A Retrospective Analysis of Apheresis Donor Deferral and Adverse Reactions at a Tertiary Care Centre in India

Plateletpheresis in the Era of Automation: Optimizing Donor Safety and Product Quality Using Modern Apheresis Instruments

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.

Analysis of Donor Safety in High Yield Plateletpheresis Procedures: An Experience from Tertiary Care Hospital in South India

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.