JPAC Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee

7.29: Platelets for Intrauterine Transfusion, Leucocyte Depleted

Update notice:  Concessionary release limits have been updated in table 7.24 following the the issue of Change Notification 22 - 2015.
The tables in the sections 7.9.4, 7.10.4, 7.11.4, 7.12.4, 7.29.4 and 7.30.4 have been updated following the issue of Change Notification No 34 – 2016.

 

A hyperconcentrated platelet component for intrauterine transfusion, prepared by apheresis, that contains less than 1 × 106 leucocytes per donation.

7.29.1: Technical information

  • The component should be free from clinically significant irregular blood group antibodies including high-titre anti-A and anti-B and should be negative for antibodies to CMV.
     
  • The component must be used by the end of Day 1.
     
  • The component must be irradiated. See the BCSH ‘Transfusion guidelines for neonates and older children’.5
     
  • The component should contain a concentration of platelets between 2 and 4 × 1012/L in a collected volume generally in the range of 50–100 mL.
     
  • All components should be quality monitored and achieve the specified requirements. The testing need not necessarily be performed before component release.
     
  • Screening of female donors for HLA/HNA antibodies should be considered as a TRALI risk reduction strategy. If platelets are to be issued as HPA-matched (e.g. HPA-1a or HPA-5b negative) then donors should be screened and found negative for all clinically significant HLA and HPA antibodies (as defined in Chapters 16 and 18). This screening can be done on an initial sample and does not need repeating at each donation unless the donor has been transfused or pregnant since the last antibody screen.
     
  • A record which demonstrates that the donor has not been transfused since the initial negative screen for antibodies and in case of female donors that the donor has not been pregnant since the initial negative screen for antibodies needs to be maintained.
     
  • Platelets for Intrauterine Transfusion, Leucocyte Depleted should be transfused through a 170–200 µm filter.

7.29.2: Labelling

For general guidelines, see section 6.6.

The following shall be included on the label:

(* = in eye-readable and UKBTS approved barcode format)

  • Platelets for Intrauterine Transfusion, Leucocyte Depleted* and volume
     
  • the blood component producer’s name*
     
  • the donation number*
     
  • the ABO group*
     
  • the RhD group stated as positive or negative*
     
  • the relevant HPA and HLA type, if necessary
     
  • the date of collection
     
  • the expiry date and time*
     
  • the temperature of storage and a comment that continuous gentle agitation during storage is recommended
     
  • the blood pack lot number*
     
  • the name, composition and volume of the anticoagulant.

In addition, the following statements should be made:

INSTRUCTION

Always check patient/component compatibility/identity

Inspect pack and contents for signs of deterioration or damage

Risk of adverse reaction/infection, including vCJD

7.29.3: Storage

For general guidelines, see section 6.7.

  • The component should be stored at a core temperature of 22 ±2°C for use up to the end of Day 1.
     
  • The component should be gently and continuously agitated during storage.

7.29.4: Testing

In addition to the mandatory and other tests required for blood donations described in Chapter 9, and leucocyte counting (see sections 6.3 and 7.1), the component shall be free from clinically significant irregular blood group antibodies and high-titre anti-A and/or anti-B and antibodies to CMV. Furthermore, all components tested for the other parameters shown in Table 7.24 shall meet the specified values.

Table 7.24 Platelets for Intrauterine Transfusion, Leucocyte Depleted – additional tests

Parameter Frequency of test Specification

Volume

Every component

Within locally defined range***

Platelet concentration

2–4 × 1012/L

pH at end of shelf life*

≥6.4

Leucocyte count**

As per sections 6.3 and 7.1

<1 × 106/unit****

* The shelf life of this hyperconcentrated platelet component has been set to reflect validation
data. Therefore, once this has been validated locally, there is no need to measure pH at expiry on
a routine basis

** Methods validated for counting low numbers of leucocytes must be used

*** Units measured and found to be outside of the range 50 to 120 mL should not be issued for transfusion
****Units tested and found to have > 2.5 x106/unit should not be issued for transfusion

Note: Visual inspection of platelet components for the swirling phenomenon, clumping, excessive red cell contamination and abnormal volume is a useful pre-issue check.

7.29.5: Transportation

For general guidelines, see section 6.11.

  • Containers for transporting platelets should be equilibrated at room temperature before use. During transportation the temperature of platelets must be kept as close as possible to the recommended storage temperature and, on receipt, unless intended for immediate therapeutic use, the component should be transferred to storage at a core temperature of 22°C with continuous gentle agitation.
     
  • Plastic overwraps should be removed prior to storage.