The present disclosure relates to fluid pooling. More particularly, the present disclosure relates to pooling a plurality of intermediate fluid volumes to create fluid products having a target content of a fluid component.
Whole blood collected from donors is often separated into components that are extremely valuable for medical therapies. Often these components are not present in a therapeutic dose, or the amount required for a procedure such as a transfusion. A number of source bags containing the desired component are then combined or “pooled” into a single bag to accomplish this therapeutic dose.
Common desired blood components include platelets which can be found in various platelet products such as buffy coat, platelet rich plasma, or platelet concentrate. There are several methods to pool platelet products in order to achieve a desirable therapeutic dose of platelets, such as 3.0e11 platelets.
This is currently accomplished using buffy coat or platelet rich plasma methods. The buffy coat method involves separating units of whole blood into red blood cells, platelet poor plasma, and buffy coat. The buffy coat content derived from multiple whole blood units are pooled and processed via a second separation to produce a platelet concentrate that forms the therapeutic platelet product. The platelet rich plasma method is similar, but rather than producing a buffy coat in the first separation, the whole blood is separated into red blood cells and platelet rich plasma. The platelet rich plasma content from multiple whole blood units is then pooled and processed via a second separation to produce the platelet product. In both methods, the platelet content of the intermediate component (buffy coat or platelet rich plasma) is unknown, and thus the process must pool enough units, typically four, to ensure the platelet content of the final product will achieve dosing requirements, such as 3.0e11 platelets. Therefore, the current process may lead to inefficiencies that prevent production of a maximum number of products from a specific number of whole blood units.
It is therefore desirable to utilize a more efficient pooling method that achieves a therapeutic dose of a specific component, such as platelets, and maximizes the amount of pooled doses available.
There are several aspects of the present subject matter which may be embodied separately or together in the devices and systems described and claimed below. These aspects may be employed alone or in combination with other aspects of the subject matter described herein, and the description of these aspects together is not intended to preclude the use of these aspects separately or the claiming of such aspects separately or in different combinations as set forth in the claims appended hereto.
In one aspect, a method is provided for creating a plurality of fluid products each having a minimum content of a fluid component. The method includes providing a plurality of intermediate fluid volumes each having a known content of a fluid component, determining a plurality of combinations of at least two of the intermediate fluid volumes and pooling the plurality of intermediate fluid volumes according to the determined plurality of combinations so as to create a plurality of fluid products each having a content of the fluid component at least equal to the minimum content of the fluid component. When determining how to combine the intermediate fluid volumes, each intermediate fluid volume is assigned to only one of the combinations, with each combination having a content of the fluid component at least equal to a minimum content of the fluid component for a fluid product. The intermediate fluid volumes are assigned for each combination so as to maximize the number of combinations each having a content of the fluid component at least equal to the minimum content of the fluid component for the fluid product.
In another aspect, a fluid component pooling system is provided. The fluid component pooling system is for use in combination with a fluid flow circuit including a plurality of source containers each holding an intermediate fluid volume with a known content of a fluid component and a plurality of fluid product containers for holding a fluid product with a minimum content of the fluid component. The system includes a pump, a clamp, and a controller coupled to the pump and the clamp. The controller is configured to actuate the pump and the clamp to create a plurality of fluid products each having a minimum content of the fluid component. The controller is configured to determine a plurality of combinations of at least two of the intermediate fluid volumes in which each intermediate fluid volume is assigned to only one of said plurality of combinations, each combination has a content of the fluid component at least equal to the minimum content of the fluid component for the fluid product, and said at least two of the intermediate fluid volumes are assigned for each combination so as to maximize the number of combinations each having a content of the fluid component at least equal to the minimum content of the fluid component for the fluid product. The controller actuates the pump and the clamp to pool the intermediate fluid volumes into the fluid product containers according to the determined plurality of combinations, with each combination of pooled intermediate fluid volumes defining a fluid product having a content of the fluid component at least equal to the minimum content of the fluid component.
These and other aspects of the present subject matter are set forth in the following detailed description of the accompanying drawings.
