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Pérez-Aliaga AI, Ayerra I, Sánchez-Guillén J, López FJ, Puente F, Aranda A, Domingo JM, Garcés C. Routine results of an algorithm for managing the production of blood components. Vox Sang 2024; 119:541-547. [PMID: 38410835 DOI: 10.1111/vox.13609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/06/2024] [Accepted: 02/12/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND AND OBJECTIVES The variability in the number of donations together with a growing demand for platelet concentrates and plasma-derived medicines make us seek solutions aimed at optimizing the processing of blood. Some mathematical models to improve efficiencies in blood banking have been published. The goal of this work is to validate and evaluate an algorithm's impact in the production of blood components in the Blood and Tissues Bank of Aragon (BTBA). MATERIALS AND METHODS A mathematical algorithm was designed, implemented and validated through simulations with real data. It was incorporated into the fractionation area, which uses the Reveos® fractionation system (Terumo BCT) to split blood into its components. After 9 months of daily routine validation, retrospective activity data from the Blood Bank and Transfusion Services before and during the use of the algorithm were compared. RESULTS Using the algorithm, the outdating rate of platelet concentrates (PC) decreased by 87.8% in the blood bank. The average shelf life remaining of PC supplied to Transfusion Services increased by almost 1 day. As a consequence, the outdating rate in the Aragon Transfusion Network decreased by 33%. In addition, extra 100 litres of plasma were obtained in 9 months. CONCLUSIONS The algorithm improves the blood establishment's workflow and facilitates the decision-making process in whole blood processing. It resulted in a decrease in PC outdating rate, increase in PC shelf life and finally an increase in the volume of recovered plasma, leading to significant cost savings.
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Affiliation(s)
| | | | | | - F Javier López
- Department of Statistical Methods and Institute for Biocomputation and Physics of Complex Systems (BIFI), University of Zaragoza, Zaragoza, Aragón, Spain
| | - Fernando Puente
- Blood and Tissues Bank of Aragón (BTBA), Zaragoza, Aragón, Spain
| | - Alfonso Aranda
- Blood and Tissues Bank of Aragón (BTBA), Zaragoza, Aragón, Spain
| | | | - Carmen Garcés
- Blood and Tissues Bank of Aragón (BTBA), Zaragoza, Aragón, Spain
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Reddoch-Cardenas KM, Perez SL, Ferdin JN, Meledeo MA. Evaluation of platelets componentized with the Reveos Automated Blood Processing System and stored for 7 days at room temperature in a non-Di(2-ethylhexyl) phthalate (DEHP) platelet pooling set. Transfusion 2024; 64 Suppl 2:S146-S154. [PMID: 38491915 DOI: 10.1111/trf.17780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Platelet concentrates (PCs) used for transfusion can be produced by apheresis or derived from whole blood (WB). The Reveos device is the first US Food and Drug Administration-approved automated blood processing system that can produce PCs. In this work, we evaluated the quality and function of Reveos-collected PCs stored for 7 days at room temperature. STUDY DESIGN AND METHODS WB was collected from healthy donors and componentized on the day of collection (Fresh) or after an overnight hold (Overnight). PCs were produced (n = 7 Fresh; n = 6 Overnight), stored at room temperature in plasma, and evaluated on days 1 and 7 for quality metrics, platelet activation, clot formation, and aggregation response. RESULTS Platelet count was comparable between Fresh and Overnight PCs. A drop in pH was reported in Fresh day 7 PCs (p < .001, vs. day 1) but not in Overnight. Overnight units displayed the lowest levels of P-selectin expression (p = .0008, vs. day 7 Fresh). Reduced clot strength and increased lysis were observed in both Fresh and Overnight units on day 7 (vs. day 1). Overnight-hold PCs resulted in the highest clot strength on day 7 (p = .0084, vs. Fresh). No differences in aggregation were reported between groups. CONCLUSION Reveos-processed PCs produced from overnight-hold WB performed better in hemostatic function assays and displayed reduced activation compared to fresh WB-derived PCs, although both PC groups maintained platelet quality throughout storage. Utilization of overnight WB for PC preparation with Reveos holds promise as an alternative method of producing platelets for transfusion purposes.
