Optimizing Whole Blood Collections

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Collection Set Choices – How and Why the Collection Set Chosen Matters

This section describe the reasons why a particular whole blood collection system and volume of whole blood collected can have a direct effect on the amount of plasma recovered during component processing steps. 

Impact of CP2D/Nutricel® Additive Solution versus CPDA-1 Collection Systems

Blood containers used for whole blood collections have different configurations using anticoagulant-preservatives and additive solutions.颇尔 Medical manufactures whole blood collection systems with CPDA-1ii anticoagulant-preservative, as well as CP2Diii anticoagulant-preservative and Nutricelivadditive solution (AS-3).

When using a 颇尔 Collection System with CP2D/AS-3 solutions, a greater volume of plasma is removed from the CP2D red blood cells.After plasma removal, the AS-3 solution is added to the CP2D red blood cell bag, which allows for up to 42 days storage.

CPDA-1 red blood cell products are produced by removing plasma from centrifuged whole blood.The volume of the plasma removed will determine the hematocrit of the CPDA-1 red blood cell unit.To ensure the presence of adequate glucose for red blood cell metabolism for up to 35 days storage, a hematocrit of 80% or lower is requiredv.颇尔’s CP2D/AS-3 Collection Systems yields approximately 48 mL more plasma for each 500 mL whole blood collection and 7 additional storage days when compared to CPDA-1 Collection Systems.In addition, AS-3 does not contain mannitol and can be used for pediatric transfusions.If your Blood Establishment decided to convert from CPDA-1 to CP2D/AS-3, there would be one less bag type at the collection sites, within your IT system, and for inventory management. 

By converting from CPDA-1 to CP2D/AS-3 Collection Systems, your Blood Establishment could:
  • Gain 48 mL additional plasma from each whole blood collection
  • Gain 7 additional storage days for each whole blood collection
  • Have one less bag type for collection sites, IT systems, and inventory management

iiCPDA-1 = citrate-phosphate-dextrose-adenine solution
iiiCP2D = citrate-phosphate-dextrose-dextrose solution
ivNutricel = AS-3 solution
vAABB Technical Manual, 16th edition, page 946.

Impact of Leukotrap® RC System with RC2D Filter versus Leukotrap WB System

颇尔 provides a portfolio of products for leukocyte reduction.The Leukotrap RC System with the RC2D Filter provides in-line leukocyte reduction of red blood cells.The Leukotrap WB System provides in-line leukocyte reduction of whole blood.While each system has its benefits, red cell filtration has an advantage over whole blood filtration when it comes to plasma recovery.

When using the Leukotrap WB System, leukocyte reduction is performed on the whole blood before centrifugation.As illustrated in Figure 11, whole blood and its associated plasma is held up in the WBF Filter during the leukoreduction step and is not recovered after centrifugation.Thus there is an inherent decrease in the volume of obtainable plasma with whole blood filtration.With the Leukotrap RC System with the RC2D Filter, leukocyte reduction is performed after centrifugation and plasma expression.Therefore all of the recoverable plasma is obtained from the whole blood.

图 11

Plasma Yield Dynamics - WB versus RBC In-Line Systems

Plasma Yield Dynamics - WB versus RBC In-Line Systems

颇尔 Medical’s Leukotrap RC System with RC2D Filter yields more plasma for each 500 mL whole blood collection as compared to the Leukotrap WB System.As shown in Figure 12, using the Leukotrap RC System instead of a whole blood filtration system your Blood Establishment could increase plasma yields by up to 7%.The Leukotrap RC System with RC2D Filter will allow you to obtain maximum plasma yield from whole blood.

图 12

Plasma Recovery - WB versus RBC In-Line System
Plasma Recovery - WB versus RBC In-Line System

Whole Blood Collection Volume

The volume of the whole blood collection directly impacts the amount of available plasma as described in the Blood Separation and Centrifugation section of this guide.Table 3 summarizes theoretical plasma yields at 38% and 54% hematocrit values.Maximum collection volume settings for the system used will yield more plasma.

Table 3

Collection Scale Settings and Estimated Plasma Recovery
Collection Scale Setting (mL) with Leukotrap RC System Estimated Additional Plasma (mL) with 38% Hct Estimated Additional Plasma (mL) with 54% Hct
450 279 207
485 301 223
500 310 230
510 316 235
525 326 242

Automated Blood Scale/Mixer for Accuracy and Standardization

Whole blood units can be simultaneously weighed and agitated during collection by utilizing automated blood collection mixers.These devices are able to standardize collection volumes by ensuring final whole blood units are within 0-2% of the weight or volume setting.By standardizing whole blood collection volumes, maximum settings can be used with less concern for overweight blood collections.

Optimizing Plasma Recovery from 颇尔 Whole Blood Collection Systems

The following describes how to optimize plasma recovery within the individual whole blood collection and component processing steps.

