Premium
Phased implementation of pathogen‐reduced platelets in a health system facilitates increased manufacturing at the blood center
Author(s) -
Allen Elizabeth S.,
Vincent Colleen,
Reeve David A.,
Kopko Patricia M.
Publication year - 2019
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.15480
Subject(s) - medicine , population , blood product , surgery , environmental health
BACKGROUND Pathogen reduction treatment (PRT) reduces the risk of transfusion‐transmitted infections from established and emerging organisms. Manufacturing, however, is complex. In our university health system, we phased in pathogen‐reduced platelets (PR PLTs) by patient population. We then assessed the implementation strategy and investigated factors in the supply chain that prevented us from meeting the goal of providing greater than 90% PR PLTs within 6 months. STUDY DESIGN AND METHODS In Phase 1, PR PLTs were provided in the outpatient cancer center. Phase 2 added inpatients undergoing bone marrow transplantation, and Phase 3 included all patients. In Phase 4, the blood center implemented manufacturing optimization strategies. Product supply and usage during the first 23 months after implementation were evaluated. Investigation of the supply chain included analysis of (1) the number of in‐state hospitals receiving PR PLTs; (2) the fraction of products eligible for PRT before and after manufacturing improvements. RESULTS During Phases 1 and 2, PR products comprised 44% and 53% of PLTs transfused in the phased‐in areas. At 6 months, 41% of PLTs were PR, and at 23 months, 92%. The fraction of PR PLTs transfused in our system correlated logarithmically with the number of in‐state hospitals receiving them (R 2 = 0.71) and the number of PR PLTs sold to those hospitals (R 2 = 0.80). CONCLUSION Phased implementation is a practical and ethical way to introduce PR PLTs in a health system and facilitates scalability at the blood center. Widespread availability of PR products may require collective action and can be increased by optimization strategies during manufacturing.