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Ashok C, Mahto S, Kumari S, Kumar A, Deepankar, Vidyapati, Prasad M, Mahajan M, Chaudhuri PK. Impact of Plateletpheresis on the Hemoglobin, Hematocrit, and Total Red Blood Cell Count: An Updated Meta-Analysis. Cureus 2024; 16:e61510. [PMID: 38962593 PMCID: PMC11221759 DOI: 10.7759/cureus.61510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2024] [Indexed: 07/05/2024] Open
Abstract
Plateletpheresis has become a pivotal part of transfusion medicine. With the increasing demand for plateletpheresis, donor safety is an area of concern because plateletpheresis alters donor hematological parameters. For a better understanding of plateletpheresis, a systemic review is needed to study more evidence-based aspects of plateletpheresis. Electronic databases PubMed, Google Scholar, and Cochrane Library were used to find articles from January 1, 1980, to May 23, 2024. The random effect model was used to meta-analyze the effect of plateletpheresis on hematocrit, hemoglobin, and red blood cell (RBC) count. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. A total of 24 studies were found; the effect of plateletpheresis on hemoglobin, hematocrit, and RBC count was studied in the following respective numbers of donors: 3,374, 3,374, and 690. A decrease of hemoglobin, hematocrit, and RBC count was observed after plateletpheresis having a weighted mean difference (WMD) of 0.50 (95%CI = -0.72 to -0.27), WMD of -1.36 (95%CI = -2.05 to -0.66), and WMD of -0.18 (95%CI = -0.23 to -0.12), respectively. Plateletpheresis shows a decrease in the value of hematological parameters such as hemoglobin, hematocrit, and erythrocyte count due to blood loss in the kits employed in the procedure; cell lysis was also seen because of exposure of erythrocytes to stress or change in osmotic pressure. Thus, strict criteria for donation must be developed for better safety of the donors. Improved automated cell separators for plateletpheresis should be made available in blood banks to ensure good quality hematologic products. Our findings suggest that the duration of the procedure should be decreased.
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Affiliation(s)
- Chanchal Ashok
- Pathology, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Sunil Mahto
- Pathology, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Sushma Kumari
- Blood Bank, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Amit Kumar
- Laboratory Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Deepankar
- Ophthalmology, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Vidyapati
- Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Manoj Prasad
- Internal Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Mayank Mahajan
- Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
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Augustine M, Murugesan M, Nayanar SK, Padmanabhan M. Adopting a vein assessment tool improves procedural outcomes in double dose platelet collections - A prospective study. Transfus Apher Sci 2021; 60:103198. [PMID: 34187772 DOI: 10.1016/j.transci.2021.103198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study aims to determine the phlebotomy and procedural outcomes using a vein assessment tool (VAT) in Double Dose Platelet (DDP) collections by apheresis. METHODS VAT was based on assessing vein visibility, palpation and size with maximum score of 12 and the least being 0 and the scores were graded as adequate and inadequate. A vein-viewer was used for studying cubital vein patterns (type 1-5). Phlebotomy outcome was defined based on need for re-puncture. Procedural outcomes in terms of target yield attained and RBC reinfusion completed. Chi square test and Mann- Whitney U test were used to assess the vein score and pattern against phlebotomy and procedural outcome. RESULTS Out of 200 DDP collections, the phlebotomy was successful in 88 % with good procedural outcome in 94 % donations. The cut off in VAT scores for successful phlebotomy was ≥8 (AUC: 70 %). Median vein scores of the arm selected for phlebotomy was 9 and graded adequate in 154 (77 %) donations.Odds for successful phlebotomy was 3.7 times higher when donors had an adequate VAT grades(p = 0.003). Procedural outcomes was favourable when at least one arm had adequate VAT grade when compared to both arms being inadequate (98 % vs 82 %; p < 0.001). Phlebotomy failure was more with first time apheresis donors than repeat apheresis donors (p = 0.014). CONCLUSION This study indicated that a VAT score with a cut off of ≥8 had better phlebotomy and procedural outcomes in DDP collections and that donor with at least one arm having the VAT score of ≥8 are preferred for DDP collections.
