1
|
Gil-Betancur A, Mantilla-Gutierrez CY, Cardona-Arias JA. Effect of plateletpheresis on total platelet count and mean platelet volume: A meta-analysis. J Evid Based Med 2020; 13:206-214. [PMID: 32615026 DOI: 10.1111/jebm.12403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 01/01/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Currently, there are discrepancies in the reports on the extent of the reduction in platelet count after platelet donation by apheresis, and its impact on mean platelet volume (MPV). This study was conducted to meta-analyze the effect of plateletpheresis on platelet count and on mean platelet volume, based on studies published between 1980 and 2018. METHODS Medline-Pubmed, Scielo, ScienceDirect, and Scopus databases were searched from inception to December 31 2019. The PRISMA guidelines, reproducibility, and evaluation of the methodological quality were guaranteed. Heterogeneity was evaluated with DerSimonian-Laird's, publication bias with a Begg's test. Sensitivity analysis and cumulative meta-analysis were also conducted, as well as a forest plot. RESULTS Twenty-five studies with 3769 donors were systematized to analyze platelet count, and seven studies with 1176 donors to observe MPV. Most studies were published in India and the United States. There was a postprocedure reduction in both variables. The reduction in platelet count was 14.3 × 103 /μL (95% CI 11.4 to 17.1 × 103 ⁄μL). The reduction in MPV was 1.43 fL (95% CI 0.3 to 2.5 fL). The analysis of subgroups showed that, in the case of platelet count, the reduction is not statistically significant two weeks after donation. CONCLUSION Platelet donation by apheresis reduces platelet count and MPV in donors, which is detrimental to the purposes of the procedure; although the decrease is not clinically significant for the donor or the recipient. This demonstrates the need for subsequent studies to evaluate variables, such as donation frequency and donation intervals, should be considered to evaluate if the reported decrease is easily compensated, without adverse consequences for donors, or if modifications in donor selection criteria are required.
Collapse
Affiliation(s)
- Alejandro Gil-Betancur
- Health and Sustainability Research Group, School of Microbiology, University of Antioquia, Medellin, Colombia
| | - Carmen Yulieth Mantilla-Gutierrez
- Bacteriologist and Clinical Laboratory, General Hospital of Medellín Luz Castro de Gutiérrez, University of Antioquia, Medellin, Colombia
| | | |
Collapse
|
2
|
Hans R, Sharma RR, Marwaha N. Effect of plateletpheresis on postdonation serum thrombopoietin levels and its correlation with platelet counts in healthy voluntary donors. Asian J Transfus Sci 2019; 13:10-16. [PMID: 31360004 PMCID: PMC6580838 DOI: 10.4103/ajts.ajts_86_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND: Thrombopoietin (TPO) is regulated by a feedback mechanism between megakaryocytes and platelets. This is important in plateletpheresis donors to compensate for donation-associated platelet loss. AIMS AND OBJECTIVES: The aim and objective of this study were to investigate changes in serum TPO levels in healthy plateletpheresis donors and its correlation with platelet recovery pattern. MATERIALS AND METHODS: Out of 50 plateletpheresis donors recruited in the study over 1 year, only 29 completed follow-up and were further analyzed. Plateletpheresis procedures were performed on two types of cell separators (TRIMA ACCEL®, Terumo BCT Lakewood Colorado and AMICUS®, Fresenius Kabi, Germany). Platelet parameters were estimated pre- and post-platelet donation, at 3rd- and 5th-day postdonation. Serum TPO levels were determined using quantitative sandwich enzyme-linked immunosorbent assay technique (Raybiotech, USA) as per the protocol of the manufacturer. RESULTS: The majority of donors (72%) in our study were first-time donors. The baseline platelet count was 226 ± 44 × 103/μl with a significant decline (30%; P < 0.001) in postdonation phase and remained below baseline on the 3rd and 5th day. The serum TPO levels increased significantly (P < 0.001) from a baseline of 227.81 (interquartile range [IQR]: 176.06) pg/ml to 269.94 (IQR: 110.68) pg/ml postdonation and remained elevated from baseline levels on the 3rd and 5th day. An inverse relation was observed between change in serum TPO levels and platelet count during postdonation phase which was not statistically significant (P > 0.05). CONCLUSION: Serum TPO levels increase significantly post plateletpheresis donation corresponding to decrease in platelet counts showing that TPO plays a vital role in compensatory mechanism after platelet loss.
