title: Implications of a switch to a 100% apheresis platelet supply for patients and for blood donors: a risk benefit analysis.
abstract: BACKGROUND
  A 100% apheresis platelet supply is considered to increase transfusion safety by lowering donor exposures for transfusion recipients. We performed a risk benefit analysis to contrast the reduction of donor exposures and the risk of contaminated blood products in the nation-wide inventory with the donor risks associated with a switch to a 100% apheresis platelet supply in Germany.
  
  
  METHODS
  Donor exposures and the number of contaminated blood products resulting from HIV-like, HBV-like, HCV-like pathogens and two theoretical agents with infection rates of 10 and 1000 in 100 000, respectively, were calculated for a 100% apheresis platelet supply in Germany based on the 2006-2012 hemovigilance reports. These numbers were compared with the current mixed platelet supply of pooled and apheresis platelets. Moreover, additional donation time and apheresis donor complications resulting from a 100% apheresis platelet supply were estimated.
  
  
  RESULTS
  Per million total blood products (red cells, platelets, fresh frozen plasma), a 100% apheresis platelet supply would reduce donor exposures by 87 100 and the number of contaminated blood products ranging from 0·8 to 871·1. On the other hand, this requires additional 29 478 apheresis donations, 3·4 years additional donor time, and would be associated with 58 additional donor complications, respectively.
  
  
  CONCLUSIONS
  A 100% apheresis platelet supply would reduce donor exposures and the number of contaminated blood products in the inventory, but would increase apheresis complications in donors. Potential risks for patients must be carefully weighed against the risks for donors, dependent on the specific pathogen scenario.
authors.affiliation: Institute for Immunology and Transfusion Medicine, Universitätsmedizin Greifswald, Greifswald, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Thiele
authors.affiliation: German Red Cross Blood Service West, Bad Kreuznach, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Alt-Mayer
authors.affiliation: Institute for Immunology and Transfusion Medicine, Universitätsmedizin Greifswald, Greifswald, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Greinacher
authors.affiliation: Ruhr University, Bochum, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Bux
mesh_terms: D001782:Blood Donors; D001792:Blood Platelets / Q000502:physiology; D058731:Blood Safety; D006801:Humans; D017713:Platelet Transfusion / Q000009:adverse effects; D010983:Plateletpheresis; D018570:Risk Assessment
keywords: apheresis platelets; donor exposure; pooled platelets; transfusion-transmitted infection