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Neonate Platelet Aliquots - references?


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Hi everyone! 

I am writing a procedure for making aliquots from platelet pheresis units - I had done this a lot at my prior institution and I need a policy/procedure for my current hospital since we have a rather large NICU.

Does anyone have any references/CFRs/CGMP that can help me or procedures they can share?

Thank you!! And have a great weekend!

S

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"Interesting topic, we had a 32 bed NICU and I don't remember ever transfusing platelets."

we have a larger NICU, but have transfused plts to babies twice already this week, so it's not uncommon from where I sit.

we have NAIT babies very frequently, as well as babies that bleed, drop their plts, need to go to surgery, and we bump their platelets first. 

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I've attached our policies for preparing aliquots in general and our platelet policy.  Hope this helps.  Oh, we decided all aliquots in syringes expire 4 hours after being made to make it easier for both blood bank and nursing staff to remember.  We used to let the RBC and FFP syringes expire in 24 hours but nursing in particular would think all syringes expire 24 hours and we wasted a lot of syringe aliquots until I changed it.

BBI0015 Preparation of Aliquots.04.03.2020.doc BBI0017 Platelets 04.03.2020.doc

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On 4/1/2021 at 11:08 AM, Sonya Martinez said:

I've attached our policies for preparing aliquots in general and our platelet policy.  Hope this helps.  Oh, we decided all aliquots in syringes expire 4 hours after being made to make it easier for both blood bank and nursing staff to remember.  We used to let the RBC and FFP syringes expire in 24 hours but nursing in particular would think all syringes expire 24 hours and we wasted a lot of syringe aliquots until I changed it.

BBI0015 Preparation of Aliquots.04.03.2020.doc 256 kB · 7 downloads BBI0017 Platelets 04.03.2020.doc 486 kB · 7 downloads

2.2.1        Pathogen Reduced Platelets and Cold Storage Platelets are not to be accepted and must be returned to the supplier.

 

 

Why do you not accept Pathogen reduced plts?

We are switching over to Psoralen treated plts, but have never transfused plt to any baby.

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  • 3 weeks later...

lalamb:  Sorry for the delayed response I'm going live with a computer upgrade this week and I've been neglecting everything else!! 

We will be accepting pathogen reduced platelets starting May 1.  Mostly it's because our physicians on the transfusion committee are extremely conservative (and rather dated) and wanted more data.  But we don't really have a choice since our secondary vendor for platelets is ARC and they are going 100% PRT later this year.  Besides most of the other area hospitals that have NICUs and PICUs in SD county are run by Rady Children's Hospital and they use PRT now anyway.  Lastly, our primary vendor collects more apheresis and just started their PRT collections recently. 

 

It will be interesting starting this weekend when we can accept them.  I'm not looking forward to all the calls from nursing since the label doesn't actually state pathogen reduced.  We'll see who reads their education and emails!!

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18 hours ago, Sonya Martinez said:

It will be interesting starting this weekend when we can accept them.  I'm not looking forward to all the calls from nursing since the label doesn't actually state pathogen reduced.  We'll see who reads their education and emails!!

We are going to put a hang tag with a fluorescent green label on our pathogen reduced platelets using the language suggested by Cerus - FDA approved as a substitute for irradiated product, meets AABB requirements for CMV neg, etc. etc. I'm not optimistic about many people actually reading the education materials.

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On 4/27/2021 at 1:00 PM, sgoertzen said:

We apply this custom label to all PR platelets and PR platelet aliquots (see attached picture).  We're a children's hospital and we've been giving PR platelets to neonates since March 2017 with no problems.

PR Platelets.docx 114.1 kB · 6 downloads

That's a great idea.  Do you print the labels yourself or did you have them made by a printing company (like Shamrock)?

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Hi Sonya - yes, it's a custom label we had them make for us at Shamrock. If you like it, they may just let you order ours rather than create your own!  Hope you are all well and happy in San Diego! 

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  • 1 month later...
On 4/1/2021 at 2:08 PM, Sonya Martinez said:

I've attached our policies for preparing aliquots in general and our platelet policy.  Hope this helps.  Oh, we decided all aliquots in syringes expire 4 hours after being made to make it easier for both blood bank and nursing staff to remember.  We used to let the RBC and FFP syringes expire in 24 hours but nursing in particular would think all syringes expire 24 hours and we wasted a lot of syringe aliquots until I changed it.

BBI0015 Preparation of Aliquots.04.03.2020.doc 256 kB · 26 downloads BBI0017 Platelets 04.03.2020.doc 486 kB · 16 downloads

so so helpful!!  thank you sonya!!!

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On 4/9/2021 at 6:23 AM, lalamb said:

2.2.1        Pathogen Reduced Platelets and Cold Storage Platelets are not to be accepted and must be returned to the supplier.

 

 

Why do you not accept Pathogen reduced plts?

We are switching over to Psoralen treated plts, but have never transfused plt to any baby.

Hi lalamb

That's a typing error, sorry.  It should read we don't accept cold storage platelets.  We didn't accept pathogen reduced platelets because our NICU was worried about the lower volume of platelets in each unit but we had them talk to those working at UCSD who's been 100% PRT for a while and they changed their minds.  Then it was just getting the build done which is tedious and extremely time consuming in our computer system since we divide and change to an open code for syringing.  Luckily we decided not to irradiate them or that would have been even more codes to build and validation!

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