The embodiments disclosed herein are for the purpose of providing a description of the present subject matter, and it is understood that the subject matter may be embodied in various other forms and combinations not shown in detail. Therefore, specific designs and features disclosed herein are not to be interpreted as limiting the subject matter as defined in the accompanying claims.
Disclosed herein are computer-based methods for optimizing pooling of volumes of fluid so as to maximize the number of final fluid products with at least a minimum amount of a fluid component.
Techniques according to the present disclosure will be explained in the context of pooling a plurality of intermediate platelet volumes (e.g., volumes of buffy coats or platelet rich plasma or platelet concentrate) so as to form final platelet products, but it should be understood that the techniques described herein are not limited to the pooling of volumes of platelets, but may be applied to other fluids and other fluid components. For example, the component can be any component desirable for a particular treatment, including, but not limited to, components such as platelets, red or white blood cells, T-cells, stems cells, etc. Typically, these cells are pulled or separated from a base starting fluid such as whole blood, with a unit or other amount of whole blood being processed to produce a single intermediate fluid volume having some amount of the cells. Any of a number of possible approaches may be applied to separate the base fluid, including (but not limited to) centrifugation, separation via a spinning membrane, and filtration.
The amount of the component in the intermediate fluid volumes can be measured by any known method. In an exemplary embodiment, the amount of component is measured by optical detection. In other exemplary embodiments, the amount of component is measured as part of complete blood count, by flow cytometry, or any other cell quantification method completed by an automated cell counting system.
Cell component therapies typically require a minimum amount of a specific component to perform the process, such as a blood transfusion. For example, in the case of platelets, the desired therapeutic amount is typically 3.0e11, but it should be understood that the target or minimum content of a fluid component in a final fluid product may vary without departing from the scope of the present disclosure.
In some cases, the amount of cells yielded from the unit or other amount of starting fluid will not be sufficient for a therapeutic dose of the cells, in which case a plurality of intermediate volumes of the separated component (e.g., buffy coat or platelet rich plasma or platelet concentrate, when a platelet product is to be produced) are combined or pooled to produce a final product having at least the target or minimum cell content. The exact manner in which the intermediate fluid volumes are combined or pooled to produce the final product may vary without departing from the scope of the present disclosure.
When the content of the fluid component in each of a plurality of intermediate fluid volumes is known, the intermediate fluid volumes can be assigned to sorting bins with other intermediate fluid volumes that have the same content (step 20 of
The bottom row of the last column of
The number 3.3e11 is used in the illustrated example instead of 3.0e11 (which is a typical platelet content for a therapeutic dose) for various reasons. For example, it may be desirable to select a number greater than the minimum number in order to better ensure that the minimum platelet content is achieved. This may be prudent on account of the expected efficiency of the particular procedure employed to pool each combination of intermediate fluid volumes and subsequent post-processing, such as separating the platelet product, and performing other post-processing procedures so that the final platelet product is a therapy ready product. For example, if the pooling and post-processing processes have an estimated or calculated efficiency of 90%, an intermediate fluid volume having 1.1e11 platelets can be expected to contribute approximately 1.0e11 platelets to a final therapy ready product. In this case, a combination of intermediate fluid volumes having a total of 3.3e11 platelets may be expected to result in a final product actually having 3.0x11 platelets. As the number can clearly vary, the first step (identified in
After the intermediate fluid volumes (which may be collected and stored according to any suitable approach without departing from the scope of the present disclosure) have been sorted by their content of the fluid component of interest (as in step 120 of
A plurality of combinations of at least two intermediate fluid volumes are determined, with the most efficient combinations of the intermediate fluid volumes being determined through a series of steps. Before assigning any particular intermediate fluid volume to a combination, the availability of complementary intermediate fluid volumes is assessed. The bin with the intermediate fluid volumes each having the largest content of the fluid component (in the illustrated example, Bin1) is considered first (step 132 of
It should be understood that step 134 of