Collapse
Affiliation(s)
- Rekha Hans
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ratti Ram Sharma
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Neelam Marwaha
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
3
|
Tuan HT, Hock LS, Abdullah ZW. Haemostatic parameters, platelet activation markers, and platelet indices among regular plateletpheresis donors. J Taibah Univ Med Sci 2018; 13:180-187. [PMID: 31435321 PMCID: PMC6695059 DOI: 10.1016/j.jtumed.2017.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 10/25/2017] [Accepted: 10/31/2017] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Plateletpheresis is generally a safe procedure for platelet donation. Studies on the effects of haemostatic parameters and possible association between automated plateletpheresis and hypercoagulable state are limited. Hence, this study aimed to investigate the effects of plateletpheresis on regular donors using haemostatic parameters, i.e. natural anticoagulant proteins, platelet indices, and platelet activation markers. METHODS A total of 139 participants (plateletpheresis donors and normal controls) were recruited and divided into two groups: Group 1 participants who underwent tests for haemostatic and platelet indices and Group 2 participants who underwent tests for platelet activation markers using CD62P and PAC-1 monoclonal antibodies. RESULTS A significant mild shortening of prothrombin time and platelet activation were demonstrated (by increased CD62P and PAC-1 markers) among regular plateletpheresis donors as compared to healthy controls. The current pre-donation platelet count of plateletpheresis donors was significantly lower than their mean baseline platelet count obtained before their first plateletpheresis procedure. However, no significant differences were observed for the other platelet parameters (platelet count, mean platelet volume, platelet distribution width, activated partial thromboplastin time, protein C, protein S, antithrombin, and von Willebrand Factor antigen) between plateletpheresis donors and healthy controls. CONCLUSION This study concludes that regular plateletpheresis is a safe procedure. A possibility of mild platelet activation among regular donors requires further confirmation. However, pre-analytical platelet and FVII activations could occur in vitro contributing to these findings.
Collapse
Affiliation(s)
- Hulwani T.M. Tuan
- Department of Pathology, Hospital Seberang Jaya, Pulau Pinang, Prai, Penang, Malaysia
| | - Lim S. Hock
- Faculty of Health Sciences, Universiti Teknologi MARA Pulau Pinang, Bertam Campus, Penang, Malaysia
| | - Zaidah W. Abdullah
- Haematology Department, School of Medical Sciences, Health Campus, University Sains Malaysia, Kelantan, Malaysia
| |
Collapse
|
4
|
Jaime-Pérez JC, Jiménez-Castillo RA, Vázquez-Hernández KE, Salazar-Riojas R, Méndez-Ramírez N, Gómez-Almaguer D. Plateletpheresis efficiency and mathematical correction of software-derived platelet yield prediction: A linear regression and ROC modeling approach. J Clin Apher 2016; 32:329-334. [DOI: 10.1002/jca.21518] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 10/24/2016] [Accepted: 10/25/2016] [Indexed: 11/08/2022]
Affiliation(s)
- José Carlos Jaime-Pérez
- Department of Hematology; Dr. José Eleuterio González University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León; Monterrey México
| | - Raúl Alberto Jiménez-Castillo
- Department of Hematology; Dr. José Eleuterio González University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León; Monterrey México
| | - Karina Elizabeth Vázquez-Hernández
- Department of Hematology; Dr. José Eleuterio González University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León; Monterrey México
| | - Rosario Salazar-Riojas
- Department of Hematology; Dr. José Eleuterio González University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León; Monterrey México
| | - Nereida Méndez-Ramírez
- Department of Hematology; Dr. José Eleuterio González University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León; Monterrey México
| | - David Gómez-Almaguer
- Department of Hematology; Dr. José Eleuterio González University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León; Monterrey México
| |
Collapse
|
5
|
Keklik M, Eser B, Kaynar L, Sivgin S, Keklik E, Solmaz M, Ozturk A, Buyukoglan R, Yay M, Cetin M, Unal A. Comparison of plateletpheresis on the Fenwal Amicus, Fresenius COM.TEC, and Trima Accel Cell separators. J Clin Apher 2015; 30:171-5. [PMID: 25230340 DOI: 10.1002/jca.21358] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 07/02/2014] [Accepted: 08/28/2014] [Indexed: 02/05/2023]
