Comparative evaluation of blood component preparation with the top‐and‐top and top‐and‐bottom methods: A change in Uruguay

Background Hospital de Clínicas, in conjunction with the Universidad de la República UDELAR in Uruguay, evaluated the quality of blood components after separation with a top‐and‐bottom (TB) system, comparing it with the top‐and‐top (TT) system and verifying compliance with local and international standards. Study Design and Methods Whole blood (WB) was collected using TB ( n = 150) and TT ( n = 130). TB units were processed with MacoPress Smart, obtaining red cell concentrate (RCC), plasma (PL), and buffy coat (BC). After 2 h, BC had a soft spin centrifugation for a single unit of platelet concentrate (SUPC). TT bags were managed on day 0 (up to 8 h of collection) with manual press obtaining RCC and platelet‐rich plasma units (PRP). PRP had hard spin centrifugation and was separated again with the manual press to collect PL and SUPC. Results TB system produced RCC with higher haemoglobin concentration and Haematocrit but with lower volume and Hb/unit ( p < 0.001). The TB system produced RCC with lower leukocytes and residual platelet levels ( p < 0.001). SUPC showed fewer residual leukocytes and red cell levels with TB ( p < 0.001), but TT produced a higher mean platelet count than the TB system (p < 0.001). During this evaluation, there was no significant difference in the mean plasma volume ( p = 0.178). Conclusion The analysis favors the implementation of TB in the HC Blood Bank, improving the quality and safety of the transfusion service.