Transfusion service platelet bacterial testing?

[LaraT23]

I am wondering how many of you are doing any sort of platelet bacterial contaminatin screening? The AABB bulletin that came out last week seemed to lean towards doing this only on long stored, >3 days old platelets. Any experience?

Thanks.

[rravkin@aol.com]

Lara, we have been performing Verax testing for bacterial contamination for the past approx. 4 months. The testing takes approx 1/2hr and we do the testing prior to assignment. In emergencies we have an emergency release form which the physician has to sign, taking responsibilty for the product not being tested for bacterial contamination.

[BANKTECH]

We perform BDS testing, using the Pall eBDS Oxygen analyzer. We do this for apheresis, randoms, and pre-pooled platelets. It is easier for us to test before we label the products, instead of lengthening turn around time by testing once an order is received. we can sample 24 hours after collection.

[BBCLS]

We perform BDS testing, using the Pall eBDS Oxygen analyzer. We do this for apheresis, randoms, and pre-pooled platelets. It is easier for us to test before we label the products, instead of lengthening turn around time by testing once an order is received. we can sample 24 hours after collection.

Same here.

[L106]

But I think Lara's original question was addressing testing the platelet products closer to the end of their shelf life (ie: like after the plateletpheresis has been stored at the hospital's Transfusion Service for 4 days.) (Right, Lara?)

Donna

[StephanieM]

We did Verax testing when we were receiving random donor platelets but discontinued it when we switched to only receiving PLP or Acrodose.

After reading the AABB bulletin, it sounded like they were suggesting performing Verax testing on PLPs and acrodoses as well. Is that what everyone is doing? Verax testing on all platelet products???

[Annadele]

We use Verax testing to extend the expiration time of our platelets expiring at midnight. Platelets that test Verax negative can be transfused before 4 am rather than tossed at midnight. Our workload is such that Verax testing each individual platelet before issue would be prohibitive.

The ABC newsletter from July included an interesting article with some preliminary results from hospitals using PGD tests. One study found 7 positives via PGD in 70,561 platelets tested. Two others in smaller hospitals both found no positives out of a few thousand platelets tested - both of these discontinued its use as a point-of-issue screening for all platelets.

I am wondering how many of you are doing any sort of platelet bacterial contaminatin screening? The AABB bulletin that came out last week seemed to lean towards doing this only on long stored, >3 days old platelets. Any experience?

Thanks.

[SMILLER]

Can someone give us a reference for the AABB bulliten in question?

Thanks, Scott

[sgoertzen]

Can someone give us a reference for the AABB bulliten in question?

Thanks, Scott

AABB Association Bulletin #12-04 - Recommendation to Address Residual Risk of Bacterial Contamination of Platelets

Dated October 4, 2012

[Abdulhameed Al-Attas]

We use BAC T/ALERT 3D automated microbial detection system,by bio Merieux,inc.

Edited October 23, 2012 by Abdulhameed Al-Attas

[MEG]

We currently BDS test everything. We sample at 24 and read at 18. So am I understanding this correctly? I can either sample at 36-48 and effect my shelf life availability. Or we can secondary test at issue for all products and that secondary test is only valid for 4 hours?

[BB479]

We still use a lot of random donor platelets, and we perform Verax PGD testing on all of those on the day of issue. We have a small apheresis collection program and send samples to our blood center for eBDS testing at 24 hours but have started also testing them with the PGD on day of issue to start the process of validating that method for use with our apheresis platelets. Unfortunately, our collection rate is so low that it will take a very long time until we have much data regarding the apheresis products on day of issue.

Wish that the PGD testing was faster but it is quite simple.

[cthherbal ☆]

I am wondering how many of you are doing any sort of platelet bacterial contaminatin screening? The AABB bulletin that came out last week seemed to lean towards doing this only on long stored, >3 days old platelets. Any experience?

Thanks.

So far our transfusion service does no Point of Issue testing of apheresis platelets. How are folks changing practice without adding this test? Here is a link to the bulletin: http://www.aabb.org/resources/publications/bulletins/Pages/ab12-04.aspx

[lyla_n]

When a platelet unit tests positive what to do about the other components from same unit.

Do we discard them?

[JoyG]

So far our transfusion service does no Point of Issue testing of apheresis platelets. How are folks changing practice without adding this test? Here is a link to the bulletin: http://www.aabb.org/resources/publications/bulletins/Pages/ab12-04.aspx

The conclusion of the Association Bulletin only states that an assessment of the role of point-of-issue bacterial screening should be performed at the local facility with medical staff involvement because detailed case mix and platelet logistics requires an in-depth understanding of local operations. Currently our facility is not performing any point-of-issue testing. We are testing our donor apheresis units using the eBDS. We decided that there are logistical issues with using Verax and performing point-of-issue testing at our facility. I think as long as you have documentation of your assessment of this role, the decision is up to the facility and the Medical Director.

[PAWHITTECAR]

We are a small facility and issue very few platelets (~1-2 a month) I do no time of issue testing. I feel that the small number I transfuse would make the cost too high. If it does become required I am afraid that we might have to look at not offering platelets.

[dld]

We only get plt pheresis or pre-pooled platelets from our supplier (Red Cross) who does the testing on those products. We no longer pool platelets ourselves because we would have to do the testing -- no techs/time for that.

[kirkaw]

I am a bit confused by the AABB buletin. Am I correct in thinking that they are recommending testing of all platelet products within 24 hours of transfusion, including closed-system apheresis platelets?

In looking at the product information on the Verax website, it appears that it uses a 500 uL sample of the product. How do you get the sample without creating an open system?

Is anyone willing to share what the Verax system costs?

Thanks!