Benefits of apheresis collection © 2012 Haemonetics Corp COL-COPY-000476(AA)

Content Trends in blood collection Donor recruitment Benefits of apheresis Efficiency Standardization Cost-efficiency Patient safety Management of stock Quality

Trends in blood collection Shortage of targeted blood types & components Increase of blood production costs New technologies, instruments Shrinking donor base Health issues Social attitudes Selection criteria Increased Demand for components Europe is predicting shrinking demand for Red Cells, but there is an imbalance of blood groups and specific blood types collected vs. needed.- so that there are blood group / blood type specific shortages Shrinking Donor Base- Gen X isn’t as community Oriented as past generations –True for Europe as well.- an aging donor population Fast Paced Society- time is of the essence Cost Containment- competing blood banks in some areas. Low RC price in some EU countries Technological Advancements Regulatory Issues Decreased errors in documentation due to automation of data collection and data entry – improvement in compliance and audits Testing is done from one set of samples for both units thereby decreasing the cost of testing in half .

Possible ways to respond Donor recruitment Implement more efficient methods for donation Apheresis!

Increase the donor recruitment efforts Donor recruitment is very costly in marketing campaign and resources. A UK (NBS) study demonstrated that in order to just slightly increase the donor population, recruitment costs would have to exponentially grow. Increase the donor recruitment efforts Costs Additional donors Baseline Aging donor population Decreased willingness to donate New, more stringent guidelines

Benefits of apheresis Efficiency Standardization Cost-efficiency More components per donor Standardization Better consistency in volume, yield, product quality Cost-efficiency Reduce lab cost, testing costs Patient safety Reduce exposition to multiple donors Management of stock Improve stock management by collecting product needed Quality Improve blood center management

Efficiency 2 Whole blood donors 1 2RBC & 1 RBCP donor 2 2RBC donors

Efficiency Platelets can be collected in different ways: Whole blood donation Platelet apheresis 1 unit Platelets (0.5x1011) 6-12 units Platelets (3-6x1011) + 1 unit Plasma + 1 unit RBC or 6 units Platelets + 2 unit Plasma 1 unit RBC

Standardization Apheresis collection allows the production of blood components of high quality and in standardized quantities Automated production Products ready to use Standardized products and processes In-line filtration WB RBC Apheresis RBC ± 12% Variation Haemonetics' internal study, 1994. [n = 352]. ± 6% Variation Improved red blood cell products: collection by apheresis. Smith JW, Axelrod FP, Ness PM. AABB Abstract #S263, 1995. [n = 1,612]

Apheresis derived products show better in vitro quality In- vitro (laboratory) study compares biochemical and functional properties of platelets and plasma coagulation factors in buffy coat-derived platelet concentrates (PCs) and apheresis derived platelet concentrates (APCs) over a storage period of 7 days at 20-24oC under constant agitation (52 rpm) 7 days storage Apheresis Buffy coat P-Selectin (ngmL-1) 105 362 LDH (µMS-1) 4.3 24.4 LDH = lactate dehydrogenase is a marker of a stressed platelet P-Selectin is a platelet activation marker Source: M. Böck, S.Rahrig Transfusion 2002;12:317-324

Apheresis collections are safe Procedure n Moderate rate/10,000 Severe Chi Square Whole blood 826,378 14.47 1.5 Plateletpheresis 72,464 6.21 1.1 WB v. Plt-pheresis and Automated RBC 6.27E -07 Automated RBC 59,995 6.83 1.16 Platelet v. Automated RBC 0.465 Automated collection of RBC as safe or safer than manual collection. 2-RBC or RBC-P: Moderate & Severe reactions Source: T. Wiltbank, Transfusion 2002;42:67S,SP137

Cost-efficiency It benefits the ratio cost-effectiveness by collecting more products from the same donor by reducing the testing costs by reducing the processing and laboratory work

Patient safety Improve the patient safety Reduce risks linked to pooled products (platelets) Reduce risks linked to residual plasma in platelets (concentrated platelets) Minimize the exposure to multiple donors (using highly repeat donors and guaranteeing the pureness and quality of the components) Reduce risk of bacteriologic contamination during the lab process.

Management of stock Multicomponents apheresis collections improve stock management by collecting products needed.

Management of stock Strategy Donation type Donors RBC units Plt units FFP units Whole Blood 100 1. Less donors 30 2RBC 60 Plasma 22 66 SDP 2 12 4 LDPRBC 10 Total 1 94 (-6%) 102 2. More platelets 20 Total 2 150 (+50%)

Management of stock Adopt type of donation to donor profile Supply meets demand Adjust blood type specific shortages and surpluses Optimize collection efficiency for given donor population Type of donation Blood type % of donors Platelets, WB A 43% 2RBC, RBCP, WB B 11% O 41% FFP, Platelets, RBCP AB 5%

Quality Usage of apheresis devices improves blood center management (SOP’s, data management, GMPs)

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