Effect of plateletpheresis on hematocrit, hemoglobin and erythrocyte count: Meta-analysis 1980-2018

Analysis of erythrocyte and iron study data among plateletpheresis donors in Hangzhou, China

BACKGROUND

The purpose of this study is to obtain the iron parameters level of blood donors and the population who need to pay attention to iron parameters level in this area.

METHODS

A total of 993 plateletpheresis donors were included in this study, including 798 males and 195 females. The results of erythrocyte and iron parameters of blood donors were compared and analyzed in different groups according to the gender, age and number of blood donations.

RESULT

The proportion of men and women with low serum ferritin (SF) levels was 10.8 % and 27.7 %, respectively. The mean levels of serum iron (SI), SF, transferrin saturation (Tfs), hemoglobin (Hb) and hematocrit (HCT) of male blood donors decreased with the increase of age groups, but there was no significant statistical difference between the results of female blood donors. The level of SI, SF, Tfs, Hb and HCT of male donors decreased with the increase of blood donations in the past year, while TRF and TIBC increased. The level of Hb, HCT and SF of female donors showed no significant downward trend, while the levels of TRF increased with increasing donations in the past year, excluding first-time donors. The SI of female donors trended down, and TIBC trended up with increasing donations.

CONCLUSION

Blood collection institutions need to focus on iron parameters levels in older and frequent male donors, and young fertile female donors.

Plateletpheresis donor deferral patterns at a tertiary care hospital in North India: A need for rethink of haemoglobin cutoff

INTRODUCTION

The donor deferral criteria for blood or apheresis donations are established for two main reasons: (i) to ensure the safety of the blood donor (non-maleficence); (ii) to obtain safe blood of standard quality that has therapeutic benefit for the patient (beneficence). This study was planned to assess the various causes and patterns of plateletpheresis donor deferral in our hospital and to subsequently assess whether any evidence based changes can be done in the current plateletpheresis donor deferral criteria in India to maximize the platelet donor pool without compromising donor safety.

MATERIAL AND METHODS

The present study was conducted from May 2021 till June 2022 in the department of transfusion medicine of a tertiary care hospital in North India. The first part of the study was conducted from May 2021 till March 2022 to assess the various causes of donor deferral by analysing the plateletpheresis donor deferral data during the corresponding period. The second part of the study was conducted from April 2022 till June 2022, to assess: (i) average decrease in haemoglobin after plateletpheresis procedure; (ii) red blood cell loss during plateletpheresis procedure; (iii) to determine whether any correlation exists between donor haemoglobin and platelet yield.

RESULTS

During the study period, a total of 260 donors were screened for plateletpheresis, out of which 221 (85%) donors were accepted and 39 (15%) donors were deferred for various reasons. Out of the 39 deferred donors, 33 (84.6%) were temporary deferrals, while 6 (15.4%) were permanent deferrals. Low haemoglobin (Hb < 12.5 g/dl) was a cause of deferral in 12.8% (n = 5) of the deferred donors. 192 (73.9%) out of the 260 donors were replacement donors. The calculated mean decrease in haemoglobin as a result of plateletpheresis procedure was 0.4 g/dl. No correlation was seen between donor pre-donation haemoglobin and platelet yield (p = 0.86, r = 0.06, R² = 0.003). The calculated mean red cell loss as a result of plateletpheresis procedure was 28 ml.

CONCLUSION

Low haemoglobin (<12.5 g/dl) is a significant cause of temporary plateletpheresis donor deferral in India. In view of the advancement in plateletpheresis technology, which has resulted in minimal red cell loss with the current generation apheresis devices, haemoglobin cutoff of 12.5 g/dl needs to be reconsidered. Perhaps, after performing a multi-centric trial, a consenscus can be reached for revision of haemoglobin cutoff for plateletpheresis donations.

A multivariate analysis of the risk of iron deficiency in plateletpheresis donors based on logistic regression

BACKGROUND

The purpose of this study was to analyze the application of individual factors, blood cell related indicators, and blood donation frequency in predicting the risk of iron deficiency of plateletpheresis donors.

METHODS

A total of 801 plateletpheresis donors were included in this study. The relationship between risk factors and iron deficiency was retrospectively analyzed by univariate analysis and logistic regression analysis. The application of Hb, MCHC, RDW-CV and blood donation frequency combined prediction of iron deficiency risk among plateletpheresis donors was evaluated.