Abstract
Blood component donations by apheresis have become more common in modern blood transfusion practices. We compared three apheresis instruments (Fenwal Amicus, Fresenius COM.TEC, and Trima Accel) with regard to platelet (PLT) yield, collection efficiency (CE), and collection rate (CR). The single-needle or double-needle plateletpheresis procedures of the three instruments were compared in a retrospective, randomized study in 270 donors. The blood volume processed was higher in the COM.TEC compared with the Amicus and Trima. Also there was a significantly higher median volume of ACD used in collections on the COM.TEC compared with the Amicus and Trima. The PLT yield was significantly lower with the COM.TEC compared with the Amicus and Trima. Additionally, the CE was significantly lower with the COM.TEC compared with the Amicus and Trima. There was no significant difference in median separation time and CR between the three groups. When procedures were compared regarding CE by using Amicus device, it was significantly higher in single-needle than double-needle plateletpheresis. When double-needle Amicus system was compared with double-needle COM.TEC system, CE and PLT yield were significantly higher with Amicus system. When single-needle Amicus system was compared with single-needle Trima system, CE and PLT yield were significantly higher with Trima system. All instruments collected PLTs efficiently. However, the CE was lower with the COM.TEC compared with the Amicus and Trima. Also, we found Amicus single-needle system collected PLTs more efficiently compared with the double-needle system. CE and PLT yields were significantly higher with the single-needle Trima instrument compared with the single-needle Amicus device.
Collapse
Affiliation(s)
- Muzaffer Keklik
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Bulent Eser
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Leylagul Kaynar
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Serdar Sivgin
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ertugrul Keklik
- Department of Physiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Musa Solmaz
- Apheresis Unit, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ahmet Ozturk
- Department of Statistics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ruksan Buyukoglan
- Department of Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mehmet Yay
- Blood Center, Erciyes University, Kayseri, Turkey
| | - Mustafa Cetin
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ali Unal
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| |
Collapse
|
6
|
Nomani L, Raina TR, Sidhu M. Feasibility of applying the 2day deferral for repeat plateletpheresis: Indian perspective. Transfus Apher Sci 2013; 48:341-3. [PMID: 23643473 DOI: 10.1016/j.transci.2013.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As the use of single donor apheresis platelets and plateletpheresis procedures done steadily increases in India, the plateletpheresis donors are at an increased risk of postpheresis anemia and thrombocytopenia. This study was planned in order to evaluate the effect of plateletpheresis on the hematological parameters in the local donor population and to evaluate the possibility of following the 2day deferral for repeat plateletpheresis. A total of 60 plateletpheresis procedures performed over a period of 1year with CS 3000 Plus Baxter Fenwal were evaluated. All the post-donation hematological parameters showed a significant decrease from the pre-donation values (p<0.001). Post-donation hemoglobin <12g, which is defined by WHO as anemia irrespective of the gender occurred in 25% (n=15) of the donors. The post-donation platelet count was less than 100×10(9)/L in 16.6% (n=10) of the procedure. The ability of these donors to serve as repeat plateletpheresis donor after 2days as recommended by AABB needs to be evaluated by further studies done post donation. Keeping in view the hematological profile of our donor population we recommend that donors who already have a low or borderline pre-donation platelet count and hemoglobin should be assessed and monitored post-donation for decrements in these parameters. While serving as repeat donors, their pre donation hemoglobin and platelet counts should be tested again.
