Bridging the clinical equivalence gap: a nationwide survey on healthcare professionals' perceptions of whole blood-derived versus apheresis platelets in China

INTRODUCTION: Despite evidence supporting the clinical equivalence of whole blood-derived platelets (WBDP) and apheresis platelets (AP), AP remains the dominant choice for platelet transfusions in many countries. This study aimed to assess Chinese healthcare professionals' preferences, barriers, and conditional acceptance of WBDP as an alternative to AP, especially in the context of platelet shortages and rising clinical demand. METHODS: A nationwide survey targeting physicians, transfusionists, and blood center staff was conducted via the WeChat Mini Program. The survey included 35 questions focusing on attitudes toward AP and WBDP, particularly regarding safety, efficacy, and barriers to WBDP adoption. A total of 781 participants from various healthcare institutions across China completed the survey. RESULTS: A substantial majority of physicians (78.41%) and transfusionists (93.88%) exhibited a preference for AP compared to WBDP, safety (77.54% and 86.12%) and clinical efficacy (63.77% and 84.9%) as primary factors. Surprisingly, 94.32% of physicians and 89.59% of transfusionists expressed willingness to use WBDP when AP is unavailable, primarily due to blood resource shortages. One of the key findings of this task was that merely 31% of blood center staff and 27% of their hospital customers acknowledged the clinical equivalence between AP and WBDP, with 47% and 53% expressing no opinion. Key barriers to WBDP adoption included concerns over transfusion reactions (92%), efficacy (72%), and safety (68%). To improve the current situation, the following strategies were identified to enhance WBDP adoption: increasing clinical research (60.87%) and physician education (46.96%). CONCLUSION: This survey highlights significant reservations among healthcare professionals regarding the clinical equivalence and safety of WBDP. Future efforts should focus on bridging the knowledge gap, optimizing WBDP collection and distribution, and promoting the rational use of both platelet products to address shortages and ensure high-quality patient care.