RESULT

The rate of iron deficiency in this study was 31.5 % (241/766). The age, gender (the ratio of male donors), red blood cell related indicators, blood donation frequency were statistically different between the normal and iron deficiency group (all P < 0.05). Age, gender, the reciprocal of Hb and MCHC, RDW-CV, total number of blood donation and number of plateletpheresis donation in the past year, these indicators to predict the risk of iron deficiency area under the curve (AUC) were 0.558, 0.672, 0.785, 0.717, 0.599, 0.621, 0.646, respectively. The AUC of these indicators combined to predict the risk of iron deficiency was 0.877, higher than all single indicators. The sensitivity and specificity of these indicators combined in prediction of iron deficiency were 88.89 % and 81.57 %, respectively.

CONCLUSION

Age, gender, the reciprocal of Hb and MCHC, RDV-CV, blood donation frequency are associated with the risk of iron deficiency in plateletpheresis donors. The combination of these indicators has high value in predicting the risk of iron deficiency.

Analysis and clinical significance of peripheral blood routine changes of platelet donors with ultra-high frequency donation

BACKGROUND

Increasing platelet donation frequency has become an important way to meet the growing clinical platelet need. Accordingly, the problem of whether the increase in platelet donation times will have an adverse effect on the health of donors has attracted more and more attention, and become an important factor affecting the donor enthusiasm and the safety of blood collection and supply.

METHODS

Eleven ultra-high frequency platelet donors who donated more than or equal to 20 times in 2021 were selected, and the main peripheral blood routine indicators of hemoglobin, platelet and hematocrit were analyzed.

RESULTS

The above indicators of all donors fluctuated with the increase of donation times. Among them, older donors (≥50 years old) exhibited a significant downward trend in the above three indicators, and one young donor showed a downward trend in hemoglobin and hematocrit indicators. While the other donors showed the relatively stable performance of the above indicators.

CONCLUSION

The effect of ultra-high frequency platelet donation on the main peripheral blood indexes of donors shows obvious age compliance, that is, the potential harm to ultra-high frequency donors older than 50 years is significantly greater than that of donors of other ages. Older platelet donors should be cautious about ultra-high frequency donations to avoid adverse health hazards. Meanwhile, the work will provide technical reference for the more scientific and efficient development of the platelet harvesting work and the establishment of the clinical blood supply system for related patients.

Horiba Micros ES 60 Blood Cell Analyzer in Blood Donor Eligibility: A Validation Study

Background: Eligibility criteria for blood donation require hemoglobin levels of ≥12.5 g/dL for women and ≥13.5 g/dL for men, and a platelet count of ≥180 × 109/L. Screening methods before donation should ensure high accuracy, precision, and ease in operation. We assessed the performance, precision, and repeatability of the Horiba Micros ES 60 (Horiba) compared to the Beckman Coulter DXH 800. Methods: Performance was compared by testing samples for each of the 11 devices across 6 sites in the Transfusion Service of Friuli Venezia Giulia Region, Italy. We measured precision by calculating the coefficient of variation (CV), concordance with ρ-Pearson’s correlation coefficient, and accuracy with F-tests. The intra-assay agreement was examined in the 11 devices, and repeatability was performed by using CV and the Kruskal−Wallis test. Results: The precision of Horiba was acceptable. Overall, ρ-Pearson’s coefficients indicated a strong correlation and positive relationship between all variables. The Bland−Altman plots showed that most of the differences lay within the limits of agreement. All CV were below the reference threshold for all the parameters. Finally, the Kruskal−Wallis test reported non-significant statistical differences for all parameters, except platelet count (p < 0.000). Conclusions: Horiba is adequate for routine pre-donation screening. The intra-assay agreement further demonstrates the accuracy of the device.

Prevalence and causes of pre-donation deferrals among potential plateletpheresis donors at a blood center in Eastern China

BACKGROUND

In China, the platelet donation interval is 14 days. The eligibility criterion of plateletpheresis donors (PD) is more stringent than that of whole blood donors, so the deferral causes are very complicated. However, the deferral prevalence and causes among PDs are not well known in China.

OBJECTIVE

To analyse the deferral prevalence and influencing factors during pre-donation among PDs in a blood centre in Eastern China.