Collapse
Affiliation(s)
- Laila Nomani
- Government Medical College, Bakshi Nagar, Jammu, J&K, India.
| | | | | |
Collapse
|
7
|
Automated platelet collection using the latest apheresis devices in an Indian setting. Transfus Apher Sci 2009; 41:135-8. [PMID: 19709930 DOI: 10.1016/j.transci.2009.07.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In a developing nation like India where there is a scarcity of resources and voluntary donors, provision of safe and good quality blood and its components is a huge challenge. The demand for platelets is increasing constantly due to better management of various patient categories, specifically hemato-oncological cases, where there is an increased demand of platelet transfusion. The use of apheresis single donor platelets (SDPs) has been attributed to increased gap between demand and supply of whole blood derived random donor platelets (RDPs). Moreover, the other benefits of SDPs such as decreased donor exposure and simplification of inventory management cannot be overlooked. However, the increased costs and logistic problems, compounded by the lack of awareness, limit the donor recruitment and procedures for SDPs. In Indian scenario, there are no specific guidelines or standards available which can be followed, while simultaneously addressing the associated problems. In this review, we have tried to analyze the various problems of donor selection, donor safety and the quality issues regarding plateletpheresis. Based on this we have tried to give certain recommendations which might help the centers in resolving the problems related to plateletpheresis.
Collapse
|
8
|
Tendulkar A, Rajadhyaksha SB. Comparison of plateletpheresis on three continuous flow cell separators. Asian J Transfus Sci 2009; 3:73-7. [PMID: 20808650 PMCID: PMC2920476 DOI: 10.4103/0973-6247.53877] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Platelet concentrate (PC) remains one of the most important support measures in thrombocytopenic patients. An efficient cell separator is a prerequisite for an optimally functioning apheresis setup. Donor blood count may undergo a temporary reduction after the procedure. AIM The aim was to find the extent of reduction in donor blood count (hemoglobin, hematocrit, white blood cell, and platelet) after plateletpheresis and to evaluate the cell separator for collection efficiency, processing time, and leukoreduction. STUDY DESIGN AND METHODS Two hundred and thirty seven procedures performed on the Amicus (N = 121), Fenwal CS-3000 Plus (N = 50) and Cobe spectra (N = 66) in a one year period were evaluated. The procedures performed on the continuous flow centrifugation (CFC) cell separators and donor blood counts (pre and post donation) done were included in the study. RESULTS The percent reduction in hemoglobin (HB), hematocrit (HCT), white blood cell (WBC) and platelet count ((PLT ct) was 2.9, 3.1, 9, 30.7 (Mean, N = 237) respectively after the procedure. The post donation PLT ct reduced to < 100x109/L (range 80-100) in five donors (N = 5/237, Amicus). The pre donation PLT ct in them was 150-200x109/L. Collection efficiency (percent) of Amicus (79.3) was better as compared to the other two machines (CS: 62.5, Cobe: 57.5). PC collected on Cobe spectra had <1x106 WBC. The donor pre donation PLT levels had a positive correlation to the product PLT yield (r = 0.30, P = 0.000). CONCLUSION Monitoring donor blood counts helps to avoid pheresis induced adverse events. A cautious approach is necessary in donors whose pre donation PLT ct is 150-200x109/L. The main variable in PLT yield is donor PLT ct (pre donation). High collection efficiency is a direct measure of an optimally functioning cell separator.