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Affiliation(s)
- Merline Augustine
- Transfusion Medicine, Malabar Cancer Centre, Thalassery, Kerala, India
| | | | | | - Maya Padmanabhan
- Clinical Research and Biostatistics, Malabar Cancer Centre, Thalassery, Kerala, India
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Skagerlind L, Toss F. Prevention of hypokalaemia and hypomagnesaemia following peripheral stem cell collection - a prospective cohort study. Vox Sang 2021; 116:916-923. [PMID: 33491787 DOI: 10.1111/vox.13075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/16/2020] [Accepted: 12/28/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Citrate-based anticoagulation reduces plasma potassium and free magnesium in patients undergoing peripheral stem cell collections. Whether the effects may be mitigated by pre-procedure oral electrolyte supplements has not been previously assessed. MATERIALS AND METHODS Results from a historic cohort (2010-2013) guided a systematic prospective intervention in subjects deemed at risk for clinically meaningful hypokalaemia and hypomagnesaemia. From 2015 to 2019, 136 patients were enrolled in the study. Pre- and post-apheresis electrolyte levels were measured, and oral potassium and magnesium supplements were systematically administered based on the pre- electrolyte levels. RESULTS We saw a 37% absolute reduction in severe hypokalaemia and 39% absolute reduction in hypomagnesaemia in the prospective intervention cohort when compared to the historic cohort. Multivariate analyses indicated that part of the effect was due to the electrolyte intervention, while part of the effect likely stemmed from other procedure-related changes implemented during the study period. CONCLUSION Oral potassium and magnesium prophylaxis appear to reduce hypokalaemia and hypomagnesaemia following peripheral stem cell collection. Whether the effect size is sufficient to motivate the intervention warrants further investigation, preferably in a prospective randomized trial setting.
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Affiliation(s)
- Lars Skagerlind
- Department of Haematology, Umeå University Hospital, Umeå, Sweden
| | - Fredrik Toss
- Department of Clinical Microbiology, Division of Clinical Immunology, Umeå University, Umeå, Sweden.,Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
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Almutairi H, Salam M, Batarfi K, Alharbi D, Wani F, Almutairi A, Al-Shammari B, Al–Surimi K. Incidence and severity of adverse events among platelet donors: A three-year retrospective study. Medicine (Baltimore) 2020; 99:e23648. [PMID: 33350744 PMCID: PMC7769365 DOI: 10.1097/md.0000000000023648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 11/11/2020] [Indexed: 11/25/2022] Open
Abstract
Adverse events (AEs) are unfortunate consequences of platelet donation. This study reports the incidence and severity of AEs and the associated risk factors in platelet donation at a major blood donation center in Riyadh, Saudi Arabia.A review of donation records was conducted between 2014 and 2017. Eligible study participants were 5007 platelet donors who had donated 7969 times. Each donation was accounted for as a single study subject. Participants' characteristics were described and analyzed as potential contributing factors to adverse events.The average age of platelet donors was 30.0±7.3 years. First-time donors comprised (n = 3,100, 61.9%) of the sample, and 1907 (38.1%) were multiple donors (periodic/routine). Their average BMI was 28.6 ± 4.9 kg/m2. Most donors have blood type "O" and Rheo "positive". The range of blood volume processed was 0 to 5273 ml, while the procedure duration ranged from 0 to 90 minutes. The average platelet yield was 3.8 ± 3.5 ∗1011 platelets per unit, and the average collected volume was 257.6 ± 86.1 ml. Incidence of AEs was 4.2%, of which 91.3% were mild and 8.7% were severe. AEs were vascular injuries (65.3%), vasovagal reactions (11.6%), and citrate toxicity (5.3%). AEs were associated with first-time donation, adj.OR (95%CI) = 1.5 (1.1-1.8) and lower BMI, adj. OR (95% CI) = 1.4 (1.1-1.8). Citrate toxicity was present in severe forms, unlike vascular injuries and vasovagal reactions that tended to be milder. Donors with hemoglobin levels above 16 g/dl, adj. OR (95% CI) = 1.3 (1.1-1.7) and platelet levels below 250,000, adj. OR (95% CI) = 1.3 (1.1-1.6) were more likely to contract AEs than others.Reporting adverse events is essential to establish a benchmark for the annual incidence rates to be compared against local and international figures. Blood donor centers should also take notice of blood donors characteristics that are associated with higher incidence and more severe forms of AEs during or after platelet donation.
