Effects of Apheresis Platelet Transfusion on PLT, MPV, PDW and PCT / 中国实验血液学杂志

OBJECTIVE@#To investigate the changes of platelet count (PLT), plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW) before and after apheresis platelet transfusion, the correlation between the parameters and their clinical significance.@*METHODS@#A total of 38 patients who received apheresis platelet transfusion were selected, their results of blood routine test closest to the time point of apheresis platelet transfusion were consulted from hospital information system and the changes of PLT, PCT, MPV and PDW were compared before and after transfusion. The correlation between above parameters was analyzed. The correlation of body mass index (BMI) with the increased multiple and increased value after platelet infusion was also analyzed.@*RESULTS@#Compared with pre-infusion, PLT and PCT significantly increased (both P <0.001) while MPV and PDW showed no significant difference after apheresis platelet transfusion (P >0.05). The difference of PLT and PCT before and after apheresis platelet transfusion had no correlation with PLT and PCT before transfusion (r =0.002, r =0.001), while the difference of MPV and PDW was negatively correlated with MPV and PDW before transfusion (r =-0.462, r =-0.610). The PLT growth rate was positively correlated with PCT growth rate before and after apheresis platelet transfusion (r =0.819). BMI was positively correlated with the increased multiple of PLT after infusion (r =0.721), but not with the increased value of PLT after infusion (r =0.374).@*CONCLUSION@#Apheresis platelet transfusion can cause platelet parameters change and shows different characteristics. Characteristic changes of platelet parameters and their correlation can be used as reference indices to evaluate the efficacy of apheresis platelet transfusion.

Evaluation of hierarchical teaching model in advanced training of therapeutic blood component apheresis / 中国输血杂志

【Objective】 To explore the efficiency of hierarchical teaching model in advanced training of therapeutic blood component apheresis. 【Methods】 A total of 76 students who participated in the advanced training(≥3 months) of therapeutic blood component apheresis in Blood Transfusion Department of our hospital from January 2016 to December 2021 were taken as subjects. They were divided into observation group(hierarchical teaching mode, n=46) and control group (traditional teaching mode, n=30) using random number table method. The assessment scores of the two groups in terms of theoretical knowledge and experimental operation ability before and after the advanced traning were compared, and the satisfaction of students for the teaching models were collected by questionnaires. 【Results】 After training, the average score of the observation group and control group in terms of theoretical knowledge and experimental operation ability were 52.57±2.17 vs 51.00±2.73, 34.74±1.99 vs 33.40±2.42, respectively (P<0.05), and the training satisfaction was 95.35% (41/43) vs 78.57% (22/28) (P<0.05). 【Conclusion】 Compared to traditional teaching mode, hierarchical teaching mode in advanced training of therapeutic blood component apheresis has better effect on the trainees to master relevant theoretical knowledge and operational skills.

Application and effect of partnership plan competition in the recruitment of apheresis platelet donation / 中国输血杂志

【Objective】 To analyze the demographic characteristics of apheresis platelet donors who participated in the Partnership Plan Competition(PPC) of Beijing Red Cross Blood Center, and to analyze the effect of publicity and recruitment of apheresis platelet donors, so as to provide reference for formulating recruitment strategy of apheresis platelet donation. 【Methods】 Apheresis blood donors who participated in PPC from March 18, 2021 to May 18, 2021 were selected as research subjects, and their demographic data in terms of gender, age, occupation and education, and relevant blood donation data within 12 months such as the number of blood donations, whether they were regular blood donors were collected. The demographic characteristics of PPC donors and promising groups were analyzed. 【Results】 There were 58 recruiters participating in the PPC, and a total of 170 people were recruited; 53.53%(91/170) successfully participated in the donation of apheresis platelets, and 35.16%(32/91) became regular blood donors. Those 18-30 years old college male students were promising group in the PPC, and were more willing to participate in the recruitment and donation of apheresis platelets. 【Conclusion】 The PPC has significant effect on the promotion and recruitment of apheresis platelets donation. Measures such as setting the types of souvenirs according to the preferences of promising groups, strengthening publicity of PPC, encouraging non-blood donors to participate and expanding targeted recruitment can be taken in the future to increase the success rate of blood donation of the recruitment.