Collapse
Affiliation(s)
- Anita Tendulkar
- Department of Transfusion Medicine, Tata Memorial Hospital, Mumbai - 400 012, India
| | | |
Collapse
|
9
|
Altuntas F, Sari I, Kocyigit I, Kaynar L, Hacioglu S, Ozturk A, Oztekin M, Solmaz M, Eser B, Cetin M, Unal A. Comparison of Plateletpheresis on the Fenwal Amicus and Fresenius Com.Tec Cell Separators. Transfus Med Hemother 2008; 35:368-373. [PMID: 21512626 PMCID: PMC3076329 DOI: 10.1159/000151351] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2008] [Accepted: 07/01/2008] [Indexed: 02/05/2023] Open
Abstract
SUMMARY: BACKGROUND: A variety of apheresis devices are now available on the market for plateletapheresis. We compared two apheresis instruments (Fenwal Amicus and Fresenius COM.TEC) with regard to processing time, platelet (PLT) yield and efficiency, and white blood cell (WBC) content. MATERIAL AND METHODS: Donors undergoing plateletpheresis were randomly separated into two groups (either the Amicus or the COM.TEC cell separator). RESULTS: In the pre-apheresis setting, 32 plateletpheresis procedures performed with each instrument revealed no significant differences in donors' sex, age, weight, height and total blood volume between the two groups. However, the pre-apheresis PLT count was higher with the COM.TEC than with the Amicus (198 × 10(3)/μl vs. 223 × 10(3)/μl; p = 0.035). The blood volume processed to reach a target PLT yield of ≥3.3 × 10(11) was higher in the COM.TEC compared to the Amicus (3,481 vs. 2,850 ml; p < 0.001). The median separation time was also significantly longer in the COM.TEC than in the Amicus (61 vs. 44 min; p < 0.001). 91 and 88% of the PLT products collected with the Amicus and the COM.TEC, respectively, had a PLT count of >3.3 × 10(11) (p = 0.325). All products obtained with both instruments had WBC counts lower than 5 ↔ 10(6), as required. There was no statistical difference with regard to collection efficiency between the devices (55 ± 15 vs. 57 ± 15%; p = 0.477). However, the collection rate was significantly higher with the Amicus compared to the COM.TEC instrument (0.077 ± 0.012 × 10(11) vs. 0.057 ± 0.008 × 10(11) PLT/min; p < 0.001). CONCLUSION: Both instruments collected platelets efficiently. Additionally, consistent leukoreduction was obtained with both instruments; however, compared with the COM.TEC instrument, the Amicus reached the PLT target yield more quickly.
Collapse
Affiliation(s)
- Fevzi Altuntas
- Department of Hematology and Apheresis Unit, Erciyes Medical School, Kayseri, Turkey
- *Fevzi Altuntas, MD, Department of Hematology and Apheresis Unit, Erciyes Medical School, 38039 Kayseri, Turkey, Tel. +90-532 6588050, Fax -352 4379348,
| | - Ismail Sari
- Department of Hematology, Pamukkale Medical School, Denizli, Turkey
| | - Ismail Kocyigit
- Department of Hematology and Apheresis Unit, Erciyes Medical School, Kayseri, Turkey
| | - Leylagul Kaynar
- Department of Hematology and Apheresis Unit, Erciyes Medical School, Kayseri, Turkey
| | - Sibel Hacioglu
- Department of Hematology, Pamukkale Medical School, Denizli, Turkey
| | - Ahmet Ozturk
- Department of Statistics, Erciyes Medical School, Kayseri, Turkey
| | - Mehmet Oztekin
- Department of Hematology and Apheresis Unit, Erciyes Medical School, Kayseri, Turkey
| | - Musa Solmaz
- Department of Hematology and Apheresis Unit, Erciyes Medical School, Kayseri, Turkey
| | - Bulent Eser
- Department of Hematology and Apheresis Unit, Erciyes Medical School, Kayseri, Turkey
| | - Mustafa Cetin
- Department of Hematology and Apheresis Unit, Erciyes Medical School, Kayseri, Turkey
| | - Ali Unal
- Department of Hematology and Apheresis Unit, Erciyes Medical School, Kayseri, Turkey
| |
Collapse
|
10
|
Chaudhary R, Das SS, Khetan D, Sinha P. Effect of donor variables on yield in single donor plateletpheresis by continuous flow cell separator. Transfus Apher Sci 2006; 34:157-61. [PMID: 16510315 DOI: 10.1016/j.transci.2005.09.040] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2005] [Revised: 08/15/2005] [Accepted: 09/30/2005] [Indexed: 11/18/2022]
Abstract
The quality of single donor platelets (SDPs) in terms of yield influences platelet recovery in the recipient. Various donor factors such as pre-donation platelet count and hemoglobin (Hb) concentration affect the platelet yield. We studied the influence of pre-donation donor clinical and laboratory factors such as gender, age, weight of the donor, platelet count and Hb on the platelet yield. A total of 94 plateletpheresis procedures performed on continuous flow cell separator (CS3000, Baxter Healthcare, Round Lake, IL, USA) were evaluated for platelet yield. A relationship between pre-donation donor variables and yield of platelets was studied using the Pearson correlation. The mean platelet yield was 2.8+/-0.73x10(11). While a direct relationship was observed between pre-donation platelet count and yield (r=0.50, p<0.001), no such correlation was noticed with donor Hb concentration (r=-0.10, p>0.005). Similarly, no correlation was observed between gender (r=0.05), age (r=0.11) and weight (r=0.18) of the donor with yield. Optimization of platelet yield, which is influenced by pre-donation platelet count, is an emerging issue in blood transfusion services. Identification of such factors may help in selecting donors to obtain higher platelet yields and consequently better clinical outcome.