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Affiliation(s)
| | - Mahmoud Salam
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | | | | | - Faisal Wani
- Department of Pathology and Laboratory Medicine
| | - Adel Almutairi
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Khaled Al–Surimi
- Department of Health System Management, College of Public Health and Health Informatics, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Arcot PJ, Kumar K, Coshic P, Andriyas V, Mehta V. A comparative study of five plateletpheresis machines in a tertiary care center of India: AmiCORE vs COM.TEC vs Haemonetics MCS+ vs Spectra Optia vs Trima Accel. J Clin Apher 2020; 36:41-47. [PMID: 32894894 DOI: 10.1002/jca.21838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/24/2020] [Accepted: 08/18/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Single donor apheresis platelets are superior in quality, but their usage is limited in a developing country due to cost and time constraints. Hence the product obtained must exceed in terms of yield, donor safety and technical convenience. Previous literature available on cell separators is on older versions. AIMS Prospective comparison of 5 latest cell separators (AmiCORE, COM.TEC, Haemonetics MCS+, SpectraOptia and TrimaAccel) for product yield, performance variables and donor adverse effects. MATERIAL & METHODS From October 2019 - March 2020, 1108 donors were randomly allotted to a cell separator. Post-donation sample was taken from the donor 15-20 minutes after procedure completion. The platelet yield from the product collected was measured twice (day 0 and day 1). Donor demography, pre-and post-procedural donor peripheral blood values, performance and product variables were statistically analyzed. RESULTS AmiCORE had an optimal collection efficacy (44.6%) and collection rate (0.037 x 1011/minute). Haemonetics MCS+ had a better collection efficacy (48.4%) and rate (0.038 x 1011/minute). Spectra Optia achieved least procedural time (59.5 minutes), donor adverse effects (6.3%); highest collection efficacy (52.8%) and rate (0.056 x 1011/minute). Trima Accel achieved highest collection rate (0.056 x 1011/minute) and the least product volume (228 ml). CONCLUSION Highest collection efficacy was achieved by Trima Accel, highest collection rate by Trima Accel and Spectra Optia, lowest donor adverse effects by Spectra Optia and least number of procedural troubleshooting by COM.TEC. Apart from this, fiscal factors and service availability also need to be considered before choosing a cell separator.
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Affiliation(s)
| | - Karan Kumar
- All India Institute of Medical Sciences, New Delhi, India
| | - Poonam Coshic
- All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Andriyas
- All India Institute of Medical Sciences, New Delhi, India
| | - Vikas Mehta
- All India Institute of Medical Sciences, New Delhi, India
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The Play of Citrate Infusion with Calcium in Plateletpheresis Donors. Indian J Hematol Blood Transfus 2020; 37:295-301. [PMID: 33867737 DOI: 10.1007/s12288-020-01339-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 08/17/2020] [Indexed: 10/23/2022] Open
Abstract
Citrate is the anticoagulant of choice for plateletpheresis. Citrate toxicity is common during plateletpheresis as citrate chelates calcium and causes hypocalcemia in donors. We have conducted this study to analyze the effects of routine citrate infusion during plateletpheresis on laboratory and clinical parameters. We also compared the dose of citrate delivered to donors during plateletpheresis using two different cell separators as Haemonetics MCS + and Trima Accel. The study was conducted on 50 plateletpheresis donors who were eligible for donation. Donor demographics and baseline parameters were recorded. Pre, mid and post-procedure blood samples were collected for hematological and biochemical analysis. We found a significant decrease in baseline iCa (1.23 ± 0.07 mmol/L) from start to mid-procedure (1.19 ± 0.006 mmol/L) which recovered at 30 min post procedure (1.2 ± 0.01 mmol/L). The incidence of citrate toxicity was 10%. In donors with citrate toxicity, the post-procedure recovery of iCa was not seen and there was a further decrease in iCa levels. We also found a significant fall in Hb and platelet count post plateletpheresis. We observed that lower PLT counts (< 200 × 103/µL) necessitated higher blood volume processing and therefore a higher anticoagulant (citrate) dose. The Trima Accel cell separator reached platelet target yield faster but with a higher citrate dose as compared to Hemonetics MCS + . Ionized calcium decreases significantly during plateletpheresis but recovers soon after the completion of the procedure. Serious adverse events were not observed during plateletpheresis. The mild citrate toxicity which occurred was easily managed by slowing the procedure and administering oral calcium to donors. Trima Accel and Hemonetics MCS + both collected platelets efficiently, with minimal donor discomfort.
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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.