METHODS

From December 26, 2020 to December 25, 2021, all data of potential PDs during pre-donation were extracted from the register system and collected using Microsoft Excel. The number of deferred visits and the corresponding causes were retrospectively analysed, and the re-donation rate of deferred donors was calculated.

RESULTS

A total of 19,762 visits were included in the study. Of these 17,847 (90.3%) donated platelets successfully and 1915 (9.7%) were deferred. The prevalence of deferrals was high among those less than 35 years old (p < 0.05) and first-time donors (p = 0). The leading cause for deferral was elevated alanine transaminase (51.4%) followed by abnormal haematological parameters (37.15%). High white blood cell count was the first deferral factor (26.9%) in abnormal haematological parameters. In more than 2 ineligible items, low haemoglobin and haematocrit simultaneously were dominant (58.3%). The re-donation rate of repeat donors (65.4%) was higher than that of first-time donors (19.3%) (p = 0).

CONCLUSION

The deferral prevalence in Chinese plateletpheresis donors was not high. First-time and young donors were more frequently deferred. The repeat donors should be of concern, especially with abnormal haematological parameters.

Deferral due to low hemoglobin and predictors of permanence in the blood donation system of repeat female blood donors

OBJECTIVES

To evaluate the deferral rate due to low hemoglobin (Hb) in repeat female blood donors and identify the factors affecting their permanence in the blood donation system.

MATERIALS AND METHODS

8,368 repeat female blood donors who donated from January 2012 to December 2018 were included. Bivariate analysis and Kaplan-Meier curves were used to identify the covariates possibly associated with developing low Hb, and Cox proportional hazards modeling was used to adjust for all confounders.

RESULTS

The global deferral rate due to low Hb was 2.4 %. According to baseline Hb, the frequency of low Hb was 0.7-4.1 %, and it was higher in platelet donors (5.8-9.1 %) than in whole blood donors (1.9 %). The main predictors were baseline Hb (compared to the first quartile; hazard ratio [HR] = 0.487 for the second quartile; 0.234 for the third; and 0.095 for the fourth); change in Hb (HR = 2.689 for a >0.49 g/dL change, compared to smaller changes); the type of donation (compared to whole blood donors, HR = 2.317 for platelet donors); and donation interval (compared to >12.5 month intervals; HR = 2.220 for 8.0-12.5 months; HR = 5.658 for 5.4-8.0 months; and HR = 9.452 for <5.4 months).

CONCLUSIONS

In female blood donors at moderate altitude, the probability of developing low Hb increases with a baseline Hb of 13.5-14.0 g/dL, with a change in Hb >0.49 g/dL, in platelet donors, and with donation intervals <12.5 months. These four predictive factors can be used together for early identification of donors at risk of developing low Hb, to institute appropriate measures.

Incidence and severity of adverse events among platelet donors: A three-year retrospective study

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.

Assessment of software-derived predictive algorithms for platelet yield and blood cell count after apheresis

INTRODUCTION

Algorithms have been developed to predict the platelet yield after apheresis from the donor's data, as well as the effect on the blood cell count, to extract an acceptable platelet number without affecting the donor. However, the evaluation of these algorithms has not been widely reported. This study aimed to assess the accuracy of the predictive algorithms of the Trima Accel v. 6 blood collection system.

METHODS

Platelet concentrates (PCs) obtained by apheresis were analyzed. Platelet count and hematocrit were compared pre- and post-apheresis. Calculated post-apheresis platelet count (CPAPC), hematocrit (CPAH), and platelet yield (CPY), and their actual values were correlated. The bias of the algorithms was assessed with Bland-Altman plots, and the prediction of the extraction of single or double platelet products was evaluated.

RESULTS

Two hundred and seventy-nine PCs were analyzed. Post-apheresis platelet count (PAPC) and hematocrit were decreased. A moderate correlation was observed between CPY and the actual yield, with a negative bias, and a trend to increase alongside the magnitude of the measurements. CPAPC and CPAH were strongly correlated with their actual values without bias. Prediction of single or double platelet product extraction showed a significant agreement with the actual outcomes.

CONCLUSIONS

The predictive algorithm for the platelet yield showed bias, and a trend to underestimate the actual platelet yields when they are higher. The algorithms for the prediction of the PAPC and hematocrit did not show bias, proving their accuracy. Prediction of a single or double platelet product extraction has a strong agreement with the APY.