SDPs for infant use

[Jane]

Does anyone know of a reason that a single-donor pheresis could not be split for neonatal/infant use?? Providing platelets for babies is the only reason we would receive a platelet concentrate. Our ARC region does not produce this product any longer so we would have to specifically request it. I do not want to have to develop methods to test for bacterial contamination for the one platelet we might receive every 2-5 years so I am trying to come up with an alternative. I was just wondering if anything would contraindicate this use?

Thanks for your help!

[Cliff]

Hi Jane,

This is how we supply platelets to babies, by dividing pheresis units. We do not have random platelets in inventory any longer.

We label all of our platelets with the platelet count, you might want to consider the platelet count of the parent unit that will be left behind after you create the aliquot.

[Jane]

Cliff,

Do you have any formula to determine what amount from the pheresis to give to the infant?

[Susan Croteau]

We use SDP and give a dose of 10 - 15ml /kg for neonates.

[Cliff]

No, at our hospital the NICU physicians order platelets by the ml. We usually add 15ml to their order.

[mrhelton]

Apheresis Platelets - Neonatal Transfusion

At our facility, we have been utilizing apheresis platelets for neonatal transfusions for several years. Our bood supplier will sterile dock transfer bags to the product and then we just use it as needed - since we have the apheresis platelet that has not been entered, we can use it for several doses for the same baby thus reducing donor exposure. We too give the nursery 10 mL more than they request for them to prime the infusion line.

[John C. Staley]

We sterile dock a syringe set to the apheresis platelets and add 5ml to what ever the physician orders. Our syringe set includes a built in filter so the nurses don't have to filter again. We keep an irradiated, type AB apheresis on hand at all time for NICU and barring special circumstances, any baby needing platelets dips into it.

[Jane]

Would anyone be willing to post their procedure for SDPs for infant use? We do not have sterile docking so would that mean a 4 hour expiration for the platelets?

Thanks again to everyone for their help!

[Dawn]

Hi Jane,

Here is a sample procedure for making pheresis platelet aliquots. I took the procedure that we use and made it more generic. Of course you can skip the sterile connection device and change the outdate of both the parent and aliquot. Hope this helps.

NICU Platelet Aliquots.doc

[S.Hunt]

We split Pheresis Platelet product for neonatal transfusions when needed and have had no complications. We do make sure they are CMV negative; Irradiated; Leukoreduced; and type specific. These are firly easy to obtain when needed from either of our two suppliers ARCBS-NER or Corel Blood Services.

[adiescast]

We also use SDP for infant platelet transfusions. Our blood center has the sterile docker and charges a nominal extra charge for putting the bags on. One concern we have wrestled with is that the aliquot bags are not the right plastic for platelets. How long can platelets stay in this bag before they must be discarded? We try not to aliquot until the very last minute to avoid concerns with the adequacy of the storage bags. Has anyone else considered this or heard anything about how long platelets can be stored in these bags?

[jochewed werch]

Does anyone know of a reason that a single-donor pheresis could not be split for neonatal/infant use?? Providing platelets for babies is the only reason we would receive a platelet concentrate. Our ARC region does not produce this product any longer so we would have to specifically request it. I do not want to have to develop methods to test for bacterial contamination for the one platelet we might receive every 2-5 years so I am trying to come up with an alternative. I was just wondering if anything would contraindicate this use?

Thanks for your help!

Reply: We use RPC'S OR APC's CMV serology Neg. and leucoreduced.

I do not see any reason for not using aliquotes of apheresis platelets.

[jochewed werch]

We do the same as others commented and use SDP'S as well as R PC's. We do use a

SCD and make aliquotes with syringes and or transfer bags . platelets are CMV Neg and leucoreduced. We do not add extra to the request because they are already filtered.

j.werch

[Geriann]

Does anyone out there have statistics as to whether it is better to give an aliquot of 15ml of a platelet pheresis or to volume reduce say an aliquot of 45 ml of a pheresis to 15ml provided the abo matches? thanks, geri

[John C. Staley]

I don't really have hard and fast numbers but let me tell you a little story. About 6 years ago our neonatologist came to us complaining that they were not seeing the expected rise in plt counts after transfusion. At the time we were concentrating (volume reducing) the platelets at their request. We suggested that the process of concentrating the plts was having adverse effects on the poor little plts and they should try transfusing plts straight from the bag with out concentrating. They agreed to try it and much to no one's surprise (at least no one in the trasnfusion service) they began to see the expected increases in post transfusion plt counts. We have never looked back since. We currently provide aliquots for our neonates from AB plt apheresis units and it is working great.

[bbkdiane]

The very few times that I have needed platelet products for newborns, we have had the time to request and receive universal donor or type specific, CMV=, Leukoreduced, Irradiated SDPs with sterile docked "pedi bags" for aliquoting. This has worked just fine.

[marvy1]

I have read that neo platelets put in syringes are viable for 6 hours but have not found any source for assigning exp time for neo platelets sterile-docked into aliquot bags designed for rbc. I do remember some facilities I have worked assigned a 4 hour outdate with the reason being the type of plastic. Does anyone else have additional information?

We also use SDP for infant platelet transfusions. Our blood center has the sterile docker and charges a nominal extra charge for putting the bags on. One concern we have wrestled with is that the aliquot bags are not the right plastic for platelets. How long can platelets stay in this bag before they must be discarded? We try not to aliquot until the very last minute to avoid concerns with the adequacy of the storage bags. Has anyone else considered this or heard anything about how long platelets can be stored in these bags?

[LRosneck]

For those of you that split SDPs for baby use, do you ever give the parent product to an adult after an aliquot has been removed? If you recalculate the platelet count and it meets acceptable criteria could it be done? Would it be an issue if the product got billed for two different patients (baby and adult)?

[Brenda K Hutson]

Our Donor Center also no longer supplies platelet concentrates. We use Single Donor Platelets with aliquot bags sterile docked to them.

Brenda Hutson, CLS(ASCP)SBB

[JOANBALONE]

Hi everyone,

We assign a 4 hour outdate for all platelet aliqouts removed from single donor pheresis platelets based on the type of transfer bag we are using. There is a little blurb in the Technical Manual about this.

I have read that there is not only a miximum volume that platelet pheresis bags can hold but also a minimum volume that must remain for proper platelet function. For those of you who remove aliqouts from single donor pheresis platelets do you limit the amount of volume removed?