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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
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Baruah S, Bajpai M. Comparative assessment of single-donor plateletpheresis by Haemonetics ® MCS ® plus and Trima Accel ®. Asian J Transfus Sci 2020; 14:23-27. [PMID: 33162701 PMCID: PMC7607992 DOI: 10.4103/ajts.ajts_138_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 06/27/2018] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Single-donor platelets (SDPs) prepared by sophisticated automated equipment offer several advantages over random-donor platelets and are being increasingly used to support thrombocytopenic patients. Different apheresis machines working on the principle of centrifugation are being used worldwide to collect platelets. This retrospective study was done to compare plateletpheresis on two automated cell seperators - Haemonetics® MCS® Plus and Trima Accel®. MATERIALS AND METHODS Data for 100 single-donor plateletpheresis procedures, fifty on each machine, were retrospectively collected and analyzed. Donor characteristics were analyzed by Student's t-test and no significant difference was found between the two groups. The parameters compared between the two machines were yield, collection efficiency, blood volume processed, procedure time, acid-citrate-dextrose (ACD) used, leukodepletion achieved, quality control of the products, and adverse donor reactions. RESULTS Platelet yield (3.054 ± 0.14 vs. 3.120 ± 0.25), quality control of the platelets, leukodepletion achieved, and donor safety were comparable in both the machines. The blood volume processed (2230.74 ± 227.01 vs. 2452.90 ± 318.61), ACD used during procedure (265.48 ± 43.21 vs. 298.10 ± 53.32), procedural time (55.92 ± 13.00 vs. 68.86 ± 12.64), and the postprocedural decrease in donor count in Trima Accel® (183.10 ± 23.99 vs. 161.44 ± 63.47) were significantly less than those in Haemonetics® MCS® Plus. The median collection efficiency of Trima Accel® was found to be greater than Haemonetics® MCS® Plus (0.000649 vs. 0.000608, P = 0.020). CONCLUSION Both Trima Accel® and Haemonetics® MCS® Plus can collect SDPs safely and efficiently. Trima Accel® has higher collection efficiency and reduced incidence of citrate-related adverse effects. It also has better potential to optimize productivity due to decreased procedural time.
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Affiliation(s)
- Sukanya Baruah
- Department of Transfusion Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Meenu Bajpai
- Department of Transfusion Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
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Abu-Tineh M, Yassin MA. Extreme Levels of Platelet Count in Essential Thrombocythemia: Management and Outcome, Report of Two Cases. Case Rep Oncol 2020; 13:606-610. [PMID: 32595470 PMCID: PMC7315211 DOI: 10.1159/000507363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 11/19/2022] Open
Abstract
Myeloproliferative neoplasms including essential thrombocythemia (ET) is usually caused by somatic mutations in multiple genes, including the JAK2 (most frequently), CALR gene, and MPL. In rare cases, the disease is caused by other mutations such as THPO or TET2 gene; however, around 10–15% with ET might have triple-negative mutations. Here we present 2 cases of ET who were asymptomatic on diagnoses, but found to have extremely high platelet counts as never reported earlier. The management and treatment plan can be a challenging step. The objective is to draw attention to the early introduction of thrombocytapheresis in the management of such patients given its notable outcomes.