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Affiliation(s)
- Kristin M Reddoch-Cardenas
- Blood and Shock Resuscitation, U.S. Army Institute of Surgical Research, JBSA-FT, Sam Houston, Texas, USA
| | - Samantha L Perez
- Blood and Shock Resuscitation, U.S. Army Institute of Surgical Research, JBSA-FT, Sam Houston, Texas, USA
| | - Justin N Ferdin
- Blood and Shock Resuscitation, U.S. Army Institute of Surgical Research, JBSA-FT, Sam Houston, Texas, USA
| | - Michael A Meledeo
- Blood and Shock Resuscitation, U.S. Army Institute of Surgical Research, JBSA-FT, Sam Houston, Texas, USA
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Elhaj SA, Odeh Y, Tbaishat D, Rjoop A, Mansour A, Odeh M. Informing the State of Process Modeling and Automation of Blood Banking and Transfusion Services Through a Systematic Mapping Study. J Multidiscip Healthc 2024; 17:473-489. [PMID: 38318487 PMCID: PMC10840532 DOI: 10.2147/jmdh.s443674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/09/2024] [Indexed: 02/07/2024] Open
Abstract
Purpose The current state of the art in process modeling of blood banking and transfusion services is not well grounded; methodological reviews are lacking to bridge the gap between such blood banking and transfusion processes (and their models) and their automation. This research aims to fill this gap with a methodological review. Methods A systematic mapping study was adopted, driven by five key research questions. Identified research studies were accepted based on fulfilling the following inclusion criteria: 1) research studies should focus on blood banking and transfusion process modeling since the late 1970s; and 2) research studies should focus on process automation in relation to workflow-based systems, with papers classified into categories in line with the analysis undertaken to answer each of the research questions. Results The search identified 22 papers related to modeling and automation of blood banking and transfusion, published in the period 1979-2022. The findings revealed that only four process modeling languages were reported to visualize process workflows. The preparation of blood components, serologic testing, blood distribution, apheresis, preparation for emergencies, maintaining blood banking and transfusion safety, and documentation have not been reported to have been modeled in the literature. This review revealed the lack of use of Business Process Modeling Notation (BPMN) as the industry standard process modeling language in the domain. The review also indicated a deficiency in modeling specialized processes in blood banking and transfusion, with the majority of reported processes being described as high level, but lacking elaboration. Automation was reported to improve transfusion safety, and to reduce cost, time cycle, and human errors. Conclusion The work highlights the non-existence of a developed process architectural framework for blood banking and transfusion processes, which is needed to lay the groundwork for identifying and modeling strategic, managerial, and operational processes to bridge the gap with their enactment in healthcare systems. This paves the way for the development of a data-harvesting platform for blood banking and transfusion services.
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Affiliation(s)
| | - Yousra Odeh
- Cancer Care Informatics Research, King Hussain Cancer Center (KHCC), Amman, Jordan
- Faculty of Information Technology, Philadelphia University, Amman, Jordan
| | - Dina Tbaishat
- Cancer Care Informatics Research, King Hussain Cancer Center (KHCC), Amman, Jordan
- College of Technological Innovation, Zayed University, Dubai, United Arab Emirates
- Library and Information Science Department, University of Jordan, Amman, Jordan
| | - Anwar Rjoop
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- Department of Pathology, Blood Bank, King Abdullah University Hospital, Irbid, Jordan
| | - Asem Mansour
- Cancer Care Informatics Research, King Hussain Cancer Center (KHCC), Amman, Jordan
| | - Mohammed Odeh
- Cancer Care Informatics Research, King Hussain Cancer Center (KHCC), Amman, Jordan
- College of Arts, Technology and Environment, University of the West of England, Bristol, UK
- Global Academy for Digital Health, Bristol, UK
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Cid J, Comasòlivas N, Pérez-Aliaga A, Illingworth N, Cardoso M. Comparison of automated versus semi-automated whole blood processing systems: A systematic review. Vox Sang 2023; 118:263-271. [PMID: 36626280 DOI: 10.1111/vox.13400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/22/2022] [Accepted: 12/22/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND OBJECTIVES Implementation of automated steps in preparing blood components for transfusion from whole blood collections has produced improvements in multiple fields. The aim of this review is to summarize data from existing literature related to automation of whole blood processing systems. MATERIALS AND METHODS We searched MEDLINE for studies comparing semi-automated and fully automated whole blood processing systems published before 20 July 2021. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Additionally, we performed a manual search. RESULTS We identified 500 studies, of which 459 (92%) did not meet the eligibility criteria, and finally 17 studies were included in the analysis. Manual search included six additional studies. Publication year ranged from 2004 to 2021. Automation reduced the run-time (from 92 to 76 min), improved recovery of haemoglobin in red cell concentrates (RCCs) and resulted in higher red blood cell and platelet yields. Automation also reduced discard rates due to whole blood bag ruptures (1.2%-0.1%), low volume of RCCs (<200 ml; 0.5%-0.03%) and haemolytic plasma (2.1%-0.6%). Automation could reduce the number of full-time equivalent (FTE) operators or maintain the number of FTE operators while performing additional procedures, and it reduced to 1.13 m2 the space required for the device. CONCLUSION Automation of whole blood processing resulted in continued improvements in productivity, product quality and technical features. However, too few publications are available to reach strong conclusions. Therefore, it is necessary to expand the scientific knowledge in this field.
