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Routray SS, Tripathy S, Ray G. A Vexing Problem of Air Trapping in the Trima Accel During Plateletpheresis Procedure: Reflecting Our Experience in Troubleshooting. Cureus 2023; 15:e38518. [PMID: 37273319 PMCID: PMC10238822 DOI: 10.7759/cureus.38518] [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: 05/03/2023] [Indexed: 06/06/2023] Open
Abstract
Troubleshooting for any fault of apheresis equipment or kit is hardly addressed. Here, we report a unique problem of air trapping in a kit at two different positions leading to failure of the plateletpheresis procedure. Two plateletpheresis procedures were aborted due to "Access pressure low", though the needle position was absolutely perfect. In the third event, platelet yield was not increasing even after 30 minutes from the time of initiation. It was completed after stopping the centrifuge pump which could have displaced the air bubble from the collection port. The root cause for these events was analyzed in consultation with the apheresis technical expert and "air block" was found to be the cause. Air block can also result in a "low access pressure" alarm despite improper phlebotomy being the common cause. Perfect kit loading, checking of tubing defects prior to loading, and comparative analysis of troubleshooting to have adequate knowledge are essential tools for the smooth functioning of apheresis.
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Affiliation(s)
- Suman S Routray
- Immunohaematology and Blood Transfusion, Kalinga Institute of Medical Sciences, Bhubaneswar, IND
| | - Sukanta Tripathy
- Immunohaematology and Blood Transfusion, Kalinga Institute of Medical Sciences, Bhubaneswar, IND
| | - Gopal Ray
- Transfusion Medicine, All India Institute of Medical Sciences, Guwahati, IND
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Sahoo D, Noushad S, Basavarajegowda A, Toora E. Feasibility of high-yield plateletpheresis in routine practice: Experience from tertiary health center from South India. Asian J Transfus Sci 2023; 17:34-40. [PMID: 37188018 PMCID: PMC10180781 DOI: 10.4103/ajts.ajts_103_21] [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: 07/20/2021] [Revised: 10/13/2021] [Accepted: 10/17/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVES High-yield plateletpheresis donations can reduce donor exposure and be economically beneficial as well. However, obtaining a high-yield plateletpheresis from a maximum number of donors with low basal platelet count and its effect on postdonation platelet count of donors undergoing high-yield plateletpheresis has been a matter of concern. This study aimed to assess the feasibility of making high-yield platelet donation as a routine practice. METHODS It was a retrospective observational study to determine the effect of high-yield plateletpheresis on donor reactions, efficacy, and quality parameters. It was conducted from January 1, 2019 to June 30, 2021, at the Department of Transfusion Medicine in a tertiary care hospital of South India. RESULTS Out of the 669 procedures, 564 (84.3%) of the collection had a platelet yield of ≥5 × 1011, 468 (70%) of the collection had a platelet yield of 5.5 × 1011, whereas 284 (42.5%) met the target of 6 × 1011 by coulter. The mean drops in platelet count were 95 ± 16 × 103/μl (77,600-113,000/μl), mean platelet recruitment was 1.31 ± 0.51. The mean collection efficiency of the procedure for the 669 cases was shown to be 80.21 ± 15.34, and the mean collection rate was 0.07 × 1011 ± 0.02 per minute. Only forty donors (5.5%) experienced adverse donor reactions. CONCLUSIONS High-yield plateletpheresis can be done in routine practice with no added adverse donor reaction with effective quality products.
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Affiliation(s)
- Dibyajyoti Sahoo
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Shahida Noushad
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Esha Toora
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Chopra S, Kaur P, Bedi RK, Kaur G. Effect of double dose plateletpheresis on target yield and donor platelet recovery. Hematol Transfus Cell Ther 2023; 45:16-24. [PMID: 34294601 PMCID: PMC9938487 DOI: 10.1016/j.htct.2021.05.002] [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: 02/17/2021] [Revised: 04/20/2021] [Accepted: 05/02/2021] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION The demand for apheresis platelets has increased in the recent past and the shrinking donor pool has shifted the trend to collection of double-dose or higher yield of platelets. OBJECTIVE The present study aimed to determine the effect of double-dose plateletpheresis on the target yield and donor platelet recovery. METHODS The study was conducted on 100 healthy plateletpheresis donors, 50 of whom were in the study group, which underwent double-dose plateletpheresis (DDP), and 50 of whom were in the control group for single-donor plateletpheresis. Pre- and post-procedure samples of donors were subjected to a complete blood count. The DDP product was sampled for platelet yield and then split into two parts. Platelet yield, collection efficiency, collection rate, recruitment factor and donor platelet loss were calculated. RESULTS The mean platelet yield in the SDP was 4.09 ± 1.15 × 1011 and in the DDP, 5.93 ± 1.04 × 1011. There was a significant correlation between the pre-donation platelet count and platelet yield. The total of platelets processed for the SDP were 5.42 ± 1.08 × 1011 and for the DDP, 7.94 ± 0.77 × 1011. The collection efficiency was 71.93 ± 25.14% in the SDP and 72.94 ± 16.28% in the DDP, while the collection rates were 0.78 × 1011 and 0.94 × 1011 per minute, respectively. The average recruitment factor observed was 0.98 in the SDP, while it was 0.99 in the DDP. The mean platelet loss observed in the SDP was 35.55 ± 8.53% and in the DDP, 37.76 ± 8.65%. CONCLUSION The double-dose plateletpheresis supplements the platelet inventory in developing countries where the apheresis donor pool is limited. It is prudent to ensure stringent donor selection criteria for donors donating high-yield platelet products, thus enhancing donor safety and retention.