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Affiliation(s)
| | - Mohamed A Yassin
- National Center for Cancer Care and Research, Department of Oncology, Hematology and BMT Section, Hamad Medical Corporation, Doha, Qatar
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Navkudkar A, Desai P, Rajadhyaksha S. Effect of citrate on ionized calcium levels during plateletpheresis procedures. ACTA ACUST UNITED AC 2020. [DOI: 10.1111/voxs.12573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Anisha Navkudkar
- Department of Transfusion Medicine Tata Memorial Hospital HBNI Mumbai India
| | - Priti Desai
- Department of Transfusion Medicine Tata Memorial Hospital HBNI Mumbai India
| | - Sunil Rajadhyaksha
- Department of Transfusion Medicine Tata Memorial Hospital HBNI Mumbai India
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Kumawat V, Goyal M, Marimuthu P. Analysis of Donor Safety in High Yield Plateletpheresis Procedures: An Experience from Tertiary Care Hospital in South India. Indian J Hematol Blood Transfus 2020; 36:542-549. [PMID: 32647430 DOI: 10.1007/s12288-020-01266-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 02/17/2020] [Indexed: 02/06/2023] Open
Abstract
The apheresis platelets are the preferred blood components for the thrombocytopenic hemato-oncology patients. The one of the important factors for post transfusion increment is the dose of the platelet product infused. The minimum platelet product yield is defined but the amount of maximum possible platelets collection from a single donor is not universally defined. There is lots of apprehension in our country for apheresis procedures harvesting more than a standard unit. This retrospective observational study was conducted to determine safety of high yield plateletapheresis collection among Indian donors This retrospective observational study was conducted for a period of 15 months including all consecutive plateletapheresis procedures. The informed consent had been obtained from all donors including high yield plateletapheresis (Yield ≥ 5 × 1011). The apheresis product was subjected to platelet count. The donor adverse reactions were recorded along with procedural details. Post procedure complete blood count was done for the donors who consented for post procedure blood sample draw A total 569 procedures were performed during this period including 174 high yield procedure. The 526 procedures were analyzed for adverse donor reactions. The 43 were excluded for adverse donor reaction analysis due to yield less than 3 × 1011 (n = 43). The adverse reactions rate between high yield procedures (18/174, 10.34%) and normal yield (20/352, 5.68%) were not statistically different (p = 0.052). The phlebotomy related complication (3.23%) followed by citrate toxicity (2.28%) were the two most common adverse reaction observed. The adverse reactions associated with high yield plateletapheresis procedures are comparable to normal yield procedures in term of overall adverse reactions observed and post procedural platelet counts. This can be beneficial to patients by providing products of greater yield.
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Affiliation(s)
- Vijay Kumawat
- Department of Transfusion Medicine, Citizens Hospital, Nallagandla, Serilingampally, Hyderabad, 500019 India.,Transfusion Medicine & Haematology, NIMHANS, Bengaluru, 560029 India
| | - Manu Goyal
- Department of Hematopathology and Genetics, AMPATH at Citizens Hospital, Nallagandla, Serilingampally, Hyderabad, 500019 India
| | - Palniappan Marimuthu
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bengaluru, 560029 India
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Gil-Betacur A, Mantilla-Gutiérrez CY, Cardona-Arias JA. Effect of plateletpheresis on hematocrit, hemoglobin and erythrocyte count: Meta-analysis 1980-2018. Sci Rep 2019; 9:19770. [PMID: 31875045 PMCID: PMC6930275 DOI: 10.1038/s41598-019-56175-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 11/19/2019] [Indexed: 01/24/2023] Open
Abstract
The effects of platelet donation by apheresis on different parameters of the erythrogram are still unclear. The objective was to meta-analyze the effect of plateletpheresis on hematocrit, hemoglobin, and erythrocyte count, with a systematic review with random effects meta-analysis of the mean difference. The PRISMA guidelines were considered, as well as 133 search strategies on four different databases. Reproducibility was guaranteed and methodological quality was evaluated. Heterogeneity was evaluated with Galbraith and DerSimonian-Laird’s, publication bias with a funnel plot and a Begg’s test, sensitivity analysis and a cumulative meta-analysis were also conducted. Eighteen (18) articles were included, 17 evaluated the effects on hematocrit in 2,564 donors; 13 on hemoglobin in 1,640 donors; and 4 on red blood cell count in 243 donors. A decrease of 2.26% (CI95% = 2.11–2.41) was observed in hematocrit, of 0.80 g/dL (CI95% = 0.75–0.86) in hemoglobin and −0.21 × 1012/L (CI95% = −0.13; −0.29) in red blood cell count. Plateletpheresis has a negative effect on the erythrogram parameters, explained by blood loss in the kits used for the procedure and cell lysis. Such evidence is relevant to secure the efficiency and safety of the procedure, improve selection processes or determine the number of donations that can be performed without affecting donors’ health.
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Affiliation(s)
- Alejandro Gil-Betacur
- Microbiólogo y Bioanalisista. MSc Microbiología y Bioanálisis. Grupo de investigación Salud y Sostenibilidad, Escuela de Microbiología, Universidad de Antioquia, Medellín Colombia, Banco de Sangre Universidad de Antioquia, Medellín, Colombia
| | - Carmen Yulieth Mantilla-Gutiérrez
- Bacterióloga y laboratorista Clínica, MSc Microbiología y Bioanálisis, Universidad de Antioquia, Hospital General de Medellín Luz Castro de Gutiérrez, Medellín, Colombia
| | - Jaiberth Antonio Cardona-Arias
- Microbiólogo y Bioanalisista, MSc Epidemiología, MSc Economía aplicada, PhD (candidato) Salud Pública, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia.
