Profiling clinical platelet and plasma use to inform blood supply and contingency planning: PUPPY, the prospective utilization of platelets and plasma study.
BACKGROUND
Demand for platelet (PLT) and plasma transfusions is increasing. Improved clinical supply and contingency planning requires greater understanding of usage profiles and urgency of clinical requirement.


METHODS
This study was a random-sample survey of PLT and plasma units produced in Victoria, Australia, to determine product disposition, recipient demographics, clinical indications for transfusion, and urgency (or "deferability") of need. PLTs and fresh-frozen plasma (FFP) were tagged with a case report form before distribution.


RESULTS
A total of 1252 PLT and 1837 FFP units were tagged, comprising 8.3 and 13.3% of all products issued during the study period. The fate of 1243 PLT and 1808 FFP units was determined. Of products issued, 72.2% of PLTs and 87.8% of FFP were transfused. Hematologic and oncologic disorders accounted for 63.9% of PLT transfusions, with acute myeloid leukemia alone accounting for 26%. Conversely, surgical patients received the largest proportion of FFP (40.4%), predominantly for cardiothoracic, solid organ transplant, and vascular surgery. Approximately 15% of PLT transfusions and 35% of plasma transfusions were required within 1 hour, and 80% of PLT transfusions and 90% of FFP transfusions were required within 24 hours. Wastage rates were higher in regional blood banks.


CONCLUSIONS
The PUPPY study is a comprehensive and detailed population-based assessment of PLT and plasma usage, including urgency of use. It identifies specific clinical areas with high demand for PLT and FFP transfusion and demonstrates the high urgency of need for both products. These data inform clinical supply and contingency planning activities.
The Australian Red Cross Blood Service, Melbourne, Australia. pasquale.fedele@monashhealth.org.|Monash Haematology, Parkville. pasquale.fedele@monashhealth.org.|Walter and Eliza Hall Institute of Medical Research, Parkville, Australia. pasquale.fedele@monashhealth.org.
Pasquale L
PL
Fedele
The Australian Red Cross Blood Service, Melbourne, Australia.|Kirby Institute for Infection and Immunity, University of New South Wales.|Department of Haematology, St Vincent's Hospital, Sydney, Australia.
Mark N
MN
Polizzotto
The Australian Red Cross Blood Service, Melbourne, Australia.|Monash Haematology, Parkville.|School of Clinical Sciences, Monash Health, Clayton, Australia.
George
G
Grigoriadis
The Australian Red Cross Blood Service, Melbourne, Australia.|Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
Neil
N
Waters
The Australian Red Cross Blood Service, Melbourne, Australia.|Royal Children's Hospital, Parkville, Australia.
Mary
M
Comande
The Australian Red Cross Blood Service, Melbourne, Australia.|Department of Haematology, Eastern Health, Box Hill, Australia.
Marija
M
Borosak
The Australian Red Cross Blood Service, Melbourne, Australia.
David
D
Portbury
The Australian Red Cross Blood Service, Melbourne, Australia. erica.wood@monash.edu.|Monash Haematology, Parkville. erica.wood@monash.edu.|School of Clinical Sciences, Monash Health, Clayton, Australia. erica.wood@monash.edu.|Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. erica.wood@monash.edu.
Erica M
EM
Wood
D001771:Blood Banks / Q000592:standards; D016913:Blood Component Transfusion / Q000706:statistics & numerical data*; D001792:Blood Platelets; D006402:Hematologic Diseases / Q000628:therapy; D006801:Humans; D009369:Neoplasms / Q000628:therapy; D010934:Planning Techniques; D010949:Plasma; D013514:Surgical Procedures, Operative; D011795:Surveys and Questionnaires; D000094902:Blood Banking / Q000379:methods