Collapse
Affiliation(s)
- Rajendra Chaudhary
- Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India.
| | | | | | | |
Collapse
|
11
|
Strasser EF, Schuster M, Egler K, Bauer J, Weisbach V, Ringwald J, Zimmermann R, Zingsem J, Eckstein R. Frequently used plateletpheresis techniques result in variable target yields and platelet recruitment of donors. Transfusion 2005; 45:788-97. [PMID: 15847670 DOI: 10.1111/j.1537-2995.2005.04353.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Standard plateletpheresis techniques and effects on platelet (PLT) donors were investigated to provide an informative basis for advancement of apheresis software. STUDY DESIGN AND METHODS Three paired groups with 33 male and 22 female blood donors were prospectively investigated by analyzing blood counts of donors and products. Four apheresis platforms, the COBE Spectra LRS and the Trima v4 (Gambro BCT) and the AS.TEC204 and the COM.TEC (Fresenius Hemocare), were compared. Deviations of the collected from programmed PLT targets and donor PLT recruitment were calculated for single-unit PLT concentrates (SU-PCs; 3 x 10(11) PLTs) and double-unit PLT concentrates (DU-PCs; 6 x 10(11) PLTs). RESULTS Regarding SU-PCs, the productivity of the COM.TEC machine was superior to the AS.TEC204 machine, because of shorter processing time (54 min vs. 67 min) and higher yields (2.90 x 10(11) PLTs vs. 2.75 x 10(11) PLTs). Compared to the Spectra machine, the Trima v4 machine showed higher collection efficiencies (CEs) and shorter processing time and complied better with the programmed target (SU-PCs, 3.24 x 10(11) PLTs vs. 3.70 x 10(11) PLTs; DU-PCs, 6.87 x 10(11) PLTs vs. 7.56 x 10(11) PLTs). Harvests of the Spectra machine (DU-PCs) exceeded the target by 40 percent, which resulted in high PLT loss for donors. A longer processing time resulted in some higher CEs (SU-PCs, 53%; DU-PCs, 58%), which could contribute to this result. PLT recruitment compensated PLT loss to some extent. CONCLUSION The major finding was that the newer devices (COM.TEC and Trima) gave more predictable yields than the older devices (AS.TEC204 and Spectra) and resulted in lower PLT deficit. PLT software should be improved to minimize relevant variations of collected yields regarding the programmed target.
Collapse
Affiliation(s)
- Erwin F Strasser
- Department of Transfusion Medicine and Haemostaseology, University Hospital Erlangen, Erlangen, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Guerrero-Rivera S, Gutiérrez-Espíndola G, Talavera JO, Meillón-García LA, Pedraza-Echevarría M, Pizzuto-Chávez J. Hemoglobin and platelet count effect on platelet yields in plateletpheresis. Arch Med Res 2003; 34:120-3. [PMID: 12700007 DOI: 10.1016/s0188-4409(02)00453-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Platelet transfusion in thrombocytopenic patients, especially those with marrow failure, remains one of the most important support measures available. Treatment success depends on rational use of platelet transfusion. Platelet yield, reflected in transfused platelet dose, influences platelet recovery in the patient and allows prolonging intervals between transfusions. In this study, our main objective was to identify donor laboratory and clinical factors that showed some influence on platelet yield obtained by apheresis. METHODS Healthy donor laboratory and clinical data were analyzed prior to performing plateletpheresis. Platelet yield was quantified after plateletpheresis procedure was concluded in two different ways: a) prefixed volume of 5,000 mL processed, and b) volume determined according to manufacturer recommendations. Age, gender, hemoglobin concentration, platelet and leukocyte count, height, and weight were included as yield-predicting donor variables. RESULTS In group A, two variables were significant: donor platelet count and hemoglobin (Hb) concentrations with r = 0.554, and in group B, donor platelet count, Hb concentrations, and volume with r = 0.758. CONCLUSIONS Donor platelet count and hemoglobin concentrations influence platelet yield: higher platelet count corresponds to higher yield, while hemoglobin shows an inverse relationship, i.e., the lower the hemoglobin concentrations, the higher the platelet yield.