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13
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Gupta AM, Bajpai M. Delayed adverse events in male plateletpheresis donors: Initial insights on donor safety. J Clin Apher 2019; 35:18-24. [DOI: 10.1002/jca.21753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/05/2019] [Accepted: 09/11/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Abhaykumar M. Gupta
- Department of Transfusion MedicineInstitute of Liver and Biliary Sciences New Delhi India
| | - Meenu Bajpai
- Department of Transfusion MedicineInstitute of Liver and Biliary Sciences New Delhi India
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14
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Kaur D, Kandwal M. Alarmed or unalarmed!! Donor red cell lysis during plateletpheresis procedure. Transfus Apher Sci 2018; 57:277-280. [PMID: 29610044 DOI: 10.1016/j.transci.2018.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 02/22/2018] [Accepted: 03/05/2018] [Indexed: 11/25/2022]
Abstract
Plateletpheresis procedures are considered safe for donors and very few adverse events are reported. Donor related adverse events include hypo-calcemia due to citrate toxicity, vasovagal reactions, transient post-procedural decline in hemoglobin, hematocrit and platelet count. Kit related adverse events include damage of the kit or rarely mechanical damage of the red cells during procedure. This damage can lead to failure of the rinse-back of the red cells to the donors causing higher red cell loss in such donors. Here, we are reporting a kit related adverse event that led to donor red cell lysis during plateletpheresis procedure.
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Affiliation(s)
- Daljit Kaur
- Department of Transfusion Medicine, Max Superspeciality Hospital, Shalimar Bagh, Delhi 110088, India.
| | - Manoj Kandwal
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
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15
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Boddu P, Falchi L, Hosing C, Newberry K, Bose P, Verstovsek S. The role of thrombocytapheresis in the contemporary management of hyperthrombocytosis in myeloproliferative neoplasms: A case-based review. Leuk Res 2017; 58:14-22. [PMID: 28380402 DOI: 10.1016/j.leukres.2017.03.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 03/04/2017] [Accepted: 03/13/2017] [Indexed: 12/28/2022]
Abstract
Extreme thrombocytosis induces an acquired thrombotic-hemorrhagic diathesis, and left uncontrolled is a harbinger of potentially fatal vascular complications. Currently, cytoreduction with medical therapy remains the mainstay of hyperthrombocytosis management. However, it offers a less-than-ideal option in situations where a rapid reduction in platelets is urgently needed, as in the presence of vital end-organ ischemia or to ameliorate of life-threatening hemorrhage. The role of thrombocytapheresis, or plateletpheresis, in hyperthrombocytosis has become increasingly obsolete given the proactive titration of cytoreductive therapies and early identification and correction of reversible causes of reactive thrombocytosis. Despite its narrowed indications, plateletpheresis continues to offer a valuable temporizing measure in platelet count reduction before cytoreductive agents exert their maximal effect. In this context, it is important for the treating physician to be aware of the symptoms and risks associated with hyperthrombocytosis to inform best clinical practices. In this review, we discuss the role of plateletpheresis in the modern-day management of hyperthrombocytosis in patients with myeloproliferative neoplasms through a case based review of the literature. It becomes apparent throughout the discussion that the decision to perform plateletpheresis should be individualized based upon the clinical scenario, degree of thrombocytosis, available infrastructure and every patient's risk profile.
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Affiliation(s)
- Prajwal Boddu
- Department of Leukemia, MD Anderson Cancer Center, TX, USA.
