The Platelet Transfusion Service of HATS

HATS group photo
From left to right:  Alice Fuller, Kristin Uglik, Dave Lihvarchik, Adriane Hill, Sandy Thacker, Steve Baust, and Ana Ciappi.

Within the Johns Hopkins Hemapheresis and Transfusion Service (commonly referred to as “HATS”), a specialized team of nine people, known as the Platelet Transfusion Service, manages the Institution’s pheresis platelet inventory and relevant patient data.  The team is comprised of two data coordinators and seven platelet transfusion coordinators.

Data coordinators are responsible for entering and monitoring patient and product data in the OCIS blood ordering system.  They maintain transfusion reaction files, transfusion protocols, and transfusion histories for each patient being followed by the Service.  The platelet transfusion coordinators order inventory based on projected usage, designate selected products for immunized patients, and monitor the use of all platelet products within the Institution.  Our current platelet transfusion coordinators have a combined total of nearly 150 years of transfusion-related experience!

The American Red Cross is the Institution’s primary platelet supplier, providing the majority of the more than 18,000 pheresis platelets transfused each year at a cost of nearly $600 each.   It takes approximately 48 hours after collection to complete the required serological testing, label the product, and receive them into inventory.  Since pheresis platelets expire five days after collection, this leaves roughly three days to transfuse the product.   In comparison, red blood cells can be stored for more than 40 days and cost almost $200.

A primary responsibility of the Service is to monitor correct use of platelet products in order to keep outdating to a minimum, while maintaining an inventory that can support patient’s needs yet respond to unexpected emergencies.  As a result of active communication and interaction with the clinical teams, we are able to keep the platelet outdate rate to under 1%.  This rate is unprecedented in the blood banking community.

The platelet transfusion coordinators provide coverage 24/7, screening requests for and assigning platelet products to patients as needed.  Each assignment is selected based on the patient’s ABO, age, weight, CMV status, clinical condition, and transfusion goal.  This is a comprehensive, experience driven-approach based on individual patient need.  Approximately 3,000 different patients are transfused platelet products in this institution per year.

The team has recently participated in two clinical trials, under the Transfusion Medicine/Hemastasis Clinical Trial Network sponsored by NHLBI, identifying and recruiting eligible patients.  We have also participated in national meetings and have authored a paper related to bacterial contamination of platelet products that will be published in December 2009.     This is a hard working team that contributes on multiple levels to the Hopkins standard of excellence through its commitment to patient care, research, and teaching.

Alice Fuller, P.A.
HATS Lead Transfusion Coordinator