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Thokala RP, Radhakrishnan K, Anandan A, Panicker VK. Recovery of Platelet Count among Apheresis Platelet Donors. J Clin Diagn Res 2016; 10:EC01-EC04. [PMID: 28208861 DOI: 10.7860/jcdr/2016/21070.8997] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 08/18/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Increase in awareness regarding use of single donor platelets and the availability of technology has resulted in increased platelet pheresis procedures. The interval between two succesive plateletpheresis donations is much less compared to whole blood donations. Plateletpheresis procedures are associated with short term and long term adverse events. The effect of plateletpheresis on haematopoietic system remains significant. AIM To study the recovery of platelet count to baseline in plateletpheresis donors. MATERIALS AND METHODS Fifty, first time apheresis donors were followed for platelet count recovery. Platelet count was measured before donation and at 30 minutes, 48 hours, 7th day and 14th day post-donation. Donor platelet count recovery to baseline was observed during the two week period. Results were analysed statistically, p<0.05 was considered statistically significant. RESULTS Platelet count recovered to baseline by 7th day post-donation in 50% of donors in groups I (Pre-donation platelet count 1.5 lacs/μl to 2.2 lacs/μl) and II (Donors with platelet count >2.2 lacs/μl to 2.75 lacs/μl), 30% of donors in group III (Donors with platelet count >2.75 lacs/μl to 3.5 lacs/μl) of the donors. Donor's platelet count recovered to baseline in 85% of donors by day 14 in across the three groups. Recruitment of platelets from spleen was observed in donors with pre-donation platelet count on the lower limit of normal. CONCLUSION By day 7, donor's platelet count recovered to baseline in majority of the donors. Allowing enough recovery periods for donor platelet count, the minimum interval between two apheresis donations can be 7 days till more prospective studies conclude on the frequency and minimum interval between plateletpheresis donations.
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Affiliation(s)
- Ravindra Prasad Thokala
- Assistant Professor, Department of Transfusion Medicine, Sri Ramachandra Medical College and Research Institute , Chennai, India
| | - Krishnamoorthy Radhakrishnan
- Associate Professor, Department of Transfusion Medicine, Sri Ramachandra Medical College and Research Institute , Chennai, India
| | - Ashwin Anandan
- Senior Resident, Department of Transfusion Medicine, Sri Ramachandra Medical College and Research Institute , Chennai, India
| | - Vinod Kumar Panicker
- Professor, Department of Transfusion Medicine, Sri Ramachandra Medical College and Research Institute , Chennai, India
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Arora D, Garg K, Kaushik A, Sharma R, Rawat DS, Mandal AK. A Retrospective Analysis of Apheresis Donor Deferral and Adverse Reactions at a Tertiary Care Centre in India. J Clin Diagn Res 2016; 10:EC22-EC24. [PMID: 28050376 PMCID: PMC5198329 DOI: 10.7860/jcdr/2016/20707.8925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 08/24/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION With increasing demand of platelet component each day, blood bank plays a pivotal role in ensuring supply of safe blood as and when required. Plateletpheresis procedure is a relatively simple, safe and important adjunct to blood bank inventory. However, recruitment of healthy blood donors is a challenge that the health industry is facing today. AIM To determine the reasons and rates of apheresis donor deferral along with investigation of adverse reactions encountered during the procedure. MATERIALS AND METHODS Records of single donor apheresis were retrospectively analysed from 1st January 2010 to 31st December 2014. The study was carried out at Blood Bank, Safdarjung Hospital, New Delhi, India. The donor details that were studied included - age, sex, type of donation (voluntary/replacement/ repeat), reason for donor deferral and type of adverse reaction, if encountered during the procedure. RESULTS Among the 478 donors screened for plateletpheresis procedure during a study period of 5 years, 134 (28.03%) were deferred. Temporary deferrals accounted for majority (93.28%) of the deferrals. Low platelet count (50.75%) was the main reason of donor deferral followed by low haemoglobin (20.89%). Amongst the 344 selected donors, 15 (4.36%) had some type of adverse reaction associated with the procedure. CONCLUSION We suggest that the selection criteria for plateletpheresis donors should be revised to deal with shortage of apheresis donors. The criteria regarding minimum pre-procedure platelet count (above1.5 lac/μl) and haemoglobin (above 12.5 g/dl) need to be lowered so as to suit the Indian scenario. The lower adverse reaction rates, 14/344 (4.06%) associated with this procedure encourages safety of donors and is important in recruitment of new donors.