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Affiliation(s)
- Sapna Chopra
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Paramjit Kaur
- Government Medical College and Hospital, Sector 32, Chandigarh, India.
| | - Ravneet Kaur Bedi
- Government Medical College and Hospital, Sector 32, Chandigarh, India
| | - Gagandeep Kaur
- Government Medical College and Hospital, Sector 32, Chandigarh, India
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Mishra D, Kanungo G, Routray S, Agrawal M, Sahu A. Analysis of single-donor plateletpheresis procedure parameters and its association with yield in a blood center of Eastern India. IRAQI JOURNAL OF HEMATOLOGY 2022. [DOI: 10.4103/ijh.ijh_24_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Jaime-Pérez JC, Beltrán-López AL, Alvarado-Navarro DM, Espinoza-Mares M, Ancer-Rodríguez J, Gómez-Almaguer D. Assessing the performance of a plateletpheresis unit at a tertiary-care academic medical center in Mexico: A 6-year experience. J Clin Apher 2021; 36:808-814. [PMID: 34411330 DOI: 10.1002/jca.21932] [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: 07/09/2021] [Revised: 07/26/2021] [Accepted: 08/04/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Optimization of platelet (PLT) apheresis collection is a priority to satisfy the increasing demand of hemato-oncology patients. We assessed the performance of a plateletpheresis unit supporting hematology patients. STUDY DESIGN AND METHODS This descriptive retrospective study included 561 plateletpheresis collections from 2013 to 2018. For data analysis, descriptive statistics and receiver operating characteristic (ROC) curve were used. A 5-item satisfaction questionnaire was analyzed. RESULTS Ninety percent of the donors were males. The median plateletpheresis time was 89 minutes; its success rate was 92.5%; median donor PLT count was 232 × 109 /L, women median PLT count was 247 × 109 /L vs 231x109 /L in men (P = .017). Seventy-seven percent donors were candidates for a double product and 24.5% were processed; 20.8% of these donors had a weight ≤75 and 79.2% >75 kg, P = .003, and 6.6% were women and 93.4% men, P = .161. Thirty-six of donors had ≥250 × 109 /L and 16.8% was processed as a triple product. ROC analysis showed that with donor PLT counts ≥200 × 109 /L the sensitivity for obtaining double products was 0.981 and specificity 0.714, with an area under the curve (AUC) = 0.877. The adverse effect rate was 4.3%. Of the potential donors, 6.3% were rejected. The cost of processing single or double products was 430 USD. Comfort and time spent during plateletpheresis were areas for improvement. CONCLUSION Platelet count and donor weight predicted PLT yield and obtaining double products. Women had higher PLT counts, but no significant difference was found between donor gender and processed products. Assessment of the apheresis unit can help to improve its performance.
