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Experience with large scale plasmapheresis from voluntary non-remunerated donors

Ruud van Dongen, Paul Strengers

Sanquin Blood Supply Amsterdam,

The Netherlands

IPFA/BCA Global Symposium 2014 23 September 2014

Sanquin Blood Supply

•  Division Blood Bank •  Division Diagnostic Services •  Division Research •  Division Reagents •  Division Plasma products

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Blood Bank division

Blood collection •  Recruiting and medically examining donors •  Collecting blood and plasma

Products and supply •  Production and testing blood and blood products •  Stock management •  Supplying products and services to hospitals and other customers

Education and advice •  Giving advice to customers about products and offering services

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P/I/C region 1

P/I/C region 2

P/I/C region 3

P/I/C region 4

R&D blood transfusion technology

Tissue Bank

QA & RA region 1

QA & RA region 2

QA & RA region 3

QA & RA region 4

KCD / MA region 1

KCD / MA region 2

KCD / MA region 3

KCD / MA region 4

DA region 1

DA region 2

DA region 3

DA region 4

Organization Executive Board/Director

IC-BB Release management

Secretariat Consulting Services

Donor Affairs QA and RA Production DTM/

Medical affairs

IC-BB=Information Centre Blood Bank, P/I/C = Processing/Issue/Customer service, DTM= Department of Transfusion Medicine, QA/RA=quality assurance, regulatory affairs

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Activities of the blood bank

•  Responsible for the recruitment of donors and the collection of blood and plasma

•  After being collected, the blood is tested and processed into red cell concentrates, platelets and plasma

•  The blood compnents are supplied to Dutch hospitals, and plasma to the Sanquin Division of Plasma Products for the manufacturing of plasma derived medicinal products

•  Hemovigilance (registration of complications as a result of transfusions of blood products) is taking place together with TRIP (Transfusion Reactions in Patients)

•  Advising physicians and foreign organizations with respect to blood supply

•  Related activities: Umbilical cord blood bank, Bone marrow bank, Bone bank

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2013

•  Blood Bank Division has four main collection locations: Amsterdam, Rotterdam, Nijmegen and Groningen

•  56 permanent collection points and 108 mobile ones

•  Number of employees: +/- 1,400

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Key figures blood supply 2013 (1)

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Key figures blood supply 2013 (2)

Blood products

Use of red blood cell concentrates

448,488

Platelets (from whole blood in donor units)

264,906

Fresh frozen plasma 67,071 Kilograms plasma total (incl. apheresis) supplied to Plasma Products division

308,895

Usage

Number of donations 2009-2013

Total number of donations

Number of whole blood donations

Number of apheresis donations

Frequency of donation of whole blood donors

Frequency of donation of plasma donors

Donation criteria and frequency

•  Age: 18-65 (70)

•  Health check (questionnaire, blood pressure, heart rate, Hb, lab tests)

•  Donation criteria whole blood: 5 times per year

3 times per year plasmapheresis: 23 times per year, once every

two weeks

•  Avarage donation frequency: whole blood 1.7 / year plasmapheresis 5.5 / year

Plasma donor program

•  Information •  Donor selection criteria almost equal to whole blood donation (quarantine

plasma only male plasma) •  Preference for converting whole blood donors to plasma donors •  Plasmapheresis only on appointments made •  Either whole blood or plasma donation •  Immunization program for hyper immune plasma donors (hepatitis B,

tetanus, Rhesus (D).

Recruitment plasma donors   400,000 donors (2,3% of the population)

  355,000 whole blood donors

  45,000 plasma donors

  Recruitment from whole blood donors

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The process of annual planning

1. Projection of demand of red cells and FFP, and of PfF

2. Determination of number of donations of WB and of collections of plasma

3. Mobile sites:

Determination of number of WB donors needed per location x 1.3 = collection at mobile sites

5. Fixed sites

Start with the nr of Plasma donors. Plasma donors per location x 5.0 = collection of plasma.

4. Total collection – mobile collection = fixed site collection of WB.

7. WB collection per fixed is nr of donors x 1.5-1.8. The exact collection depends also on the number of sessions per week.

Fixed blood collection center

Mobile blood collection center

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Interior of mobile blood collection center

Plasma collection (apheresis)

Haemonetics PCS2 and MCS+ •  Total 239 machines (60% of total) •  Collected volume 650 / 630 ml

Plasma collection (apheresis)

Fresenius (Fenwal) Autopheresis C

•  Total 154 machines (40% of total) •  Collected volume 650 ml

We need more plasma donors. Has the donor assistant asked you already to become a plasma donor? Ask him or her for more information.

Will you marry me? Or

Please say yes to a life-changing

proposal?

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Thank you for your attention