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Affiliation(s)
- Disha Arora
- Ex-Senior Resident, Department of Pathology, Safdarjung Hospital, Delhi, India
| | - Ketan Garg
- Senior Resident, Department of Pathology, Safdarjung Hospital, Delhi, India
| | - Ankit Kaushik
- Senior Resident, Department of Pathology, Safdarjung Hospital, Delhi, India
| | - Richa Sharma
- Senior Resident, Department of Pathology, Safdarjung Hospital, Delhi, India
| | - DS Rawat
- Ex-Associate Professor and Head of Blood Bank, Department of Pathology, Safdarjung Hospital, Delhi, India
| | - AK Mandal
- Professor and Head, Department of Pathology, Safdarjung Hospital, Delhi, India
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Gite V, Dhakane M. Analysis of pre- and post-donation haematological values in plateletpheresis donors. APOLLO MEDICINE 2015. [DOI: 10.1016/j.apme.2015.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Pujani M, Jyotsna PL, Bahadur S, Pahuja S, Pathak C, Jain M. Donor deferral characteristics for plateletpheresis at a tertiary care center in India- a retrospective analysis. J Clin Diagn Res 2014; 8:FC01-3. [PMID: 25177566 DOI: 10.7860/jcdr/2014/8131.4563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 05/03/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND The demand for plateletpheresis is increasing day by day due to its many merits over random donor platelets. However, in our country, there is a dearth of apheresis donors due to greater devotion and time required for the procedure and lack of awareness. AIM The aim of the present study is to analyse the reasons for deferral of apheresis donors at a tertiary care center. MATERIALS AND METHODS This retrospective analysis was conducted to study the causes, frequency and the type of plateletpheresis donor deferral at regional blood transfusion center, Lady Hardinge Medical College and associated Shrimati Sucheta Kriplani Hospital and Kalawati Saran Childrens' Hospital. The study was undertaken over a period of two years (from January 2010 to December 2011. RESULTS Out of a total of 343 donors screened, 87 donors were deferred, the overall deferral rate being 25.36%. The most frequent cause of deferral was a low platelet count accounting for 43.5% of all the causes followed by a low hemoglobin level (27.05%). Among the donors deferred for anaemia, 15 out of 23 (65.2%) had hemoglobin in the range of 11.5-12.4gm%, representing 17.2% of all deferrals. CONCLUSION Based on these findings and the scarcity of apheresis donors in our country, we are of the opinion that the selection criteria for plateletpheresis donors should be revised to accommodate more donors and reduce deferral rate without compromising on the health of the donors.
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Affiliation(s)
- Mukta Pujani
- Associate Professor, Department of Pathology, Hamdard Institute of Medical Sciences & Research , New Delhi, India
| | - P Lalita Jyotsna
- Assistant Professor, Department of Blood Bank, Lady Hardinge Medical College , New Delhi, India
| | - Shalini Bahadur
- Assistant Professor, Department of Pathology, Hamdard Institute of Medical Sciences & Research , New Delhi, India
| | - Sangeeta Pahuja
- Assistant Professor, Department of Pathology, Lady Hardinge Medical College , New Delhi, India
| | - Chintamani Pathak
- Assistant Professor, Department of Pathology, Lady Hardinge Medical College , New Delhi, India
| | - Manjula Jain
- Director, Professor & Head, Department of Pathology & Blood Bank, Lady Hardinge Medical College , New Delhi, India
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Pandey P, Tiwari AK, Sharma J, Singh MB, Dixit S, Raina V. A prospective quality evaluation of single donor platelets (SDP) - an experience of a tertiary healthcare center in India. Transfus Apher Sci 2012; 46:163-7. [PMID: 22365925 DOI: 10.1016/j.transci.2012.01.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 01/26/2012] [Indexed: 10/28/2022]
Abstract
Quality assurance of single donor platelets (SDP) is incomplete unless clinical response to platelet transfusion is measured. The primary objective of the study was to evaluate the quality of SDP derived from plateletpheresis procedures and to evaluate the response to platelet transfusion. Procedures were performed on 2287 accepted donors while 271 donors were deferred. Platelet count <1.5 lac/μl and hemoglobin <12.5 g/dl were the leading cause of deferral. The median platelet yield in a SDP bag was found to be 3.1×10(11). The median corrected count increment (CCI) and post-transfusion platelet recovery (PPR) were found to be 10110×m(2)/μl and 24.5%, respectively. In India, the criteria for the selection of plateletpheresis donors should be revisited. Based on quality parameters, the Fresenius COM.TEC cell separator is comparable to other cell separators.