If there is only one intermediate fluid volume in the bin of those intermediate fluid volumes having the greatest fluid component content, the computer or other device implementing the algorithm advances to step 148 of
The algorithm may also advance to step 148 of
This approach of assessing the combination of the intermediate fluid volume having the greatest fluid component content and one other intermediate fluid volume may continue, with the first intermediate fluid volume being compared to a second intermediate fluid volume having successively lower fluid component contents. For example, after assessing the combination of two intermediate fluid volumes having the greatest fluid component content (steps 132 and 134 of
In the example shown in the spreadsheet of
As such, the computer or device will proceed with the algorithm by assessing whether two intermediate fluid volumes having the greatest fluid component content can be combined with a third intermediate fluid volume to meet the minimum or target content in the final fluid product (step 140 of
However, in the example provided, there are no intermediate fluid volumes containing 3.0e10 platelets. Instead, the smallest available platelet content is 5.0e10 platelets (Bin11), which would be combined with two fluid volumes from Bin1 to produce a final platelet product having 3.5e11 platelets. Although such a combination meets the minimum platelet content requirement, it exceeds that number (3.5e11 platelets vs 3.3e11 platelets), meaning that a combination including two fluid volumes from Bin1 cannot be used to most efficiently group the intermediate fluid products, as the first goal is creating as many final fluid products with the exact fluid component content (3.3e11 platelets, in the illustrated example) using the smallest number of possible intermediate fluid products (three, in the illustrated example). Therefore, the computer or device will proceed with the algorithm by moving on to other possible combinations to create a first fluid product.
The next step is assessing the combination of an intermediate fluid volume having the highest platelet content (1.5e11 platelets from Bin1, in the illustrated example) with an intermediate fluid volume having the second highest platelet content (1.4e11 platelets from Bin2, in the illustrated example) and some third intermediate fluid volume, as shown in
The next step will be again to retain a first intermediate fluid volume having the greatest platelet content (1.5e11 platelets, in the illustrated embodiment) and assess a combination including a second intermediate fluid volume from the bin having the greatest platelet content that has not yet been considered. In the illustrated example, an intermediate fluid volume from Bin1 and from Bin2 have been assessed (and rejected) as the second intermediate fluid volume in a combination, so an intermediate volume from Bin3 (containing 1.3e11 platelets) will be considered as the second intermediate fluid volume in a combination with a first intermediate fluid volume from Bin1 (step 170 of
The computer or other device implementing the algorithm will go through this process with the remaining intermediate fluid volumes that have not yet been assigned to a combination (steps 178 and 180 of
When the computer or other device assesses a twenty-first combination (which would be PLTProd21 in
The establishment of combination PLTProd21 exhausts the supply of Bin5, so the computer or other device proceeds to implement the algorithm using intermediate fluid volumes having the next highest available platelet content (of 1.0e11 from Bin6) as first and second components of subsequent combinations. This results in seven more acceptable combinations (PLTProd22-PLTProd28) before the supply of Bin6 (along with the supplies of Bin8, Bin9, and Bin10) being exhausted. At that point, the only bin having unassigned intermediate fluid volumes is Bin7 (which still has eight intermediate fluid volumes each having 9e10 platelets that have not yet been assigned to a previous combination). These eight intermediate fluid volumes of Bin7 are assigned to two combinations in groups of four (PLTProd29 and PLTProd30 of
As noted above, an algorithm according to the present disclosure may be implemented by a computer or other suitable device. Similarly, the configuration of a system for implementing the pooling of the combinations of intermediate fluid volumes assigned by execution of the algorithm may vary without departing from the scope of the present disclosure.
One possible system that can incorporate the algorithm is described in U.S. patent Publication Ser. No. 11,135,343, which is hereby incorporated herein by reference.
An embodiment of this fluid component pooling system is indicated in general at 12 in
The source containers with the intermediate fluid volumes are part of a (typically disposable or single-use) fluid flow set 16. The various components of the fluid flow circuit 16 are connected by conduits, including source tubing lines 36 and tubing line 44, which splits into pool tubing line 45 and was tubing line 46 via y-connector 48. The source tubing lines 36 are connected to the intermediate fluid volumes in a plurality of source containers 64 of intermediate fluid volumes. While four source containers 64 are illustrated, any number of source containers may be provided and pooled.