Initial screening and retest mode in apheresis platelet donors: a comparative analysis / 中国输血杂志

【Objective】 To investigate the effectiveness of current indicators in initial screening and retest before donation and access the optimal testing strategies. 【Methods】 Data of initial screening (rate method for ALT, colloidal gold method for HBsAg) and retest (rate method for ALT, ELISA for HBsAg) of 18 510 platelet donors in our center from January 2019 to December 2021 were collected, and the results were retrospectively analyzed and compared in terms of different years and number of donations. 【Results】 From 2019 to 2021, data of initial screening and retest of platelet donors were as follows: 1) the deferral rate of ALT and HBsAg was 12.98% (2 403/18 510) vs 0.26%(40/15 412); 2) the deferral rate of ALT was 13.19% (712/5 398) vs 0.20%(9/4 410)in 2019, 13.33% (873/6 549) vs 0.06%(3/5 387)in 2020 and 11.05% (725/6 563) vs 0.07%(4/5 615)in 2021; for initial screening, significant difference was noticed in ALT reactivity in 2021 as in comparison to other two years(P<0.05); 3) the reactive rate of HBsAg was 0.43% (23/5 398) vs 0.18%(8/4 410)in 2019, 0.66% (43/6 549) vs 0.20%(11/5 387)in 2020 and 0.41% (27/6 563) vs 0.09%(5/5, 615) in 2021. For initial screening, HBsAg deferral in 2021 was significantly different from 2019, while similar with 2020. 4) Among ALT deferral samples in the retest, 68.75% (11/16) were ALT≥45 U/L. Among HBsAg reactive samples, 91.67% (22/24) were reactive by single reagent. 【Conclusion】 Setting the threshold value of ALT for platelet donors in initial screening as less than 45 U/L can effectively reduce the reactive rate in the retest. HBsAg screening only for first-time platelet donors can reduce the detection cost. Adding pre-donation detection indicators according to local prevalence of transfusion transmitted diseases is conductive to reduce the discarding rate of platelets.

Efficacy of apheresis platelet transfusion in 310 patients with haematological diseases / 中国输血杂志

【Objective】 To observe the effect of platelet transfusion in inpatients with haematological diseases, analyze the possible causes of platelet transfusion refractoriness (PTR), in order to further improve the efficacy of platelet transfusion. 【Methods】 A total of 310 patients with blood disease in our hospital from August 2020 to November 2021 who received platelet transfusion were retrospectively analyzed. Possible influencing factors of platelet transfusion, including gender, age, platelet preservation time, number of platelet transfusions, complication and red blood cell product transfusion were analyzed. 【Results】 Patients were divided into effective group and refractory group according to percentage platelet recovery (PPR) and corrected count increment (CCI). PTR was defined as PPR <20% or CCI <5 000 after two consecutive transfusions in 24 h or clinical bleeding symptoms or tendency not significantly controlled. Statistical differences were noticed between the two groups in terms of gender, pretransfusion white blood cell count, anemia, and whether antibiotics were used (P<0.05). The type of disease, gender, anemia and number of comorbidities were associated with PTR. The incidence of PTR was the highest in patients with myelodysplastic syndrome, and the incidence of PTR was higher in men than in women. Transfusion units of suspended red blood cells and the number of comorbidities were negatively correlated with the transfusion efficacy (P<0.05). 【Conclusion】 Possible influencing factors of platelet transfusion included the level of white blood cells before transfusion, use of antibiotics, anemia and transfusion of red blood cells, number of comorbidities, and type of disease, while no significant differences were found in age, hemolysis, hypersplenism, platelet preservation time, and number of platelet transfusions on transfusion efficacy.

Discussion on the construction of holistic nursing based on SWOT in apheresis platelets collection / 中国输血杂志

【Objective】 To explore the application and effectiveness of holistic nursing based on SWOT in platelet collection at blood stations. 【Methods】 SWOT analysis was used to analyze the causes of adverse reactions to blood donation in platelet donors, put forward countermeasures and take holistic nursing measures. Routine nursing was adopted from January to June 2021, and holistic nursing based on SWOT analysis was adopted from July to December 2021. The adverse reactions and the nursing quality before and after the implementation of holistic nursing in the two groups were compared, and the satisfaction of blood donors to the nurses was analyzed. 【Results】 After the implementation of holistic nursing based on SWOT analysis, the incidence of adverse reactions in blood donation was 2%(2/100) in the observation group, significantly lower than 11%(11/100) in the control group(P<0.05). Nursing satisfaction score of the observation group was (93.10±4.97 points), significantly higher than that of the control group (78.12±5.36 points)(P<0.05). 【Conclusion】 The implementation of holistic nursing based on SWOT analysis can significantly reduce the incidence of adverse reactions in platelet donors and improve the satisfaction of blood donors with the nursing work, thus significantly improving the quality of nursing in the department.

