title: Introduction of a closed-system cell processor for red blood cell washing: postimplementation monitoring of safety and efficacy.
abstract: BACKGROUND
  After introduction of a closed-system cell processor, the effect of this product change on safety, efficacy, and utilization of washed red blood cells (RBCs) was assessed.
  
  
  METHODS
  This study was a pre-/postimplementation observational study. Efficacy data were collected from sequentially transfused washed RBCs received as prophylactic therapy by β-thalassemia patients during a 3-month period before and after implementation of the Haemonetics ACP 215 closed-system processor. Before implementation, an open system (TerumoBCT COBE 2991) was used to wash RBCs. The primary endpoint for efficacy was a change in hemoglobin (Hb) concentration corrected for the duration between transfusions. The primary endpoint for safety was the frequency of adverse transfusion reactions (ATRs) in all washed RBCs provided by Canadian Blood Services to the transfusion service for 12 months before and after implementation.
  
  
  RESULTS
  Data were analyzed from more than 300 RBCs transfused to 31 recipients before implementation and 29 recipients after implementation. The number of units transfused per episode reduced significantly after implementation, from a mean of 3.5 units to a mean of 3.1 units (p < 0.005). The corrected change in Hb concentration was not significantly different before and after implementation. ATRs occurred in 0.15% of transfusions both before and after implementation.
  
  
  CONCLUSIONS
  Safety and efficacy of washed RBCs were not affected after introduction of a closed-system cell processor. The ACP 215 allowed for an extended expiry time, improving inventory management and overall utilization of washed RBCs. Transfusion of fewer RBCs per episode reduced exposure of recipients to allogeneic blood products while maintaining efficacy.
authors.affiliation: Centre for Innovation, Canadian Blood Services.|Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Jason P
authors.initials: JP
authors.lastname: Acker
authors.affiliation: Centre for Innovation, Canadian Blood Services.
authors.forename: Adele L
authors.initials: AL
authors.lastname: Hansen
authors.affiliation: Canadian Blood Services, Ottawa, Ontario, Canada; and.
authors.forename: Qi-Long
authors.initials: QL
authors.lastname: Yi
authors.affiliation: University Health Network.
authors.forename: Nayana
authors.initials: N
authors.lastname: Sondi
authors.affiliation: University Health Network.|Department of Laboratory Medicine and Pathobiology, University of Toronto.
authors.forename: Christine
authors.initials: C
authors.lastname: Cserti-Gazdewich
authors.affiliation: University Health Network.|Department of Laboratory Medicine and Pathobiology, University of Toronto.
authors.forename: Jacob
authors.initials: J
authors.lastname: Pendergrast
authors.affiliation: Canadian Blood Services, Toronto, Ontario, Canada.
authors.forename: Barbara
authors.initials: B
authors.lastname: Hannach
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001793:Blood Preservation / Q000295:instrumentation* / Q000379:methods; D058731:Blood Safety; D017707:Erythrocyte Transfusion / Q000009:adverse effects; D004912:Erythrocytes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult; D017086:beta-Thalassemia / Q000628:therapy*