Platelet requests

[Liz]

Hello,

How do platelet requests come in for adults: as one concentrate, or two concentrates? etc.. I mean is the quantity stated, and is it in concentrates or # of units (for adults)?

Thanks

[Deny Morlino]

Here it is a request for a particular number of units. Have been working for several years to change the physicians' thinking from random donor platelets to pheresis units when they order platelets to no avail. We interpret any random order of 6-8 units as one pheresis unit (written into our policy).

[David Saikin]

We can only get apheresis products. My docs still order 6-10 units of plts - they get one pheresis pack with that order.

[LCoronado]

Our supplier only offers pheresis units. Since we have electronic ordering, the only option we offer is "# of pheresis units"; the maximum number each order will accept is 2. After a number of years, the docs seem to have caught on and we haven't gotten orders for 10 units for quite some time.

[Liz]

Exactly my problem. One dr says : one donor apheresis plt collect.... really?!

So how do you charge? per 6 unit concentrate? what if 2 concentrates are requested? do you send one by one? pool and is it the same charge? what if you send 9 units?

How do you collect? is it exactly one or 2 concentrates? or 10, 8 etc depending on the donor?

Thank you.

[Liz]

Does the supplier send exactly 6 units per concentrate?

[Barbarakym]

Are there places in the US that still able to receive plt concentrate? I have not seen a plt concentrate in years (I am in So Cal).

[David Saikin]

Liz

When you do apheresis - it is equivalent to 6-10 units. We charge for the apheresis product - doesn't matter how many plt conc the doc wants. If my docs want to give plts to a neonate they still get an apheresis packe because that's all that there is . . . We don't worry about the number of concentrates that are ordered. Our staff can order 1 or 2 apheresis packs in our LIS>

[BBCLS]

Hello,

How do platelet requests come in for adults: as one concentrate, or two concentrates? etc.. I mean is the quantity stated, and is it in concentrates or # of units (for adults)?

Thanks

Adults are in units. We only honor the quantity if patients are neonates or children.

[Liz]

that is good to know Dave.

what if the dr wants 2 concentrates: do you charge twice? do you pool (I dont think so) and do you give 2 packs of 6 each or possibly 9 each if your collects vary between 6-10....?

How do you deal with a dr who wants ALL that the donor can give .......?? :wow:Seriously? its not professional..

I have replacement or directed donors so if I collect 12 units I split them (for blood management), and he goes nuts!! Who is the director hmmm ...

[David Saikin]

We don't do concentrates - and they are not made in our Red Cross region unless a hospital makes their own. If the doc wants 2 concentrates he gets an apheresis pack. If he wants 10 conc, he gets an apheresis pack. If he wants 12, he gets 2 packs.

[Liz]

What is your definition of concentrate in your last post Dave, do you mean units?

and what is the def of a pack?

[David Saikin]

By concentrate I mean a random donor plt made from a single unit donation; by pack I mean a unit of plts obtained by apheresis.

[Mabel Adams]

Liz, do I understand correctly that you collect apheresis platelets but somehow divide them up into units as though they were whole-blood-derived plts? What is your working definition of a "unit" of plts? I am used to a "plt concentrate" meaning a whole-blood-derived plt, not something collected by apheresis.

[Changezi]

In our hospital policy we have only pheresis unit , what ever doctor order 2 4 6 or 8 we send one pheresis unit . pheresis unit is taking as 6 - 10 random unit coz it depends on the volume collected from the donor and donor self pletlet count etc.

[Steven Jeff]

In the UK platelets are provided from the National Blood Transfusion Service as platelet pools from 5 donors or the equivalent by apheresis of a single donor. At the hospital where I work all platelet requests are run by the consultant haematologist for approval or otherwise. The exception being major trauma.

Steve

:)

[Liz]

Liz, do I understand correctly that you collect apheresis platelets but somehow divide them up into units as though they were whole-blood-derived plts? What is your working definition of a "unit" of plts? I am used to a "plt concentrate" meaning a whole-blood-derived plt, not something collected by apheresis.

yes there is a difference in definitions here between us.

we do not collect from whole blood.

However one unit of plts is .55x 10^11 from one unit of whole blood. or so i thought, i stand to be corrected for definitions of unit.

concentrate to me is 6 units taken off an apheresis machine. if i get 12 from one apheresis collecting thats 2 concentrates.

noooooo i dont divide them up. but if i get 8 off an apheresis and due to a tight inventory, i will send an aliquote of 2 to an infant needing 2 and the remaining 6 to the adult.

sorry for grammar and spelling, i just woke up and am happy i saw your replies.

what is the evidence based , standard of care adult dose of plt apheresis in North America: 6 units (3 x 10^11)??

[Liz]

In our hospital policy we have only pheresis unit , what ever doctor order 2 4 6 or 8 we send one pheresis unit . pheresis unit is taking as 6 - 10 random unit coz it depends on the volume collected from the donor and donor self pletlet count etc.

so the dr transfuses what he needs and disposes of the rest?

[Liz]

In the UK platelets are provided from the National Blood Transfusion Service as platelet pools from 5 donors or the equivalent by apheresis of a single donor. At the hospital where I work all platelet requests are run by the consultant haematologist for approval or otherwise. The exception being major trauma.

Steve

:)

do they use something like tje Atreus? I am working with a European govt now to write a standard National law, i understood that nearly all of Europe give a pool of 5 because the 5 actual have more plts than an apheresis of 6 because of the way they are collected from the Atreus (buffy coat).

[Liz]

By concentrate I mean a random donor plt made from a single unit donation; by pack I mean a unit of plts obtained by apheresis.

and by definition how much is in a pack? (it varies based on.. the request?)

so no one divides the aphresis collect to suffice 2 patients (if 12 units)

oh oh and so may i assume that you write the absolute # of plts on the bag and not # of units like 6 or 10 ( each unit represntiong .55 x 1o^11)?

sorry fo spelling etc.... really did get not to the coffeee yet, i am so happy i am getting replies to this quetsion (question). THANK you all.. have a good Sunday and pls continue clarifying these facts to me.

[Liz]

"did get not to coffe.." what!!! hahahahaah its early morning, the male of the hen (****) did not crow yet...ohhhhh i am drinking decaf oups!!!!

[Liz]

Cliff why is that considered a dirty word? and went into****??

[SMILLER]

We have had the same experience as LCoranado. We refer to our pherisis units as "5-packs". It makes it a little easier for them when ordering to think of each order as five times what they used to order.

Scott

[Steven Jeff]

do they use something like tje Atreus? I am working with a European govt now to write a standard National law, i understood that nearly all of Europe give a pool of 5 because the 5 actual have more plts than an apheresis of 6 because of the way they are collected from the Atreus (buffy coat).

To be honest Liz I do not know how they prepare the platelets, although I do seem to recall that a pool of five was better than six individual packs.

Steve

[Liz]

I do apologise for the grammar and spelling again.

Thank you for the replies.