Plasma yield can be optimized by implementing specific centrifuge conditions and by choosing a collection system(s) that will fit into your Blood Establishment’s workflow.There are additional collection and component processing steps that can increase the amount of plasma obtained from each whole blood unit.Using the processing steps recommended below, up to 9.3 mL of additional plasma could be recovered without increasing the collection volume.The steps described in this section are summarized in Table 4.

Table 4

Collection and Component Processing Steps that Yield Additional Plasma
Process Steps Estimated Avg. Plasma Yield (mL)
1.Empty Donor Line Tubing:without segment numbers 5.2
2.Empty Donor Line Tubing:with segment numbers 4.8
3.Express Plasma to Wye versus Collection Bag Port (AS-3 systems only) 2.2
4.Empty Plasma Bag Tubing 1.9
    (leave one segment) 1.6
    (leave two segments) 0.8
5.Standardize FFP Volume 75-100

1.Empty Donor Line Tubing when using the following 颇尔 Systems:

  • Leukotrap® RC PL System
  • Leukotrap® RC System with RC2D Filter
  • Leukotrap® WB System
After whole blood collection, staff typically strip the donor line tubing into the collection bag, clamp the tubing close to the collection bag port and mix by inverting the bag.The donor line tubing is refilled with anticoagulated whole blood from the collection bag.Staff will repeat the process and then seal at a designated location on the donor line tubing.

Recommendation:Instead of refilling the donor tubing line, leave the tubing empty and seal close to the collection bag port.

Additional Plasma Yield:The length of the donor line tubing on 颇尔 Systems is approximately 51.4 inches and contains approximately 8.6 mL of whole blood (6 inches of tubing equals ~1 mL of whole blood).Based on a 40% hematocrit, the Blood Establishment will consistently increase plasma yield by 5.2 mL per whole blood collection by leaving the donor tubing empty.

2.Empty Numbered Tubing when using the following 颇尔 Systems:

  • Non-filter CP2D/AS-3 System
  • Leukotrap® WB System
  • Leukotrap® PL System
When using the 颇尔 systems listed above, routine collection and processing steps leave anticoagulated whole blood in the numbered tubing.

Recommendation:Prior to centrifugation, strip the numbered tubing into the primary bag and place a temporary clip close to the port of the primary bag.Coil empty tubing and place in the unit bundle for centrifuge bucket loading.Centrifuge, express the plasma and add the AS-3 solution to the red blood cells as usual.Once the red blood cells and additive solution are mixed thoroughly, remove the temporary clip and fill the numbered tubing with the red blood cell/additive mixture.

Additional Plasma Yield:The length of the segmented line tubing on 颇尔 Systems is approximately 48 inches and contains approximately 8 mL of whole blood (6 inches of tubing equals ~1 mL of whole blood).Based on a 40% hematocrit, the Blood Establishment will consistently increase plasma yield by 4.8 mL per whole blood collection when filling the numbered tubing with a red blood cell/additive mixture instead of whole blood.

3.Express RBC/Plasma Interface to Wye versus Primary Bag Port:

(AS-3 Systems only) During plasma expression, the RBC/plasma interface is typically expressed to the primary bag port.

Recommendation:Express the RBC /plasma interface to the wye that connects the plasma bag(s).

Additional Plasma Yield:The length of the tubing on 颇尔 Systems between the port of the primary bag and the wye is approximately 13 inches and contains approximately 2.2 mL of plasma (6 inches of tubing equals ~1 mL of plasma).The Blood Establishment will consistently increase plasma yield by 2.2 mL per whole blood collection by expressing to the wye instead of the collection bag port.

4.Empty Plasma Bag Tubing into Plasma Bag:

After plasma has been expressed off from the red blood cells, staff leaves the plasma in the entire tubing length and either seals close to the plasma bag port or creates one or two segments.

Recommendation:Strip entire plasma bag tubing line into the plasma bag and seal close to the port of the plasma bag.

Additional Plasma Yield:The length of the tubing on 颇尔 Systems between the port of the plasma bag and the wye is approximately 11.5 inches and contains approximately 1.9 mL of plasma (6 inches of tubing equals ~1 mL of plasma).The Blood Establishment will consistently increase plasma yield by 1.9 mL per whole blood collection by stripping the entire tubing line, 1.6 mL per whole blood collection if one segment is left and 0.8 mL per whole blood collection if two segments are left.

5.Standardize Fresh Frozen Plasma (FFP) Volume:

When producing FFP units from a collection system with one plasma bag, staff typically express the plasma into the plasma bag post-centrifugation and freeze as per Standard Operating Procedures to produce a FFP unit.

Recommendation:Utilize a collection system with two plasma bags.After the plasma is expressed and separated from the red blood cell component, transfer a standardized volume such as 200mL into the empty plasma bag and continue to process as a FFP unit.The plasma bag with the remaining plasma can be processed as per Standard Operating Procedures for further manufacturing.

Additional Plasma Yield:Depending on the hematocrit of the whole blood donor, plasma yields can be up to 75 – 100 mL per whole blood unit collected.

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