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Affiliation(s)
- Prashant Pandey
- Department of Transfusion Medicine, Medanta-The Medicity, Sector-38, Gurgaon-122001, India.
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Tondon R, Pandey P, Chaudhry R. A 3-year analysis of plateletpheresis donor deferral pattern in a tertiary health care institute: assessing the current donor selection criteria in Indian scenario. J Clin Apher 2008; 23:123-8. [PMID: 18615635 DOI: 10.1002/jca.20171] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION This study reports the frequency and nature of plateletpheresis deferrals and evaluates donors with low platelet count and hemoglobin levels so as to assess the possibility of reentry without hampering donor safety. MATERIALS AND METHODS Three-year retrospective data of plateletpheresis deferral was collected. Data from actual procedures was also reviewed to analyze the safety of performing plateletpheresis in donors with low hemoglobin and platelet values. RESULTS Four hundred sixteen donors were deferred for various reasons among 1,515 screened (27.5%), of which 69.7% deferrals were because of low platelet count (55.8%) and less hemoglobin levels. Among the low platelet count donor group, 20.3% had a count between 141 and 149 x 10(9)/L and 41.8% below 120 x 10(9)/L. Of the 14% donors deferred for low hemoglobin, 62.1% had values in the range of 11.5-12.4 g/dL with normal mean corpuscular volume and red cell distribution width in most (86.2%) of them. Expected blood loss in each procedure varied between 20 and 30 mL, whereas RBC contamination in the product varied from 0 to 1.6 mL in 538 procedures. There were 176 donations with predonation platelet count <180 x 10(9)/L (32.7%). None of the 14 procedures performed on donors with platelet count of 150 x 10(9)/L showed evidence of thrombocytopenia or donor reaction. CONCLUSION Lowering the cut-off value for plateletpheresis from 12.5 g/dL to 11.5 g/dL has no deleterious effect on donor safety as the blood loss is minimal. One-fifth deferrals can be reconsidered if the criteria of plateletpheresis donor selection are relaxed for hemoglobin and platelet count.
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Affiliation(s)
- Rashmi Tondon
- Department of Transfusion Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, D-2229 Indira Nagar, Lucknow 226016, Uttar Pradesh, India
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Risks of clinically significant thrombocytopenia andor lymphocytopenia in donors after multiple plateletpheresis collections. Transfusion 2008; 48:1274-8. [DOI: 10.1111/j.1537-2995.2008.01785.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
A decreasing blood donor pool in the presence of increasing blood transfusion demands has resulted in the need to maximally utilize each blood donor. This has led to a trend in the increasing use of automated blood collections. While apheresis donation shares many reactions and injuries with whole blood donation, because of the differences, unique complications also exist. Overall, evidence in the literature suggests that the frequency of reactions to apheresis donation is less than that seen in whole blood donation, though the risk of reactions requiring hospitalization is substantially greater. The most common apheresis-specific reaction is hypocalcemia due to citrate anticoagulation, which, while usually mild, has the potential for severely injuring the donor. Other reactions to apheresis donation are uncommon (e.g., hypotension) or rare (e.g., air embolism). More worrisome, and in need of additional study, are the long-term effects of apheresis donation. Recent evidence suggests that repeated apheresis platelet donations may adversely effect thrombopoiesis as well as bone mineralization. Granulocyte donation has also been implicated in unexpected long-term consequences.