Influence of blood donors' coagulation status in apheresis platelet aggregation in vitro / 中国输血杂志

【Objective】 To investigate whether the blood donors' coagulation status may lead to apheresis platelet aggregation in vitro. 【Methods】 Thirty blood donors with aggregation in apheresis platelets collected by AMICUS blood cell separator no less than 3 times previously and occurred when the last time of apheresis donation were observed in aggregated group (referred to as the experimental group); Thirty donors without aggregation in apheresis platelets collected by AMICUS blood cell separator no less than 3 times were observed in the control group simultaneously. The basic platelet parameters in the two groups, including Plt, MPV, PDW, Pet, P-LCR were detected by automatic blood cell analyzer (BC-3000Plus), and thromboelastogram indexes including reaction time(R), kinetics time(K), kinetics of clot development(α), maximum amplitude (MA) and coagulation index(CI) were tested by Thrombosis elastography (TEG) before collection. With SPSS24.0 software, t test was used to compare the differences between the two groups. 【Results】 The CI value in experimental group was significantly different from that of the control group (0.48± 1.00 vs -0.99 ±1.96, P0.05 ) . 【Conclusion】 The coagulation status of blood donors may be an independent risk factor for the in vitro aggregation of apheresis platelets.

Effects of different storage conditions on the content of key growth factors in platelet-rich plasma / 中国输血杂志

【Objective】 To study the effects of different storage temperature and different storage time on the activity of key growth factors in platelet-rich plasma(PRP), and to provide a theoretical basis for maximize the role of PRP in clinical treatment. 【Methods】 PRP was collected by blood cell isolation and apheresis, stored at 22℃ and -80℃, respectively. VEGF, TGF-β and PDGF were detected by ELISA. The content of growth factors in PRP was detected when stored at 22℃for 1, 3 and 5 days, and the growth factors content of PRP stored at 22℃ for 3 days was detected after thrombin activation for 0.5, 1 and 1.5 hours. The content of growth factor in frozen PRP (stored at -80℃ for 30 days after initial 3-days storage at 22℃ ) and fresh PRP (stored at 22℃ for 3 days) was compared. The growth factor content in PRP frozen at - 80℃ for 30, 60 and 180 days, and the growth factor content in PRP frozen at -80℃ for 180 days after repeated freeze-thaw for 1, 2, 3, 5 and 10 times were detected. 【Results】 The growth factor content of apheresis PRP was significantly higher than that of platelet-poor plasma. No statistical difference was noticed in VEGF, TGF-β and PDGF content in PRP at 1, 3 and 5 days stored at 22℃; no statistical difference was noticed in VEGF, TGF-β and PDGF content in PRP stored at 22℃ for 3 days after thrombin activation for 0.5, 1 and 1.5 hours. There was no statistically significant difference in growth factor content between PRP stored at 22℃ for 3 days versus frozen at -80℃ for 30 days after initial 3-days storage at 22℃. No statistical difference was found in VEGF, TGF-β and PDGF contents in frozen PRP repeatedly frozen and thawed for 1 to 10 times. 【Conclusion】 Apheresis PRP can release a large amount of growth factors after activation. Fresh PRP stored at 22℃ for 5 days or frozen at -80℃ for 180 days has no impact on the content of growth factors, and frozen PRP at -80℃ can achieve long-term, effective and safe preservation, which is conducive to multiple use of PRP in treatment.

Analysis on the willingness of whole blood donors to donate apheresis platelets and its influencing factors / 中国输血杂志

【Objective】 To investigate the willingness of whole blood donors to donate apheresis platelets and analyze its influencing factors. 【Methods】 A total of 400 whole blood donors from Kunshan Blood Station and Leshan Blood Station from January to May, 2023 were surveyed by random sampling, and their willingness to donate apheresis platelets were analyzed by univariate analysis and binary logistic regression analysis. 【Results】 A total of 386 valid questionnaires were collected, with a recovery rate of 96.5%. Among the 386 whole blood donors, 177 were willing to donate apheresis platelets, accounting for 45.9%. Univariate analysis showed that gender, age, education level, blood donation times, average blood donation volume, adverse reactions to blood donation, understanding of platelets, and family members' attitude towards blood donation were the main factors affecting the willingness of whole blood donors to donate platelets, and binary logistic regression analysis showed that gender, age, blood donation times, average blood donation volume, understanding of platelets and family members' attitude towards blood donation were the main factors. 【Conclusion】 Targeted recruitment of whole blood donors should be conducted to recruit more apheresis platelet donors, so as to meet clinical demand of apheresis platelets.

