RBC Unit Cell Washer

[Nibal Harb]

Hello,

 

I am looking to purchase a cell washer to wash RBC units and Apheresis platelet units. I checked with Terumo and with Haemonetics and Terumo informed me that they are sunsetting the Cobe per the FDA due to issues with parts, so they will no longer sell it or support it in the US. Haemonetics ACP215 is not validated to wash AS-3 RBC units. We only have AS-3 in our blood bank.

 

Can anyone provide a suggestion for a reliable and FDA approved cell washer that can wash AS-3 RBC units and platelets?

 

Thank you,

Nibal

[Neil Blumberg]

There is no regulatory nor clinical reason not to wash AS-3 units on the Haemonetics device.  Just validate it for red cell recovery and hemolysis, comparing AS-3 with five AS-1, CPD-A1 or other units you can obtain from another blood center, if this makes you feel more secure.  We wouldn't and won't bother to do so.  The results will likely be identical.  There is no material difference in red cell preservation issues with the various additive solutions and certainly no evidence of difference in clinical outcomes.

[Neil Blumberg]

I'd also add that none of the cell washers are FDA approved for washing platelets. We've been washing platelets on the 2991 for about 40 years :).  I believe there may be a paper on using the ACP-215 to wash platelets but as yet we do not have any hands on experience.  We have developed a manual method of platelet washing using a Sorvall centrifuge.  If your volume isn't too high, you might consider a manual wash method.  It takes a bit longer, but actually has higher recoveries (>90% vs. about 80-85% with the 2991). 

 

Folks will tell you that washed platelets don't work clinically and the count increment is Washed Tx Leukemia.pdfWashed Tx Leukemia.pdflower.  The increment is indeed lower, but if you employ platelets that aren't ABO incompatible with the recipient and remove the supernatant, the clinical results are actually better than the clueless advice to give ABO major incompatible platelets routinely (e.g., group A to group O recipients).  The PLADO study had a bleeding rate using this abominable practice of about 70%.  Our bleeding rate avoiding infusion of ABO incompatible antigen or antibody is 5%, with or without washing.  A fourteen fold difference. So by all means give washed platelets to patients with severe or recurrent reactions, or avoid infusion of ABO incompatible plasma, and, if you believe our randomized trial data, to improve the survival of younger patients with acute myeloid leukemia. References attached if anyone is interestedWashing AML Greener_et_al-2017-American_Journal_of_Hematology.pdf.

Washing Review IJCTM-101401-the-clinical-benefit-of-washing-red-blood-cells-before-transfusion.pdf Washing AML Greener Am J Hemat AML Washing Supplementary Figures and Tables.pdf Jill's washing paper.pdf Plt Washing Vo.pdf

[Nibal Harb]

Thank you very much!