Namibia's transition from whole blood-derived pooled platelets to single-donor apheresis platelet collections.
BACKGROUND
Few African countries separate blood donations into components; however, demand for platelets (PLTs) is increasing as regional capacity to treat causes of thrombocytopenia, including chemotherapy, increases. Namibia introduced single-donor apheresis PLT collections in 2007 to increase PLT availability while reducing exposure to multiple donors via pooling. This study describes the impact this transition had on PLT availability and safety in Namibia.


METHODS
Annual national blood collections and PLT units issued data were extracted from a database maintained by the Blood Transfusion Service of Namibia (NAMBTS). Production costs and unit prices were analyzed.


RESULTS
In 2006, NAMBTS issued 771 single and pooled PLT doses from 3054 whole blood (WB) donations (drawn from 18,422 WB donations). In 2007, NAMBTS issued 486 single and pooled PLT doses from 1477 WB donations (drawn from 18,309 WB donations) and 131 single-donor PLT doses. By 2011, NAMBTS issued 837 single-donor PLT doses per year, 99.1% of all PLT units. Of 5761 WB donations from which PLTs were made in 2006 to 2011, a total of 20 (0.35%) were from donors with confirmed test results for human immunodeficiency virus or other transfusion-transmissible infections (TTIs). Of 2315 single-donor apheresis donations between 2007 and 2011, none of the 663 donors had a confirmed positive result for any pathogen. As apheresis replaced WB-derived PLTs, apheresis production costs dropped by a mean of 8.2% per year, while pooled PLT costs increased by an annual mean of 21.5%. Unit prices paid for apheresis- and WB-derived PLTs increased by 9 and 7.4% per year on average, respectively.


CONCLUSIONS
Namibia's PLT transition shows that collections from repeat apheresis donors can reduce TTI risk and production costs.
Division of Global HIV/AIDS, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia.|University Medical Center Groningen (UMCG), Institute of Science in Healthy Aging & health caRE (SHARE), Groningen, NL.
John P
JP
Pitman
Division of Global HIV/AIDS, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia.
Sridhar V
SV
Basavaraju
Division of Global HIV/AIDS, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia.
Ray W
RW
Shiraishi
Blood Transfusion Service of Namibia.
Robert
R
Wilkinson
Blood Transfusion Service of Namibia.
Bjorn
B
von Finckenstein
Division of Global HIV/AIDS, Center for Global Health, US Centers for Disease Control and Prevention, Windhoek, Namibia.
David W
DW
Lowrance
Division of Global HIV/AIDS, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia.
Anthony A
AA
Marfin
Department of Pharmacy, Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), University of Groningen, Groningen, the Netherlands.|University Medical Center Groningen (UMCG), Institute of Science in Healthy Aging & health caRE (SHARE), Groningen, NL.
Maarten
M
Postma
Namibia Ministry of Health and Social Services, Directorate for Clinical Support Services.
Mary
M
Mataranyika
ID Consulting for International Development of Transfusion Medicine.
Cees Th
CT
Smit Sibinga
D001782:Blood Donors; D001792:Blood Platelets; D016208:Databases, Factual; D046148:Donor Selection; D005260:Female; D006801:Humans; D008297:Male; D009276:Namibia; D017713:Platelet Transfusion; D010983:Plateletpheresis