State of affairs: the US platelet supply and the role of whole blood–derived platelets

Abstract

PurposeThe US platelet supply is almost exclusively dependent on apheresis donors who are “aging out.” As a result, blood centers and hospitals have been experiencing spot shortages and have resorted to transfusing low-dose platelets. This paper explores using whole blood–derived platelets (WB-PLTs) to supplement the apheresis platelet (APH-PLT) supply.Design/methodology/approachThis paper reviews the history leading to the current state of the US platelet supply and includes the impact of recent events such as the COVID-19 pandemic and the implementation of the US Food and Drug Administration (FDA)-mandated bacterial mitigation strategies.FindingsWB-PLTs represent a viable source of platelets that can be used to supplement the APH-PLT supply. Whole blood automation represents a new methodology to more easily prepare WB-PLTs. Advances in donor testing and screening as well as pre-storage leukoreduction have improved the safety of WB-PLTs to the same level as APH-PLTs. Blood services in the US and abroad transfuse WB-PLTs interchangeably in all patient populations.Originality/valueThis paper highlights how the US blood industry is essentially “sole-sourced” in terms of APH-PLTs. In this post-COVID-19 period, when most industries are building redundancies in their supply chains, blood centers should consider WB-PLTs as an additional source of platelets to bolster the US platelet supply.