Collapse
Affiliation(s)
- Susana Guerrero-Rivera
- Departamento de Hematología, Hospital de Especialidades Bernardo Sepúlveda, Centro Médico Nacional Siglo XXI, Mexico City, Mexico.
| | | | | | | | | | | |
Collapse
|
13
|
|
14
|
Lazarus EF, Browning J, Norman J, Oblitas J, Leitman SF. Sustained decreases in platelet count associated with multiple, regular plateletpheresis donations. Transfusion 2001; 41:756-61. [PMID: 11399815 DOI: 10.1046/j.1537-2995.2001.41060756.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Transient but significant decreases in platelet counts have been documented to occur in donors undergoing single and serial short-term plateletpheresis collections. The effect of long-term regular plateletpheresis on donor platelet counts has not been characterized. STUDY DESIGN AND METHODS A retrospective study was performed to evaluate the effects of long-term regular plateletpheresis donation on donor platelet counts. A computerized database containing records of 11,464 apheresis collections from 939 donors over a 4-year period was queried for serial preapheresis platelet counts. Donors were categorized by sex, age, and cumulative number of donations. The average difference in platelet counts (mDeltaPC) between each donor's first and last platelet count during this period was calculated for each category. A subgroup of frequent donors was selected for analysis of mDeltaPC, using the baseline platelet count obtained before the first plateletpheresis procedure. RESULTS A significant and sustained decrease in platelet count was identified for all donation frequency categories. The frequency of donation correlated directly with decrease in platelet count for all but the highest-frequency donation group, in which deferrals for low platelet count blunted the extent of the mDeltaPC. A mean decrease of 40,000 per microL from baseline occurred in the frequent-donor subgroup. A total of 84 donors (9%) were deferred for low platelet count. The majority returned to donate successfully after temporary deferral. CONCLUSIONS Regular plateletpheresis donors develop sustained decreases in platelet count. However, clinically significant thrombocytopenia is unusual when rigorous ongoing review and prudent deferral policies are established and followed.
Collapse
Affiliation(s)
- E F Lazarus
- Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institute of Health, Bethesda, MD 20892-1184, USA
| | | | | | | | | |
Collapse
|
15
|
Abstract
To address the demand for higher plateletapheresis efficiency while maintaining consistent leukoreduction, manufacturers of apheresis systems have introduced new equipment or modifications to existing equipment. Using the same 20 donors, we compared the Fresenius AS104 (AS104), Fenwal Amicus, and COBE Spectra Version 7 Leukoreduction System (Turbo) to the COBE Spectra Version 5 Leukoreduction System (V5-LRS) and each other in regard to platelet (plt) collection efficiencies, processing times, and leukoreduction consistency. Using current pre-procedure platelet counts, target endpoints were set at 6-6.5 x 10(11) plt or 3.3-4.0 x 10(11) plt in up to 100 minutes processing time. Median platelet yields for V5-LRS, AS104, Amicus, and Turbo were 3.98, 3.63, 5.03, and 4.99 x 10(11) plt respectively; median collection efficiencies were 53, 46, 73, and 56% respectively; median collection rates were.049,.039,.065, and. 060 x 10(11) plt/minute respectively; double product frequencies were 35, 10, 40, and 30% respectively; and median processing times were 87, 92, 77, and 79 minutes, respectively. Amicus had a significantly higher collection efficiency and higher incidence of double products than all other systems. While AS104 had a significantly lower collection efficiency and lowest double product frequency than all other systems, Amicus and Turbo had significantly lower processing times than V5-LRS and AS104. AS104 leukoreduction was inconsistent, but V5-LRS, Amicus, and Turbo were consistently leukoreduced ((99.8% had <5 x 10(6) WBC at 95% confidence interval). The best overall performance was for the Amicus with Turbo a close second.