The system 12 can include various clamps (such as pool tubing clamp 26 and a wash tubing clamp 28) configured to interact with the conduits of a fluid flow circuit 16 mounted to the system 12. As examples only, the tubing clamps 26 and 28 may be solenoid pinch valves, motor-driven rotary pinch valves, linear actuators, stop cocks or any other type of automated clamping or valve device known in the art.
The intermediate fluid volumes are pumped by pump 24 through the fluid flow circuit 16 and into the fluid product containers 56. As an example only, the pump may be a peristaltic pump of the type available from Fenwal, Inc. of Lake Zurich, Ill., which is an affiliate of Fresenius Kabi AG of Bad Homburg, Germany. The single, two-way pump 24 may of course be replaced by two one-way pumps. A wash media container 58 may also be a component of the fluid flow circuit 16 in order to rinse and recover additional cells from the source containers 64. The source containers and fluid product containers may be bags, but can also be any known and functional storage container.
As illustrated in
Components of the system may be included in a housing, indicated at 18, that may be mounted on a pole, set on a surface, or otherwise positioned or mounted so as to be convenient for a user to operate.
The blood component pooling device may also include an optional air detector 32 and an optional weight scale 34. In an embodiment that omits either component, or both components, the operation of the pump may be based on predetermined times based on pump flow rates and/or source blood component and wash media bag volumes.
Although one example of a fluid component pooling system is described, obvious variations to the system, and any other operating pooling system may also utilize the disclosed algorithm to pool the intermediate fluid volumes to the fluid product containers.
Aspect 1. A method for creating a plurality of fluid products each having a minimum content of a fluid component, comprising: providing a plurality of intermediate fluid volumes each having a known content of a fluid component; determining a plurality of combinations of at least two of the intermediate fluid volumes, wherein each intermediate fluid volume is assigned to only one of said plurality of combinations, each combination has a content of the fluid component at least equal to a minimum content of the fluid component for a fluid product, and said at least two of the intermediate fluid volumes are assigned for each combination so as to maximize the number of combinations each having a content of the fluid component at least equal to the minimum content of the fluid component for the fluid product; and pooling the plurality of intermediate fluid volumes according to the determined plurality of combinations, with each combination of pooled intermediate fluid volumes defining a fluid product having a content of the fluid component at least equal to the minimum content of the fluid component.
Aspect 2. The method of Aspect 1, wherein the content of at least one of said plurality of intermediate fluid volumes is determined by optical detection.
Aspect 3. The method of any one of the preceding Aspects, wherein said fluid component comprises platelets.
Aspect 4. The method of Aspect 3, wherein the plurality of intermediate fluid volumes includes at least one volume of buffy coat.
Aspect 5. The method of any one of Aspects 3-4, wherein the plurality of intermediate fluid volumes includes at least one volume of platelet rich plasma.
Aspect 6. The method of any one of Aspects 3-5, wherein the plurality of intermediate fluid volumes includes at least one volume of platelet concentrate.
Aspect 7. The method of any one of the preceding Aspects, wherein said determining the plurality of combinations includes calculating the content of the fluid component of the fluid product defined by each combination based at least in part on an efficiency at which each combination is pooled to produce the fluid product.
Aspect 8. The method of any one of the preceding Aspects, further comprising establishing a plurality sorting bins, and assigning each intermediate fluid volume to one of said sorting bins, with each sorting bin corresponding to a different fluid component content.
Aspect 9. The method of any one of the preceding Aspects, wherein determining a first combination includes assigning to the first combination the intermediate fluid volume having the greatest content of the fluid component.
Aspect 10. The method of any one of the preceding Aspects, wherein determining each combination includes assigning to the combination the intermediate fluid volume having the greatest content of the fluid component among the intermediate fluid volumes not previously assigned to another combination.