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Affiliation(s)
- José C Jaime-Pérez
- Hematology Department, Internal Medicine Division, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Ana L Beltrán-López
- Hematology Department, Internal Medicine Division, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Dalila M Alvarado-Navarro
- Hematology Department, Internal Medicine Division, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Martín Espinoza-Mares
- Hematology Department, Internal Medicine Division, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Jesús Ancer-Rodríguez
- Pathology Department, School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - David Gómez-Almaguer
- Hematology Department, Internal Medicine Division, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
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Das SS, Sen S, Zaman RU, Biswas RN. Plateletpheresis in the Era of Automation: Optimizing Donor Safety and Product Quality Using Modern Apheresis Instruments. Indian J Hematol Blood Transfus 2021; 37:134-139. [PMID: 33707846 PMCID: PMC7900306 DOI: 10.1007/s12288-020-01337-1] [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: 04/07/2020] [Accepted: 08/11/2020] [Indexed: 11/26/2022] Open
Abstract
The increases in major surgeries, transplantations and speciality clinics have significantly increased the utilization of platelet concentrates including single donor platelets (SDP). The advantages of SDP or apheresis platelet have been discussed elaborately by previous authors as compared to random donor platelets. Here we share our experiences of plateletpheresis procedures using the modern apheresis machines with regards to product quality and donor safety. This study included 3016 procedures of plateletpheresis (1397 on Amicus and 1619 on Trima accel cell separators) on eligible donors using recommended apheresis kits. A target yield of 3 × 1011 was set as the end point of each procedure. Donor details, procedure details and donor adverse reactions if any were documented. Statistical analysis was done using the SPSS statistical package (version 13, USA). Of the total 6276 donors screened 2049 (32.6%) were deferred due to various reasons. Out of remaining 4227 eligible donors; 3016 (71.4%) underwent plateletphereis procedures based on the requirement of SDP by the patients. Mean pre-procedure platelet count and hematocrit in donors were 188.3 × 106/mL and 41.7% respectively. Mean procedure time in Amicus (76.6 min) was significantly more than the Trima accel (64.3 min) (p = 0.02). Platelet yield by Trima accel and Amicus was 2.96 × 1011 and 3.08 × 1011 respectively (p = 0.061). A total of 40 donors (1.33%) suffered adverse effect during or after apheresis procedures. While the modern plateletpheresis devices are both donor and user friendly at the same time they provide quality product consistently in lesser time.
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Affiliation(s)
- Sudipta Sekhar Das
- Department of Transfusion Medicine, Apollo Gleneagles Hospitals, Kolkata, 700054 India
| | - Subrata Sen
- Department of Transfusion Medicine, Apollo Gleneagles Hospitals, Kolkata, 700054 India
| | - R. U. Zaman
- Department of Transfusion Medicine, Apollo Gleneagles Hospitals, Kolkata, 700054 India
| | - Rathindra Nath Biswas
- Department of Transfusion Medicine, Apollo Gleneagles Hospitals, Kolkata, 700054 India
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Chellaiya GK, Murugesan M, Nayanar SK. A Study on Influence of Donor Hematocrit on the Procedural Parameters of Concentrated Single Donor Platelets Collected by Two Apheresis Devices. Indian J Hematol Blood Transfus 2020; 36:135-140. [PMID: 32158096 DOI: 10.1007/s12288-019-01163-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2019] [Indexed: 11/25/2022] Open
Abstract
With improvements in apheresis collection, platelet additive solution (PAS) is steadily replacing plasma as the storage medium in single donor platelets (SDP). Concentrating platelets in SDP with one-third of plasma and two-thirds of PAS is referred as Concentrated-SDP (C-SDP). We studied the influence of donor hematocrit (Hct) in C-SDP procedures. A retrospective study, consisting of 124 and 95 plateletpheresis donors in MCS+ and Trima respectively. We compared two apheresis equipments MCS+ and Trima with regard to donor hematocrit on procedural parameters such as collection efficiency (CE), collection rate (CR), yield per hour (Y/H), yield per litre (Y/L) and percentage blood volume processed (%BV) during C-SDP procedures. Donors were categorized into two groups with Group A (Hct ≤ 46%) and Group B (Hct > 46%) based on mean baseline Hct of the study population. Among the 219 procedures, the overall CE was significantly higher for Trima over MCS+ equipment (77 vs 56, P < 0.001). However, there was no difference in procedural outcomes like CE, Y/L, Y/H, CR with MCS+ or Trima equipment between groups. %BV processed had a negative correlation with hematocrit in MCS+ (r = - 0.305, P = 0.001) and no difference was observed with Trima equipment. Donor Hct influences C-SDP collection only in processed blood volume with MCS+ equipment. Trima had statistically better performance over MCS+ equipments in all procedural parameters during C-SDP procedures. The data will guide apheresis centre to choose equipments based on donor characteristics.
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Affiliation(s)
- Gayathiri K Chellaiya
- 1Department of Transfusion Medicine, Malabar Cancer Centre, Thalassery, Kerala India
| | - M Murugesan
- 1Department of Transfusion Medicine, Malabar Cancer Centre, Thalassery, Kerala India
| | - Sangeetha K Nayanar
- 2Department of Oncopathology, Malabar Cancer Centre, Thalassery, Kerala 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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