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28 Plasma KCE Reports 120 Human resources issues The nurses’ rate of activity is also a concern for the EFS: in practice, this rate is relatively low (in average around 55%), due to an inaccurate distribution of donation centres across the country and/or an inadequate organization of collection, especially considering the French sociological profile. In practice the use of donation rooms has not been rationalized yet, and the total amount of donor accommodation in donation rooms is often not fully used. Principles on cost rationalization Decision makers of the EFS have identified several key measures to improve cost efficiency of the donation system. All of these measures are not equally profitable for the donation system, but they all bring a helpful contribution to the smooth running of the whole process and to the best use of donated blood. The following measures listed below have been ranked from the most profitable to the less profitable (from a cost / efficiency point of view) considering today’s workforce. • Rationalizing the use of donation rooms and raising the nurses’ rate of activity: which involves a restructuring of donation facilities and a better distribution of donation. This will automatically raise the nurses’ rate of activity • Implementation of apherese with additive solution: this technique will improve individual rentability of blood donations • Unifying and raising the volume of individual donation Communication Campaigns: Further Information in Appendix “France : Plasma collection within the framework of EFS” Key points • The French system combines public law and private law rules in the field of collection, fractionation and supply. Plasma collection is not supported by public subsidies, and the sale price of plasma is fixed by the national health authorities. Delivery targets of the EFS will be raised gradually over the next years. • EFS’s communication policy targets students and young adults. • The main driver for the collection centres is to improve HR management, to increase individual collection volume, and to realize economies of scale.
KCE Reports 120 Plasma 29 2.2 TRANSFORMATION OF PLASMA INTO PLASMA DERIVATIVES 2.2.1 Quick overview of fractionation process Since the early 1940s the method of manufacturing plasma, initially developed by Pr Edwin J. Cohn, has been influenced by multiple factors, which over the years have forced the industry to adapt production in such a way that the optimal use of plasma – a human source - remains to be the leading objective. As already mentioned above, human plasma, is a unique biological material. Plasma fractionation, a “cracking” process (cf. petroleum “cracking”) used to prepare therapeutic proteins, is and remains a complex process. Human plasma derived protein products have unique characteristics linked to the origin of the starting raw material. Human plasma exhibits a complex biochemical nature due to its high protein content, close to 60 g per litre, and to the diversity of its protein components. Figure 4: Blood composition White cells & platelets 8% Red cells 42% Blood Plasma 50% Plasma Protein Other 7% 3% Water 90% Coagulation Factors 1% 1% Globulins 15% Protein Other 24% Albumin 60% Below is a list of the best-known of those proteins which are commercially available, although one should note that the order does not reflect the relative importance of the proteins. IVIG: Albumin intravenous immunoglobulin Factor VIII: coagulation factor Factor IX: coagulation factor AT-III: anti-thrombin III IMGG: intra-muscular gammaglobulin A1-AT: alpha-1 anti-trypsin Fibrin sealant IMGG anti-D: Up to 25 others intra-muscular gammaglobulin anti-Rh factor
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KCE Reports 120 Plasma 119 FAVOURIN
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KCE Reports 120 Plasma 121 APPENDIX
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73. Financement du programme de soi
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