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Affiliation(s)
- Joan Cid
- Apheresis and Cell Therapy Unit, Department of Hematology and Hemotherapy, ICMHO, IDIBAPS, Clínic Barcelona, University of Barcelona, Barcelona, Spain
| | - Nil Comasòlivas
- Terumo Blood and Cell Technologies, Inc., Denver, Colorado, USA
| | | | | | - Marcia Cardoso
- Terumo Blood and Cell Technologies, Inc., Denver, Colorado, USA
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Assessing quality of blood components derived from whole blood treated with riboflavin and ultraviolet light and separated with a fully automated device. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2022; 20:395-403. [PMID: 35175188 PMCID: PMC9480972 DOI: 10.2450/2022.0278-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/22/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Combining pathogen reduction and automated separation of whole blood (WB), together with the use of improved additive solutions, may increase reproducibility and extend shelf-life of blood components. MATERIALS AND METHODS Forty WB units were collected from volunteer donors and randomised 1:1 into two groups: 1) pathogen reduction with riboflavin and ultraviolet light (PRT); or 2) no treatment (Control). After two hours (h) at room temperature, all units underwent fully automated separation into red blood cell concentrate (RBCC), plasma and leukopack components. RBCCs were leukoreduced and stored in phosphate-adenine-glucose-guanosine-saline-mannitol (PAGGSM) solution while plasma units were shock frozen within 8 h of collection and stored at ≤ -25°C. RBCCs were sampled on day 1 and weekly thereafter until day 42, while plasma was sampled on days 1 and 30. The main study objective was to assess the in vitro quality of separated RBCCs using biochemical and haematological parameters. Plasma protein content after one cycle of freeze-thaw was also analysed. RESULTS The quality of RBCCs was largely comparable between the PRT and Control groups, except for a significantly higher degree of haemolysis and extracellular potassium levels in the PRT group after 35 days of storage. While potassium concentration was significantly higher in the PRT group at all timepoints, the degree of haemolysis exceeded the accepted European threshold (i.e., <0.8% of red cell mass in ≥ 90.0% of tested units) after day 35. Most plasma protein levels were significantly lower in the PRT than the Control group at both day 1 and day 30. DISCUSSION Pathogen reduction with riboflavin and ultraviolet light treatment of WB can be combined with fully automated separation to obtain RBCCs that may be stored for up to 35 days in PAGGSM solution with acceptable quality, comparable to that of RBCCs from untreated blood. The relative differences between factor concentrations in plasma from the PRT and the Control groups were similar during the 30-day storage.
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Qin J, Zhang J, Jiang J, Zhang B, Li J, Lin X, Wang S, Zhu M, Fan Z, Lv Y, He L, Chen L, Yue W, Li Y, Pei X. Direct chemical reprogramming of human cord blood erythroblasts to induced megakaryocytes that produce platelets. Cell Stem Cell 2022; 29:1229-1245.e7. [PMID: 35931032 DOI: 10.1016/j.stem.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/08/2022] [Accepted: 07/13/2022] [Indexed: 11/19/2022]
Abstract
Reprogramming somatic cells into megakaryocytes (MKs) would provide a promising source of platelets. However, using a pharmacological approach to generate human MKs from somatic cells remains an unmet challenge. Here, we report that a combination of four small molecules (4M) successfully converted human cord blood erythroblasts (EBs) into induced MKs (iMKs). The iMKs could produce proplatelets and release functional platelets, functionally resembling natural MKs. Reprogramming trajectory analysis revealed an efficient cell fate conversion of EBs into iMKs by 4M via the intermediate state of bipotent precursors. 4M induced chromatin remodeling and drove the transition of transcription factor (TF) regulatory network from key erythroid TFs to essential TFs for megakaryopoiesis, including FLI1 and MEIS1. These results demonstrate that the chemical reprogramming of cord blood EBs into iMKs provides a simple and efficient approach to generate MKs and platelets for clinical applications.
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Affiliation(s)
- Jinhua Qin
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing 100850, China; South China Research Center for Stem Cell & Regenerative Medicine, SCIB, Guangzhou 510005, China
| | - Jian Zhang
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin 300072, China
| | - Jianan Jiang
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing 100850, China
| | - Bowen Zhang
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing 100850, China; South China Research Center for Stem Cell & Regenerative Medicine, SCIB, Guangzhou 510005, China
| | - Jisheng Li
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing 100850, China
| | - Xiaosong Lin
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing 100850, China
| | - Sihan Wang
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing 100850, China; South China Research Center for Stem Cell & Regenerative Medicine, SCIB, Guangzhou 510005, China
| | - Meiqi Zhu
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing 100850, China
| | - Zeng Fan
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing 100850, China; South China Research Center for Stem Cell & Regenerative Medicine, SCIB, Guangzhou 510005, China
| | - Yang Lv
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing 100850, China; South China Research Center for Stem Cell & Regenerative Medicine, SCIB, Guangzhou 510005, China
| | - Lijuan He
- South China Research Center for Stem Cell & Regenerative Medicine, SCIB, Guangzhou 510005, China; Institute of Health Service and Transfusion Medicine, Beijing 100850, China
| | - Lin Chen
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing 100850, China; South China Research Center for Stem Cell & Regenerative Medicine, SCIB, Guangzhou 510005, China
| | - Wen Yue
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing 100850, China; South China Research Center for Stem Cell & Regenerative Medicine, SCIB, Guangzhou 510005, China
| | - Yanhua Li
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing 100850, China; South China Research Center for Stem Cell & Regenerative Medicine, SCIB, Guangzhou 510005, China.
| | - Xuetao Pei
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing 100850, China; South China Research Center for Stem Cell & Regenerative Medicine, SCIB, Guangzhou 510005, China.
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