Effect of multiple apheresis platelet donation on platelet indexes and aggregation rate in platelet donors / 中国输血杂志

【Objective】 To investigate the effect of multiple apheresis platelet donation on platelet indexes and aggregation function in platelet donors, and to analyze the relationship between platelet indexes and their relationship with platelet aggregation rate. 【Methods】 A total of 83 platelet donors were randomly selected from Foshan Central Blood Station from September 2021 to October 2022, and were divided into control group (n= 9, first-time platelet donors or donors with the time interval from the last platelet donation >1 year) and study group (n= 74, repeat platelet donors or donors with the time interval from the last platelet donation ≤ 1 year) according to the times of blood donation. The study group was divided into 4 subgroups: 2-5 times group, 6-10 times group, 11-15 times group and 16 times group. The platelet count(Plt), platelet distribution width (PDW), mean platelet volume (MPV), large platelet ratio (P-LCR), and maximum platelet aggregation rate (MAR) before donation in each group were detected and analyzed. 【Results】 There were no significant differences in Plt, MPV, PDW, P-LCR and MAR between the subgroups and the control group (P>0.05), and there were no significant differences in Plt, MPV, PDW, P-LCR and MAR between each subgroup (P>0.05) .There was a positive correlation between Plt and MAR in blood donors (P<0.05), and the correlation coefficient was 0.445. MPV, PDW and P-LCR were negatively correlated with MAR (P<0.05), and the correlation coefficients were -0.282, -0.233 and -0.217, respectively. Plt was negatively correlated with MPV, PDW and P-LCR (P < 0. 05), and the correlation coefficients were -0.399, -0.307 and -0.339, respectively. MPV, PDW and P-LCR are positively correlated with each other. The correlation coefficient between MPV and PDW was 0.792, that between MPV and P-LCR was 0.863, and tthat between PDW and P-LCR was 0.817. 【Conclusion】 There was no significant effect of multiple platelet donations on Plt, PDW, MPV, P-LCR and MAR in blood donors. Plt has the most significant impact on MAR among platelet indexes of platelet donors.

Analysis of monitoring results of novel coronavirus IgM and IgG antibody levels in apheresis platelets donors and impact on blood safety / 中国输血杂志

【Objective】 To monitor the positive rates of IgM and IgG antibodies and the changes in S/CO values over time in voluntary blood donors infected with SARS-CoV-2 after recovery, in order to provide theoretical basis and data support for ensuring clinical blood safety. 【Methods】 A total of 54 platelet donors who met the inclusion criteria were selected for this study, and 359 blood samples (plasma) from T1 to T7 (at 7 time points, spanning 14 to 15 weeks) were continuously monitored for SARS-CoV-2 IgM and IgG antibodies using fully automated chemi-luminescence method. 【Results】 Among 359 blood samples (plasma) from 54 donors, 349 were with valid test results.Eleven donors were tested positive for IgM, with a positive rate of 20.37%, and IgM antibody S/CO value gradually increased during T1-T3, but gradually decreased during T4-T7. Fifty-four donors were tested positive for IgG, with the positive rate of 100%, and the S/CO value of IgG antibody gradually decreased over time. During the period of T1 -T7, there was no significant difference in SARS-CoV-2 IgG antibody S/CO value between gender (male/female) or age group (18-39 years old /40-60 years old). 【Conclusion】 The positive rate of SARS-CoV-2 IgG antibody in platelet donors after recovery from SARS-CoV-2 infection was 100% during 2-14 weeks, and the IgG S/CO value gradually decreases over time. The long-term dynamic changes of SARS-CoV-2 serologically specific IgG and IgM antibodies in blood donors are worthy of further study.

