Determination of the optimal pool size of ABO-matched buffy coat (BC) units to achieve a typical adult dose (TAD) of platelets comparable to single donor platelet concentrate (SDPC): A single-center study

Abstract: BACKGROUND: The study aimed to determine the optimal pool size of ABO matched buffy coat pooled platelets (BCPP) to achieve a typical adult dose (TAD) of platelets comparable to single donor platelet concentrates (SDPC), following recent regulatory changes allowing random donor platelet concentrate (and/or buffy coat [BC]) pooling, in India. MATERIALS AND METHODS: This prospective study, done in 2024 at a tertiary hospital, included donors who met whole blood (WB) or SDPC donation criteria. WB was collected in quadruple bags and separated into red cells, plasma, and BC. BC units were pooled into groups of 4, 5, or 6 with 300 mL of ABO-matched plasma. SDPC was collected with automatic separators. The study examined four groups: BCPP, prepared from pools of four, five, or six BC units, and SDPC; 10 pools of BCPP (from three pool sizes of BC), and 10 units (SDPC) were assessed for in vitro parameters. Subsequently, conducted pilot in vivo study looked at the corrected count increment (CCI) and percentage platelet recovery (PPR) of the “optimal pool,” identified on the basis of in vitro analysis. RESULTS: The study used 150 WB and 10 SDPC donors, having no significant variations in physical, biochemical, or hematological markers across four groups. Pool-of-5 BC units met TAD standards with fewer units than pool-of-6 and produced comparable quality to SDPC. Transfusion of BCPP (pool-of-5) resulted in a CCI of 9.7 ± 4 × 10⁹/L and a PPR of 25 ± 11%. CONCLUSION: BCPP (pool-of-five BC units) provides an effective TAD, making it viable option to SDPC, with comparable quality and effectiveness.