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Affiliation(s)
- Jeffrey L Winters
- Department of Laboratory Medicine and Pathology and Division of Transfusion Medicine, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
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DAS SS, Chaudhary RK, Shukla JS. Factors influencing yield of plateletpheresis using intermittent flow cell separator. ACTA ACUST UNITED AC 2005; 27:316-9. [PMID: 16178912 DOI: 10.1111/j.1365-2257.2005.00714.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Platelet recovery in the recipient is influenced by the transfused dose of platelets, which in turn is dependent on the quality of single donor platelets (SDPs) in terms of platelet yield. Various donor factors such as predonation platelet count and Hemoglobin (Hb) concentration affect the platelet yield. A total of 61 plateletpheresis procedures performed on intermittent flow cell separator (MCS3p, Hemonetics) were evaluated for platelet yield. A relationship between predonation platelet count and Hb concentration with yield of platelets was studied using Pearson Correlation. The mean platelet yield was 2.9 +/- 0.64 x 10(11). While a direct relationship was observed between predonation platelet count and yield (r = 0.51, P < 0.001), no such correlation was noticed with donor Hb concentration (r = -0.05, P > 0.005). The yield was > or =3 x 10(11) in >80% of procedures when the predonation platelet count was > or =250 x 10(3)/mm. Optimization of platelet yield, which is influenced by predonation platelet count, is an emerging issue in blood transfusion services. However, further studies in this regard are needed using more advanced cell separators.
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Affiliation(s)
- S S DAS
- Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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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.
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Affiliation(s)
- Erwin F Strasser
- Department of Transfusion Medicine and Haemostaseology, University Hospital Erlangen, Erlangen, Germany.
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Abstract
It is possible to reliably obtain sufficient PBSC from most normal donors to perform allogeneic transplantation. The mobilization regimen, usually administration of a single daily dose of G-CSF at 7.5 to 10 micrograms/kg subcutaneously for 4 to 6 days, is tolerable with acceptable side effects. However, there is wide variability among individuals with respect to the extent of mobilization achieved by the regimen and the optimal timing of apheresis. Studies suggest that the likelihood of obtaining an adequate harvest of CD34+ cells, as defined locally may be enhanced by employing higher doses or different schedules of G-CSF, monitoring the mobilization and/or collection of PBPC, and using apheresis procedures processing 2 or more times blood volume. However, an optimal regimen for mobilization and harvesting for all donors has not yet been identified and a small percentage of donors may not mobilize adequately with G-CSF. Alternative regimens employing combinations of G-CSF and GM-CSF are available that may prove useful in such cases and novel cytokines that are even more effective than G-CSF in mobilizing stem cells are eagerly awaited. Based on currently available experience with normal donors, the short-term safety of G-CSF appears to be acceptable, however there exist several scenarios in which marrow harvesting may be preferable to G-CSF mobilization and apheresis collection of PBPC.
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Affiliation(s)
- Ping Law
- Dendreon Corporation, 3005 First Avenue, Seattle, WA 98121, USA
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Laurencet FM, Doucet A, Lydiate V, Jacquier MC, Mermillod B, Andersen S, Chapuis B. Quality evaluation of plateletpheresis using the new AMICUS (Baxter) cell separator: evolution of CD 62 expression. J Clin Apher 2000; 13:47-55. [PMID: 9704605 DOI: 10.1002/(sici)1098-1101(1998)13:2<47::aid-jca1>3.0.co;2-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The purpose of this study was to evaluate the new AMICUS (Baxter-Fenwal Division) cell separator in terms of donor safety, efficiency, and quality of the product obtained. One hundred eighty-three single-donor plateletpheresis procedures were performed, using a collection of 4-4.5 x 10(11) platelets as endpoint. During the first part of the study, the mean volume processed was 3,225 ml and the mean procedure duration 69.5 min. During the second part, after a software change, the mean volume and mean procedure time were 3,071 ml and 68.3 min, respectively. According to local policy, every collection bag was separated into two therapeutic units each containing a mean of 1.87 (1.83) x 10(11) platelets. The white blood cell (WBC) contamination per therapeutic unit was less than 5 x 10(6) in 91% of phereses performed in part one of the study and in 98% of phereses performed in part two. During the recommended 5 days storage, sequential in vitro analyses were performed in 27 units, showing limited platelet activation according to CD62 expression and morphological changes on electron microscopy (EM). Furthermore, there was a correlation between CD62 expression and the degree of WBC contamination (P = 0.03). In conclusion, platelet collection with the new Amicus allows for high platelet yields of adequate quality as judged by WBC content, CD62 expression, and electron microscopic morphological changes.
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Affiliation(s)
- F M Laurencet
- Division of Hematology, Geneva University Hospitals, Switzerland
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