| | - Lorenzo Falchi
- Department of Hematology/Oncology, Columbia University Medical Center, NY, USA
| | - Chitra Hosing
- Department of Stem Cell Transplant, MD Anderson Cancer Center, TX, USA
| | - Kate Newberry
- Department of Leukemia, MD Anderson Cancer Center, TX, USA
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16
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Dogra K, Fulzele P, Rout D, Chaurasia R, Coshic P, Chatterjee K. Adverse Events During Apheresis Procedures: Audit at a Tertiary Hospital. Indian J Hematol Blood Transfus 2016; 33:106-108. [PMID: 28194065 DOI: 10.1007/s12288-016-0681-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 05/09/2016] [Indexed: 11/28/2022] Open
Abstract
Apheretic platelets are better quality blood components which reduce donor exposure and chances of TTIs to transfusion recipients when compared to the whole blood derived components. Though safe, these apheretic donations are associated with donor adverse events. We evaluated the incidence of such adverse events associated with the modern apheresis procedures that would provide an insight as well as help formulating preventive steps to avoid frequent occurrences of such events. This prospective audit-based observational study was conducted over 1 year. Donors for plateletpheresis were selected as per the standard operating procedure of the Apheresis Lab. The apheresis procedures were done on the MCS+ (Haemonetics Corp.), Trima Accel (Terumo BCT) and COM.TEC (Fresenius Kabi AG). 1740 apheresis procedures were performed, out of which 1708 were plateletpheresis and 32 therapeutic plasma exchange (TPE) procedures for 7 patients. A total of 102 adverse events were noted; of which, 80 (78.43 %) events were associated with donors, 15 (14.71 %) were owed to equipment related problems and 7 (6.86 %) were technical aberrations. All the events associated with donors were mild. No adverse events were reported with any of the 32 TPEs. Apheresis procedures are associated with adverse events which can be reduced by meticulous donor-vigilance, superior training modules for the technical personnel and continued supervision of experienced transfusion medicine specialists. Continued efforts towards making the donor's experience with apheresis more pleasant give a forward thrust to the noble vision of preparing a voluntary apheresis donor pool in India.
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Affiliation(s)
- Kanchan Dogra
- Department of Transfusion Medicine, AIIMS, New Delhi, India
| | - Parag Fulzele
- Department of Transfusion Medicine, AIIMS, New Delhi, India
| | | | | | - Poonam Coshic
- Department of Transfusion Medicine, AIIMS, New Delhi, India
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17
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Sultan S, Baig MA, Irfan SM, Ahmed SI, Hasan SF. Adverse Reactions in Allogeneic Blood Donors: A Tertiary Care Experience from a Developing Country. Oman Med J 2016; 31:124-8. [PMID: 27168923 DOI: 10.5001/omj.2016.24] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Fragmented blood transfusion services along with an unmotivated blood donation culture often leads to blood shortage. Donor retention is crucial to meet the increasing blood demand, and adverse donor reactions have a negative impact on donor return. The aim of this study was to estimate adverse donor reactions and identify any demographic association. . METHODS We conducted a prospective study between January 2011 and December 2013. A total of 41,759 healthy donors were enrolled. Professionally trained donor attendants drew blood and all donors were observed during and following donation for possible adverse events for 20 minutes. Blood donors were asked to report if they suffered from any delayed adverse consequences. . RESULTS Out of 41,759 blood donors, 537 (1.3%) experienced adverse reactions. The incidence was one in every 78 donations. The mean age of donors who experienced adverse events was 26.0±6.8 years, and all were male. Out of 537 donors, 429 (80%) developed vasovagal reaction (VVR), 133 (25%) had nausea, 63 (12%) fainted, 35 (6%) developed hyperventilation, 9 (2%) had delayed syncope, and 9 (2%) developed hematoma. Arterial prick, nerve injury, cardiac arrest, and seizures were not observed. Donors aged less than < 30 years and weighing < 70 kg were significantly associated with VVR, hyperventilation, and nausea (p < 0.005). Undergraduates and Urdu speaking donors also had a significant association with fainting and nausea, respectively (p < 0.05). . CONCLUSION The prevalence of adverse events was low at our tertiary center. A VVR was the predominant adverse reaction and was associated with age and weight. Our study highlights the importance of these parameters in the donation process. A well-trained and experienced phlebotomist and pre-evaluation counseling of blood donors could further minimize the adverse reactions.
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Affiliation(s)
- Sadia Sultan
- Department of Hematology and Blood Bank, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Mohammad Amjad Baig
- Department of Hematology and Blood Bank, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Syed Mohammed Irfan
- Department of Hematology and Blood Bank, Liaquat National Hospital and Medical College, Karachi, Pakistan
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Tendulkar A, Shah S, Patil D, Tambe M. Platelet donation drives: A novel initiative to recruit platelet donors. Transfus Apher Sci 2014; 50:407-10. [DOI: 10.1016/j.transci.2014.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 03/07/2014] [Accepted: 03/24/2014] [Indexed: 11/29/2022]
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