that a platelet transfusion is required for a particular patient, there are no absolute indications for whole blood pooled platelets in preference to apheresis platelets.Consensus Statement 4Once it has been determined that a platelet transfusion is required for a particular patient, the relative indications for whole blood pooled platelets in preference to apheresis platelets are:Non-ABO-identical transfusions, especially for children, as the pooling process and lower plasma content reduces the risk of haemolysis associated with any potentially present high titre anti-A and/or anti-B Brief DescriptionPlasma may contain high titre anti-A and/or anti-B which may cause haemolysis if given to non-ABO-identical recipients, especially to children. A proportion of group O apheresis platelets are currently tested to identify units containing low titre anti-A and anti-B which may be used in situations where group O platelets are transfused to a non-group O patient. However, if not available, whole blood pooled platelets are preferable as the pooling process and lower plasma content reduces the risk of haemolysis associated with any potentially present high titre anti-A and/or anti-B.Bibliography ADDIN EN.REFLIST Vassallo RR, Murphy S. A critical comparison of platelet preparation methods. Curr Opin Hematol. [Review]. 2006 Sep; 13(5): 323-30.Blood Component Information. In: Service ARCBS, editor. Melbourne, Victoria, Australia 2012.Heddle NM, Arnold DM, Boye D, Webert KE, Resz I, Dumont LJ. Comparing the efficacy and safety of apheresis and whole blood-derived platelet transfusions: a systematic review. Transfusion. [Comparative Study Research Support, Non-U.S. Gov't Review]. 2008 Jul; 48(7): 1447-58.Akkok CA, Brinch L, Lauritzsen GF, Solheim BG, Kjeldsen-Kragh J. Clinical effect of buffy-coat vs. apheresis platelet concentrates in patients with severe thrombocytopenia after intensive chemotherapy. Vox Sanguinis. [Comparative Study Multicenter Study]. 2007 Jul; 93(1): 42-8.Gurkan E, Patah PA, Saliba RM, Ramos CA, Anderson BS, Champlin R, et al. Efficacy of prophylactic transfusions using single donor apheresis platelets versus pooled platelet concentrates in AML/MDS patients receiving allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant. [Comparative Study Evaluation Studies]. 2007 Sep; 40(5): 461-4.Triulzi DJ, Assmann SF, Strauss RG, Ness PM, Hess JR, Kaufman RM, et al. The impact of platelet transfusion characteristics on posttransfusion platelet increments and clinical bleeding in patients with hypoproliferative thrombocytopenia. Blood. [Multicenter Study Randomized Controlled Trial Research Support, N.I.H., Extramural]. 2012 Jun 7; 119(23): 5553-62.Schrezenmeier H, Seifried E. Buffy-coat-derived pooled platelet concentrates and apheresis platelet concentrates: which product type should be preferred? Vox Sanguinis. [Review]. 2010 Jul 1; 99(1): 1-15.Krailadsiri P, Seghatchian J. Are all leucodepleted platelet concentrates equivalent? Comparison of Cobe LRS Turbo, Haemonetics MCS+ LD, and filtered pooled buffy-coat-derived platelets. Vox Sang. 2000; 78(3): 171-5.Leukocyte reduction and ultraviolet B irradiation of platelets to prevent alloimmunization and refractoriness to platelet transfusions. The Trial to Reduce Alloimmunization to Platelets Study Group. N Engl J Med. [Clinical Trial Comparative Study Multicenter Study Randomized Controlled Trial Research Support, U.S. Gov't, P.H.S.]. 1997 Dec 25; 337(26): 1861-9.Anderson NA, Gray S, Copplestone JA, Chan DC, Hamon M, Prentice AG, et al. A prospective randomized study of three types of platelet concentrates in patients with haematological malignancy: corrected platelet count increments and frequency of nonhaemolytic febrile transfusion reactions. Transfus Med. [Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't]. 