October 17, 2021
Experts expect platelets may be in short supply in the coming years due to a number of factors, such as increasing usage, decreasing donations and the aging of the US population. Speakers discussed platelet supply and actions that can be taken to help keep it adequate during the 2021 Annual Meeting session, “Maintaining an Adequate Platelet Supply Through a Multifaceted Approach to Avoid Critical Shortages.”
Suchi Pandey, MD, from the department of pathology at Stanford University, discussed the current state of platelet supply and utilization. According to results from the National Blood Collection and Utilization Survey (NBCUS), between 2017 and 2019, there was an increase of utilization of platelets of almost 16%. At the same time, the platelet donor base has been getting older, with individuals between the ages of 51 and 60 — and even older — becoming a greater proportion of the donor pool.
To ensure the sustainability of apheresis platelet inventories, experts say we need to figure out why younger donors — between the ages of 31 and 50, who used to be dominant contributors — are becoming relatively inaccessible as donors.
Lauren Crowder, MPH, CPH, an epidemiologist with the American Red Cross (ARC), suggested a multifaceted approach to increasing the platelet supply based on modifying storage capacities, using bacterial testing to increase safety and supply, and gaining a better understanding of our donors. Unfortunately, the literature on donor motivation is sparse, and it can be costly to study; the research and qualitative data analysis needed are not commonly found in the typical blood center scientific research community.
Motivations are multi-factorial. Some of the donor motivations that have been found by researchers include:
A study by Stubbs et al., published in Transfusion in 2020, examined platelet shortages and how to address them. This study’s results suggested that the platelet supply could potentially be increased by increasing the use of whole-blood-derived platelets, providing additional education on the correct use of platelets, integrating cold-stored platelets, implementing lower content requirements for apheresis units and extending the shelf life of components.
Mayo Clinic initiated a paid donors program and found that there were fewer “no shows,” deferrals and reactions, and there was no significant increase in test positivity. The program also improved the availability of platelets.
This type of program requires a cost in time and money to set up, which raises the question of who will pay for it? The blood center? The hospital transfusion service? The government?
Crowder concluded that a paid model may work well for smaller donor centers and hospital-based blood centers but for larger blood centers, the paid model is less feasible.
In addition, we need to continue to track and try to understand platelet usage. There is a need for additional publication and sharing of donor demographic trends and large-scale multi-center studies on generational differences in donor behaviors, especially those in Gen Z/iGen (who are 24 years of age and younger).