We have been recently informed that our supplier will begin producing random plt concentrates again. (they had moved away from these due to bacterial testing). Of course, they will be supplying the plts but will not be doing the bacterial testing, therefore it will fall on us. How are other hospitals handling this testing of plt concentrates? Are you just doing testing on media or using Bac-T. How much product is being used and are you testing the whole pool or each plt individually? If we were to take these concentrates, it would be because there is a shortage of pheresis and these would be our only choice. We would be pooling 6-10 to transfuse in place of a pheresis. Any help would be appreciated.

We test our platelets for bacterial contamination by testing the pH. Any platelet that tests at a pH lower than 6.9 we consider not suitable for transfusion. We test each platelet individually before we pool them. I tend to use randoms due to cost. We are mostly a trauma hospital so donor exposure is not an issue for us.

We test each platelet concentrate's pH individually using a Multistix strip. Anything less than 7.0 is quarantined. However, because of time and staff shortages we seldom ever use platelet concentrates, we just go the easy way with platelet pheresis. Concentrates are more or less a back up for us.

We use a handheld pH meter on each individual unit, culturing and then discarding those with pH < 6.2. Not sensitive, not specific, but the best we can do until we either get 1) an FDA ok to use the Bac-T or other technololgy on pooled, LR RDPs (that test takes too much plasma to do on individual units), or 2) a "dipstick" type test that could be used at time of issue. There is such a device in trials now, but FDA approval will be only for LR SDPs or RDPs. Since we LR RDPs after pooling, we may need to wait for the miracle of approved 7 day pools to occur!

We waste about 0.5-1%; have had 2 true positives in over 60,000 units tested, so this is truly a worthless endeavor in my mind. I'm more concerned about the positive units we're missing; and if this is the case, why are we doing this at all? I don't believe we're really improving patient safety by any great degree. So we don't get dinged on CAP and/or AABB. But that's just me spoutin' off!

MJ

Perhaps you could suggest to them to look into bacterially testing the random platelets. Our supplier in Florida (Florida Blood Service in St. Pete) has designed a method to effectively test random platelets using culturing. I am not sure if FBS is marketing the process or procedure, but it may be worthwhile for your supplier to investigate!