1997 Mar; 7(1): 33-9.Heddle NM, Blajchman MA, Meyer RM, Lipton JH, Walker IR, Sher GD, et al. A randomized controlled trial comparing the frequency of acute reactions to plasma-removed platelets and prestorage WBC-reduced platelets. Transfusion. [Clinical Trial Comparative Study Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't]. 2002 May; 42(5): 556-66.Enright H, Davis K, Gernsheimer T, McCullough JJ, Woodson R, Slichter SJ. Factors influencing moderate to severe reactions to PLT transfusions: experience of the TRAP multicenter clinical trial. Transfusion. [Clinical Trial Multicenter Study Randomized Controlled Trial Research Support, U.S. Gov't, P.H.S.]. 2003 Nov; 43(11): 1545-52.Schrezenmeier H, Walther-Wenke G, Muller TH, Weinauer F, Younis A, Holland-Letz T, et al. Bacterial contamination of platelet concentrates: results of a prospective multicenter study comparing pooled whole blood-derived platelets and apheresis platelets. Transfusion. [Comparative Study Multicenter Study Research Support, Non-U.S. Gov't]. 2007 Apr; 47(4): 644-52.Eder AF, Herron R, Strupp A, Dy B, Notari EP, Chambers LA, Dodd RY, Benjamin RJ. Transfusion-related acute lung injury surveillance (2003-2005) and the potential impact of the selective use of plasma from male donors in the American Red Cross. Transfusion. 2007; 47: 599-607.Gajic O, Rana R, Winters JL, Yilmaz M, Mendez JL, Rickman OB, O’Byrne MM, Evenson LK, Malinchoc M, DeGoey SR, Afessa B, Hubmayr RD, Moore SB. Transfusion-related acute lung injury in the critically ill: prospective nested case-control study. Am J Respir Crit Care Med. 2007; 176: 886-91.Robillard P, Hyson C, McCombie N. TRALI, possible TRALI and respiratory complications of transfusion reported to the Canadian Transfusion-Transmitted Injuries Surveillance System. Transfusion. 2007; 47 Suppl: 5A.Patel SR, Smith NH, Kapp L, Zimring JC. Mechanisms of alloimmunization and subsequent bone marrow transplantation rejection induced by platelet transfusion in a murine model. Am J Transplant. 2012 May; 12 (5): 1102-12.Win N, Chapman CE, Bowles KM, Green A, Bradley S, Edmondson D, et al. How much residual plasma may cause TRALI? Transfus Med. [Case Reports]. 2008 Oct; 18(5): 276-80.Lucky T, Seed C. Transfusion- transmissible Infections in Australia 2012 Surveillance Report. In: Service ARCBS, editor.2012.SaBTO report of the CMV Steering Group. In: Advisory Committee on the Safety of Blood Tissue and Organ, editor.2012.Marktel s, Napolitano S, Zino E, Cappelli B, Chiesa R, Poli F, Crocchiolo R, Ronchi P, Rossini S, Ciceri F, Roncarolo M, Fleischhauer K. Platelet transfusion refractoriness in highly immunized beta thalassemia children undergoing stem cell transplantation. Pediatr Transplant. 2010 May; 14(3): 393-401.Tormey CA, Sweeney JD, Champion MH, Pisciotto PT, Snyder EL, Wu Y. Analysis of transfusion reactions associated with pre-storage-pooled platelet componnets. Transfusion. 2009 Jun; 49 (6): 1242-7.Kiefel V, Bassler D, Kroll H, Paes B, Giers G, Ditomasso J, et al. Antigen-positive platelet transfusion in neonatal alloimmune thrombocytopenia (NAIT). Blood. [Multicenter Study Research Support, Non-U.S. Gov't]. 2006 May 1; 107(9): 3761-3. ................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- platelet refractoriness
- csp 001 selection of blood components for transfusion
- strategies for inactivation of viruses bacteria in blood
- clinical indications for aph and whole blood pooled plts
- blood products and transfusion
- csp 004 pooling platelets
- oig compliance charges accessed based on physician s order
- hematology oncology stanford university
- joint program in transfusion medicine
Related searches
- indications for high dose fluzone
- indications for tens unit
- hcm indications for icd
- indications for surgery mitral regurgitation
- indications for icd in hcm
- indications for mra brain
- indications for shoulder mri
- indications for hip mri
- indications for dental antibiotic prophylaxis
- indications for icd placement
- indications for chest physiotherapy
- indications for chest percussion therapy