Donor Safety in Haemapheresis: Development of an Internet-Based Registry for Comprehensive Assessment of Adverse Events from Healthy Donors

Safety and protection of plasma donors: A scoping review and evidence gap map

BACKGROUND AND OBJECTIVES

As part of a large-scale project to safely increase plasma collection in Europe, the current scoping review identifies the existing evidence (gaps) on adverse events (AEs) and other health effects in plasmapheresis donors, as well as factors that may be associated with such events/effects.

MATERIALS AND METHODS

We searched six databases and three registries. Study characteristics (publication type, language, study design, population, outcomes, associated factors, time of assessment, duration of follow-up, number and frequency of donations, convalescent plasma [y/n], setting and location) were synthesized narratively and in an interactive evidence gap map (EGM).

RESULTS

Ninety-four research articles and five registrations were identified. Around 90% were observational studies (57 controlled and 33 uncontrolled), and most of them were performed in Europe (55%) or the United States (20%). Factors studied in association with donor health included donor characteristics (e.g., sex, age) (n = 27), cumulative number of donations (n = 21), donation frequency (n = 11), plasma collection device or programme (n = 11), donor status (first time vs. repeat) (n = 10), donation volume per session (n = 8), time in donation programme (n = 3), preventive measures (n = 2) or other (n = 9).

CONCLUSION

The current scoping review provides an accessible tool for researchers and policymakers to identify the available evidence (gaps) concerning plasmapheresis donation safety. Controlled prospective studies with long-term donor follow-up are scarce. Furthermore, additional experimental studies comparing the health effects of different donation frequencies are required to inform a safe upper limit for donation frequency.

Adverse events associated with donor plateletpheresis: 10 years’ experience from Vojvodina, Serbia

Background/Aim. Plateletpheresis is a medical procedure used for the collection of donor platelets with multiple benefits for patients who will receive apheresis platelets. The procedure takes one hour and is well tolerated by donors. Nevertheless, adverse events may occur during and after the plateletpheresis procedure. The aim was to present one centre experiences in order to determine the incidence and type of adverse events associated with donor plateletpheresis. Methods. A retrospective analysis of adverse events associated with donor plateletpheresis was conducted in the Blood Transfusion Institute of Vojvodina over the period from January 1, 2010 through December 31, 2019. Results. Out of 2073 platelet donors 94.84% were multiple blood donors, predominantly male (98.55%). Adverse events were identified during 180 (8.68%) platelet donations with no statistical significance in occurrence in the first time (10.28%) and repeat donors (8.59%). Mild local reactions related to venous access (42.22%) were the most common adverse events. Generalized symptoms exhibited 16.67% of donors, 26.11% exhibited symptoms related to apheresis - citrate reactions and 15% exhibited those related to other complications. During plateletpheresis occurred 95.55% adverse events and 4.45% after. Conclusion. Donor plateletpheresis is a generally safe procedure, well tolerated by donors. Understanding risk factors for possible occurrence of adverse events provide support for adoption of measures to prevent them.

Optimising plasmapheresis procedure: The role of plasma unit weight setting

The AUSL-IRCCS of Reggio Emilia Transfusion Unit operates in two blood donor centers. Plasmapheresis protocols and machines are identical in both centers, except for the final unit weight setting: 700 g in Center 1 and 720 g in Center 2. Within a wider study to assess the anticoagulant content in plasma units through proton nuclear magnetic resonance, we compared the efficiency of the two settings. We analyzed 215 and 100 consecutive samples from Centers 1 and 2, respectively. We collected processed blood volume, net plasma collected and anticoagulant volume in the plasma units. In our experience, setting the machine at 720 g instead of 700 g was associated with a small increase in plasma content of the final unit (only 4 mL), but implied an increase of more than 100 mL of the total processed blood and a higher amount of anticoagulant in the unit. On the contrary, the difference in donor's reinfused anticoagulant was negligible. Our findings come from an observational study suggesting that, in view of a minimal advantage in terms of collected net plasma, there might be relevant disadvantages for the donor in prolonging plasmapheresis over 700 g. Since observed differences may be attributed to confounding factors, we recommend always checking the marginal efficiency of the procedure when the balance target value of the setting is increased. Randomized cross-over studies are needed to find the optimal target weight for plasma units. These studies could also help defining personalized plasmapheresis procedures, thus further optimizing donor safety.