Collapse
Affiliation(s)
- E A Burgstaler
- Division of Transfusion Medicine and Section of Biostatistics, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA
| | | | | |
Collapse
|
16
|
Lewis SL, Kutvirt SG, Bonner PN, Simon TL. Effect of long-term platelet donation on lymphocyte subsets and plasma protein concentrations. TRANSFUSION SCIENCE 1997; 18:205-13. [PMID: 10174686 DOI: 10.1016/s0955-3886(97)00011-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Previous studies of changes in immune function in platelet donors have investigated subjects who were undergoing plateletpheresis using older equipment that is no longer in general use. Therefore, the purpose of this study was to determine the effect of long-term platelet donation on lymphocyte numbers and subsets and plasma protein concentrations in platelet donors using newer cell separators. Three groups included in the study were nondonor controls (n = 27), long-term whole blood donors (n = 29), and long-term platelet donors (n = 20). Using a cross-sectional analysis, lymphocyte numbers and subsets were determined and compared among the three groups. Plasma concentrations of total protein, globulin, albumin, and IgG were also compared. Among the three groups there were no significant differences in total white blood cell counts, percentage or absolute number of lymphocytes, or percentage or absolute number of lymphocyte subsets. Serum total protein, globulin, albumin, and IgG concentrations of platelet donors were within normal ranges. These data support the current Food and Drug Administration (FDA) and American Association of Blood Banks' standards for the frequency of platelet donation allowed and monitoring required for plateletpheresis donors. Furthermore, these data indicate that the FDA could eliminate the requirement for the warning in informed consents about lymphocyte depletion in platelet donors.
Collapse
Affiliation(s)
- S L Lewis
- Department of Pathology, School of Medicine, University Of New Mexico, Albuquerque, NM 87131 USA.
| | | | | | | |
Collapse
|
17
|
Abstract
Collection of platelets by apheresis has been a major advance in transfusion medicine. It has allowed the supply of a therapeutically beneficial component to grow with medical needs. Donors find fulfillment in more frequent donations than are possible with whole blood and know that their donation fills a special need. New technology allows leukocyte reduction in the collection of the component with or without the use of filtration. Matching for refractory patients is possible. However, platelets collected by apheresis have not been shown to be hemostatically different from platelets separated from whole blood donations, and thus, do not represent an advance in therapeutic efficacy. The use of apheresis platelets does reduce donor exposure, but this has not been shown to be a safety advance, although it seems intuitively obvious that transfusion risk is statistically reduced in some patients requiring only a few platelet transfusions. Support of patients by apheresis platelets may or may not reduce the risk of alloimmunization. Apheresis platelets from some equipment have less white blood cell contamination even in the absence of filtration, which may be an advantage. Apheresis platelets could be a major step in the ultimate customization of blood collection, in which some donors would preferentially donate red blood cells, whereas others would donate platelets or plasma depending on their blood type and ability to donate frequently, and the current medical need of their donation. Perhaps this would be the most significant advance from the medical progress initiated by Cohn almost 50 years ago.
Collapse
Affiliation(s)
- T L Simon
- Blood Systems, Inc., Scottsdale, AZ 85257
| |
Collapse
|
18
|
Schoendorfer DW, Williamson LH, Sheckler VL, Fitzgerald BP. Platelet collection with the Autopheresis-C apheresis system. Vox Sang 1990; 58:100-5. [PMID: 2339518 DOI: 10.1111/j.1423-0410.1990.tb02070.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This report describes a new system for collection of platelet concentrate (PC) and cell-free plasma (PPP) from apheresis donors. The system uses two separation devices and requires only a single venipuncture. The Plateletcell device separates primary platelet concentrate (PPC) from anticoagulated whole blood and the Plasmacell-C device separates the PPC into PC and PPP. Results of functional studies performed indicate that the separation process does not alter viability of either the PPC, the PC, or the PPP. Platelet function after 5 days of storage is maintained. An average yield of 3.4 +/- 0.7 x 10(11) platelets in 201 g of PC and 422 g of PPP were harvested in 71 +/- 13 min of donor time from donors with preprocedure hematocrits averaging 42.5 +/- 2.0% and preprocedure platelet counts averaging 265 +/- 61 x 10(3)/microliters.
Collapse
|
19
|
|