I am the Blood Bank Supervisor for a small community hospital and we infuse a handful of pooled platelets each month (in the absence of readily available apheresis units from our blood supplier). We currently use pH testing (performed on each plt unit within 24 hours of issue) as our method for detecting bacterial contamination prior to pooling.

However, I just read in the CAP BDP survey, that CAP & AABB will no longer accept glucose & pH testing as methods for bacterial detection in platelets. Does this mean we can no longer use the pH testing at all? Or does it mean we just won't have a CAP survey material for proficiency testing of it? What other methods are available/recommended that would be cost effective in our circumstances?

Thank you for any and all input!

Heather

I appreciate your query, At present people are screening Blood Components using EBDS system which works on oxygen consumption principle please go for it.

P. Naga Raju

M.Sc.,PGDTT(SVIMS),

Technical Supervisor

I am the Blood Bank Supervisor for a small community hospital and we infuse a handful of pooled platelets each month (in the absence of readily available apheresis units from our blood supplier). We currently use pH testing (performed on each plt unit within 24 hours of issue) as our method for detecting bacterial contamination prior to pooling.

However, I just read in the CAP BDP survey, that CAP & AABB will no longer accept glucose & pH testing as methods for bacterial detection in platelets. Does this mean we can no longer use the pH testing at all? Or does it mean we just won't have a CAP survey material for proficiency testing of it? What other methods are available/recommended that would be cost effective in our circumstances?

Thank you for any and all input!

Heather

I would just arrange with your supplier to keep one unit of apheresis platelets on hand, and switch them out for credit. Our supplier has almost exclusively gone to pheresis platelets and it is much nicer for the transfusion service. There is no pH testing no glucose levels, nothing.

As our blood suppliers only supply us with apheresis platelets we normally never have any trouble with having to use surrogate testing to detect bacterial contamination, as the blood supplier performs bacterial testing on all thier apheresis platelets. However, about 3 times a year we will have to take bacterially untested platelets from our supplier during a time of short supply and high usage. We have used both the PH and glucose strips as our surrogate test, but also must find an alternative test as the AABB ( 01/31/2011) and CAP (6/2011) will no longer allow this surrogate testing. As the Verax Platlet PGD test is used for whole blood derived platelets, is there another FDA approved test for testing single units of apheresis platelets for bacterial contaminiation when recieved in a hospital untested? Would the EBDS system mentioned above be acceptable for this purpose? Does anyone know where I can get information about these systems, including who makes them?

The Verax Biomedical Platelet PGD test can also be used to test leukocyte reduced apheresis platelets. The package insert (available on FDA website) is attached. For those units that are emergently released from your supplier, have the units been sampled for bacteria but just not incubated for the prescribed period of time prior to release to your facility or have they not even been sampled?

UCM190504.pdf

....... Would the EBDS system mentioned above be acceptable for this purpose? Does anyone know where I can get information about these systems, including who makes them?

The eBDS system is made by Pall so you could get some information from their website. It appears their system requires a minimum of an 18 hour incubation period though so sounds as if would not be feasible for the situation you described.

A problem I foresee with testing of platelets for bacteria using the eBDS is that those of us that lack a sterile docker or heat sealer are going to have a problem. Following is from the Pall website:

1. Sterile connect the Pall eBDS Sample Set to the platelet product. Refer to Performance Data for optimal sampling time.
   

It is much easier to have your blood center test the platelets (all apheresis are tested prior to release) but even here in North Texas with a large donor base we still transfuse about eighty units of random platelets a month. Up to twenty of those units require pH and glucose testing, now we are looking at not receiving products in a timely fashion for those patients with pooled platelet orders. Our local blood center performs testing on their own collections but not on units imported from the Metro blood supplier. So in the event that our local supplier has depleted all random platelet stock we will have to make arrangements to change the order to apheresis or wait until random platelets with testing performed are available. Yet another layer of complexity to add to the heap.

The eBDS system is made by Pall so you could get some information from their website. It appears their system requires a minimum of an 18 hour incubation period though so sounds as if would not be feasible for the situation you described.

Somewhere I got the idea suppliers were going to be able to pool whole blood plts using a sterile docker, test the whole pool for bacterial contamination, then send it out as a pre-pooled product. Not sure where I got this but it seems a reasonable answer to the small hospitals if the supplier can't provide an apheresis unit. Of course, computers and billing might need some revamping.