About 2.5 million units of platelets are transfused each year in the U.S., and data from the National Blood Collection and Utilization survey show a 16% increase in platelet transfusions and a 2% decrease in collections between 2017 and 2019. In 2019, approximately 40% of U.S. hospitals indicated that they routinely had platelet supply issues causing delays in surgeries and transfusions. Additionally, the number of platelets needed is predicted to steadily increase. The U.S. FDA has approved two methods for collecting platelets—apheresis-derived platelets from one donor (~94% national supply) and manually processed whole blood derived platelets from platelet-rich plasma pooled from three or more donors (~6% national supply). Two other semi-automated and one fully automated system for collecting platelets from whole blood, however, are used in other countries. A team of experts in the transfusion medicine community is recommending that the FDA consider approving at least one of these other technologies to process platelets in order to ensure a stable supply. These semi-automated and fully-automated technologies efficiently use all donated whole blood components, decrease manual time, and would substantially increase platelet production without the need to increase the number of donors. Potential disadvantages to these new technologies include upfront costs of new equipment and a slight decrease in RBCs collected. In addition, transfusion recipients would have increased donor exposures, but with current screening methods the increased risk of transfusion-transmitted infections in minimal. To meet patient demand for platelets and not jeopardize patient outcomes, transfusion experts are urging the U.S. to expand the platelet supply chain.
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