Countermeasures of adverse reactions to blood donation in low-weight blood donors for the MCS+ blood cell separator UPP procedure / 中国输血杂志

【Objective】 To reduce the occurrence of adverse reactions to blood donation during platelet collection in female blood donors with low body weight and high platelet count, so as to improve the comfortableness during platelet collection and increase the proportion of repeated blood donors. 【Methods】 The control group and observation group were compared to explore the causes that may cause adverse reactions in the blood collection cycle using blood collection process program software in MCS+, and the incidence of blood donation reaction was compared and observed by increasing the times of oral administrations of calcium gluconate by 10%, increasing the number of collection cycles and reducing the peak plasma volume of the last cycle. 【Results】 After comparing the two groups, it was found that the incidence of adverse reactions in the observation group and the control group was 16.7%(3/18) and 81.2%(26/32), the proportion of repeated donors in the observation group and the control group was 77.7%(14/18) and 31.2%(10/32). 【Conclusion】 Female platelet donors with low body weight and high platelet count should be given more care during the collection process. It is suggested that giving more times of oral administrations of calcium gluconate by 10% and one more collection cycle to reduce the collection peak in each cycle, as well as the supplement of saline, which can effectively reduce the occurrence of adverse reactions to blood donation, thus improving blood donation satisfaction and increasing the proportion of repeated blood donors.

Study on platelet components production in 19 provincial blood centers in China before and during the COVID-19 epidemic / 中国输血杂志

【Objective】 To study the changes of platelet components(PC), apheresis platelets (AP) and pooled platelet concentrates (PPC) production of 19 provincial blood centers before and during the COVID-19 epidemic. 【Methods】 The data related to the collection of AP and the preparation of PPC from 2016 to 2021 of 19 provincial blood centers was collected. The production of PC, AP and PPC during the four years before the epidemic (i.e. 2016-2019) and during the COVID-19 epidemic (i.e. 2020 and 2021) were calculated respectively, and the change of production was analyzed. 【Results】 The total production of PC in 19 blood centers steadily increased from 2016 to 2019, with a decrease of 4.16% in 2020 and an increase of 15.60% in 2021, exceeding the output before the COVID-19 epidemic. In 2020, the production of PC of 42.11% (8/19) blood centers decreased compared with 2019, while 94.74% (18/19) in 2021 increased compared with 2020. The changes of AP output was basically consistent with the trend of PC. The total production of PPC in 2017 and 2018 both doubled compared to the previous year, while decreased by 67.98% in 2019, increased by 30.38% in 2020 and decreased by 27.08% in 2021. 【Conclusion】 The total production of PC kept increasing steadily between 2016 and 2019, but decreased in 2020 under the COVID-19 epidemic, with some blood centers being significantly affected. In 2021, with the strong support from government and various measures by blood centers, the total production of PC increased.

Application of inspection sheet in apheresis platelet collection / 中国输血杂志

【Objective】 To explore the effect of inspection sheet on improving the quality of apheresis platelet, the satisfaction of blood donors and the cooperation ability of phlebotomists in the process of apheresis platelet collection. 【Methods】 Apheresis platelet donors from May to August 2021 in our center were selected as control group(without inspection sheet) and those from September to December 2021 were included in the observation group (with inspection sheet). The incidence of abnormal collection and the causes during collection process were compared between the two groups.And 100 first-time blood donors in each group were randomly selected for satisfaction survey. The questionnaire was made to investigate the phlebotomists’ recognition on the implementation of inspection sheet. 【Results】 The number of blood donors in the two groups were 6 673 and 6 559, with 111 and 49 abnormal cases, respectively. The total incidence of abnormal cases during blood collection before and after the implementation of inspection sheet was 1.66% and 0.75%, respectively, with the latter significantly lower than the former(P<0.001). The most common causes of abnormal conditions were repetitive puncture, followed by adverse reaction of blood donation, red blood cells contamination in platelet and fatty blood. The satisfaction of first-time blood donors was higher than before the implementation, and the recognition of phlebotomists on the inspection sheet was more than 90%. 【Conclusion】 The implementation of inspection sheet helps to regulate the collection process, strengthen the responsibility and service consciousness of phlebotomists, improve the satisfaction of blood donors, reduce the incidence of adverse events, and improve the quality of platelet products, which is worth popularizing in blood collection and supply institutions.