Aspect 11. The method of any of the preceding Aspects, wherein determining each combination includes: assigning to the combination the two intermediate fluid volumes having the greatest content of the fluid component among the intermediate fluid volumes not previously assigned to another combination, determining a difference between the minimum content of the fluid component and the combined content of the fluid component of said two intermediate fluid volumes, determining whether there is an intermediate fluid volume that has a content of the fluid component equal to said difference and that has not been previously assigned to another combination, assigning to the combination said intermediate fluid volume having a content of the fluid component equal to said difference when such an intermediate fluid volume is available, and rejecting the combination when no such intermediate fluid volume is available.
Aspect 12. The method of any one of the preceding Aspects, wherein determining the plurality of combinations includes assigning the intermediate fluid volumes so as to produce combinations of a number of intermediate fluid volumes each having the minimum content of the fluid component before assigning a greater number of intermediate fluid volumes to a combination so as to produce a combination exceeding the minimum content of the fluid component.
Aspect 13. The method of any one of the preceding Aspects, wherein determining the plurality of combinations includes: assigning the intermediate fluid volumes so as to produce combinations of three intermediate fluid volumes each having the minimum content of the fluid component, when it is no longer possible to produce a combination of three intermediate fluid volumes having the minimum content of the fluid component, assigning the intermediate fluid volumes so as to produce subsequent combinations of four intermediate fluid volumes each having the minimum content of the fluid component, and when it is no longer possible to produce a combination of four intermediate fluid volumes having the minimum content of the fluid component, assigning to each subsequent combination the intermediate fluid volumes having the lowest content of the fluid component until producing a combination having at least the minimum content of the fluid component.
Aspect 14. A fluid component pooling system for use in combination with a fluid flow circuit including a plurality of source containers each holding an intermediate fluid volume with a known content of a fluid component and a plurality of fluid product containers for holding a fluid product with a minimum content of the fluid component, the system comprising: a pump; a clamp; and a controller coupled to the pump and the clamp and configured to actuate the pump and the clamp to create a plurality of fluid products each having a minimum content of the fluid component, wherein the controller is configured to determine a plurality of combinations of at least two of the intermediate fluid volumes in which each intermediate fluid volume is assigned to only one of said plurality of combinations, each combination has a content of the fluid component at least equal to the minimum content of the fluid component for the fluid product, and said at least two of the intermediate fluid volumes are assigned for each combination so as to maximize the number of combinations each having a content of the fluid component at least equal to the minimum content of the fluid component for the fluid product, and actuate the pump and the clamp to pool the intermediate fluid volumes into the fluid product containers according to the determined plurality of combinations, with each combination of pooled intermediate fluid volumes defining a fluid product having a content of the fluid component at least equal to the minimum content of the fluid component.
Aspect 15. The system of Aspect 14, wherein said fluid component comprises platelets.
Aspect 16. The system of Aspect 15, wherein the plurality of intermediate fluid volumes includes at least one of volume of buffy coat.
Aspect 17. The system of any one of Aspects 15-16, wherein the plurality of intermediate fluid volumes includes at least one volume of platelet rich plasma.
Aspect 18. The system of any one of Aspects 15-17, wherein the plurality of intermediate fluid volumes includes at least one volume of platelet concentrate.
Aspect 19. The system of any one of Aspects 14-18, further comprising a second clamp coupled to the controller, wherein the controller is configured to actuate the pump and the second clamp to convey a wash medium through the fluid flow circuit.
Aspect 20. The system of any one of Aspects 14-19, further comprising an air detector.
It will be understood that the embodiments and examples described above are illustrative of some of the applications of the principles of the present subject matter. Numerous modifications may be made by those skilled in the art without departing from the spirit and scope of the claimed subject matter, including those combinations of features that are individually disclosed or claimed herein. For these reasons, the scope hereof is not limited to the above description but is as set forth in the following claims, and it is understood that claims may be directed to the features hereof, including as combinations of features that are individually disclosed or claimed herein.
This application claims the benefit of and priority of U.S. Provisional Patent Application Ser. No. 63/319,066, filed Mar. 11, 2022, the contents of which are incorporated by reference herein.
Number | Date | Country | |
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63319066 | Mar 2022 | US |