Preparation quality control and clinical application observation of pooled platelets with leukocytes reduced / 中国输血杂志

【Objective】 To investigate the preparation quality and clinical application effect of pooled platelets with leukocytes reduced. 【Methods】 The quality and clinical effect of the buffy-coated method prepared pooled platelets leukocytes reduced (experimental group, n=40) and apheresis platelets leukocytes reduced (control group, n=40) were compared. 【Results】 The platelet volume (mL), platelet count (×1011), red blood cell contamination (×108) and residual white blood cell (×106) of the experimental group and control group were 278.90±7.92 vs 276.52±8.01, 2.66±0.09 vs 2.66±0.83, 0.54±0.42 vs 0.83±0.84, 0.29±0.54 vs 0.27±0.51, respectively, with no significant difference. The results of bacterial culture were negative, all met the requirements of relevant national standards. In addition, the CCI (×103, 24 h) and PPR (%) were 15.11±9.86 vs 14.61±12.55 and 54.23±18.70 vs 61.41±19.09 respectively, with no significant difference, indicating a certain degree of therapeutic effect. 【Conclusion】 The quality and clinical therapeutic effect of pooled platelets leukocytes reduced were consistent with that of apheresis platelets leukocytes reduced.

Streptococcus gallolyticus bacteremia detected in apheresis platelets and its link to colonic neoplasms

Introduction: Streptococcus gallolyticus belongs to theStreptococcus bovis complex, and it is a common bacterium colonizing the gastrointestinal tract. Its presence in the blood may suggest an underlying pathology such as a colonic neoplasm. We report herein a case of S. bovis bacteremia in an apheresis platelet donor, review similar cases in the literature, and suggest a flowchart for the management of similar cases in other blood donation centers. Case Presentation: A 61-year-old subject presented to a Hemotherapy Service to make an apheresis platelet donation. On quality control testing, S. gallolyticus was identified in hemoculture, and the donor was called back for follow-up. At first, a new hemoculture was requested, and the patient was referred to the outpatient department of infectious diseases to further investigate pathologies associated with S. gallolyticus. A subsequent colonoscopy investigation evidenced a polypoid structure in the ascending colon. Pathology reported the resected specimen as a low-grade tubular adenoma. Conclusion: Isolation of S. bovis in blood products requires further investigation and should be managed with precision by Hemotherapy Services. A standard protocol for the management of asymptomatic patients with S. bovis positive hemoculture, with the requests of a new blood culture, a colonoscopy, and an echocardiogram is crucial, as it may ensure early diagnosis and reduce morbidity and mortality. (AU)

Plasmaféresis terapéutica en paciente pediátrico con encefalitis autoinmune / Therapeutic apheresis in pediatric patient with autoimmune encephalitis

La encefalitis autoinmune es un cuadro con una expresión neuropsiquiátrica especialmente en pediatría, aunque existen diversas opciones de tratamiento, otras alternativas terapéuticas se relacionan con procedimientos que pueden tener un mayor beneficio para el paciente, como es la plasmaféresis. Este procedimiento, representa una de las terapias de primera línea en este padecimiento. Hace poco se cuenta con la disponibilidad de estos equipos, motivo por el cual describimos este primer procedimiento en pediatría a nivel Bolivia describiendo el manejo en un paciente con encefalitis autoinmune.

Autoimmune encephalitis is a condition with a neuropsychiatric expression, especially in pediatrics, although there are various treatment options, other therapeutic alternatives are related to procedures that may have a greater benefit for the patient, such as plasmapheresis. This procedure represents one of the first line therapies in this condition. This equipment has recently become available, which is why we describe this first procedure in pediatrics at the Bolivian level, describing the management of a patient with autoimmune encephalitis.

Development and implementation of a COVID-19 convalescent plasma program in a middle-income economy

Abstract Introduction Convalescent Plasma therapy is one of the therapeutic strategies that has been used for patients with the Covid-19 disease. Implementing a program with national extension to supply hospitals with this blood component is a great challenge mainly in a middle-income economy. Objectives Our objective was to develop and implement a Covid-19 Convalescent Plasma Program which met established quality standards and was adapted to a reality of limited resources. Methods A multicentric convalescent plasma collection program was developed and implemented, based on four main sequential procedures: selective donor recruitment, pre-donation antibody screening (Anti-SARS-CoV-2- Chemiluminescence IgG Abbott), convalescent plasma collection by apheresis or whole-blood processing and distribution to the hospitals according to local demand. Results From the 572 candidates submitted to the pre-donation antibody screening, only 270 (47%) were considered eligible for plasma donation according to the established criteria. Higher levels of total antibody were associated with the donor age being above 45 years old (p= 0.002), hospital admission (p= 0.018), and a shorter interval between the diagnosis of the SARS-CoV-2 infection and plasma donation (p < 0.001). There was no association between the ABO and Rh blood groups and their antibody levels. Of the 468 donations made, 61% were from the collection of whole-blood and 39%, from apheresis. The Covid-19 Convalescent Plasma units obtained were distributed to 21 different cities throughout the country by air or ground transportation. Conclusion The implementation of a Covid-19 Convalescent Plasma program in a continental country with relatively scarce resources is feasible with alternative strategies to promote lower cost procedures, while complying with local regulations and meeting quality standards.

Lipoprotein apheresis efficacy and challenges: single center experience

Abstract Introduction Lipoprotein apheresis (LA) is an extracorporeal therapy which removes apolipoprotein B-containing particles from the circulation. We evaluated techniques and efficiency of lipoprotein apheresis procedures applied to patients with familial and non-familial hypercholesterolemia (FH) at our center. Methods We retrospectively evaluated 250 LA procedures applied to 27 patients with dyslipidemia between March 2011 and August 2019. Results A total of 27 patients, of whom 19 (70.4%) were male and 8 (29.6%), female, were included. Eighteen (66.7%), 6 (22.2%) and 3 (11.1%) patients were diagnosed with non-FH, homozygous FH (HoFH) and heterozygous FH (HeFH), respectively. Two different apheresis techniques, direct adsorption of lipoproteins (DALI) (48.8%) and double filtration plasmapheresis (DFPP) (51.2%), were used. The change in the serum total cholesterol (TC) level was the median 302 mg/dl (171-604 mg/dl) (60.4%) in HoFH patients, 305 mg/dl (194-393 mg/dl) (60.8%) in HeFH patients and 227 mg/dl (75-749 mg/dl) (65.3%) in non-FH patients. The change in the serum low-density lipoprotein (LDL) level was the median 275 mg/dl (109-519 mg/dl) (64.2%), 232 mg/dl (207-291 mg/dl) (64.5%) and 325 mg/dl (22-735 mg/dl) (70.9%) in patients with HoFH, HeFH and non-FH, respectively. A significantly effective reduction in serum lipid levels, including TC, LDL and triglycerides, was achieved in all patients, regardless of the technique, p< .001. The decrease in the serum TC and LDL levels was significantly higher in the DFPP, compared to the DALI, being 220 mg/dl (-300 to 771) vs 184 mg/dl (64-415), p< .001 and 196 mg/dl (11-712) vs 157 mg/dl (54-340), p< .001, respectively. Conclusions Our results showed that LA is a highly effective treatment in reducing serum lipid levels and safe, without any major adverse event.

Characteristics and countermeasures of blood donors with adverse reactions to apheresis platelet donation / 中国输血杂志

【Objective】 To compare and study the characteristics of blood donors with and without adverse reactions to apheresis platelet donation(ARAPD), and to study the influencing factors of blood donors participating in blood donation again, so as to provide basis for putting forward scientific and reasonable countermeasures and retaining blood donors to the greatest extent. 【Methods】 157 679 platelet donors from Tianjin Blood Center from December 26, 2015 to December 25, 2020 were selected and divided into ARAPD group(n=168) and non-ARAPD group (n=157 511). Such characteristics as sex, age, height, weight, blood type, educational background, first-time donation or not, platelet count, hematocrit, phlebotomy time, circulating blood volume and anticoagulant dosage of the two groups were analyzed. Chi-square test was used to identify the high-risk population with poor blood donation response. Multivariate binary logistic regression was used to study the influencing factors of blood donors returning. 【Results】 The age, height and weight of ARAPD group were lower than those of the non-ARAPD group, and the proportion of first-time blood donors, the proportion of women and phlebotomy time were higher than those of non-ARAPD group. There was little difference between the two groups in circulating blood volume, anticoagulant dosage, pre- and post-donation platelet count and hematocrit. Logistic regression analysis showed that the influencing factors of ARAPD were age, educational background, first-time donation or not and phlebotomy time, among which age and first-time donation or not were positively correlated, education and phlebotomy time were negatively correlated (P<0.05). 【Conclusion】 Female, low age, low height and weight, and less blood donation are the basic characteristics of high-risk people with ARAPD. Low age, high education, first-time blood donation and long phlebotomy time are the influencing factors that lead to donor lapsing. Therefore, countermeasures are put forward based on the above results.