Effect of double dose plateletpheresis on target yield and donor platelet recovery

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.

Predicting donor-related factors for high platelet yield donations by classification and regression tree analysis

Introduction Collecting high-dose (HD) or double-dose (DD) apheresis platelets units from a single collection offers significant benefit by improving inventory logistics and minimizing the cost per unit produced. Platelet collection yield by apheresis is primarily influenced by donor factors, but the cell separator used also affects the collection yield. Objectives To predict the cutoff in donor factors resulting in HD and DD platelet collections between Trima/Spectra Optia and MCS+ apheresis equipment using Classification and Regression Trees (CART) analysis. Methods High platelet yield collections (target ≥ 4.5 × 1011 platelets) using MCS+, Trima Accel and Spectra Optia were included. Endpoints were ≥ 6 × 1011 platelets for DD and ≥ 4.5 to < 6 × 1011 for HD collections. The CART, a tree building technique, was used to predict the donor factors resulting in high-yield platelet collections in Trima/Spectra Optia and MCS+ equipment by R programming. Results Out of 1,102 donations, the DDs represented 60% and the HDs, 31%. The Trima/Spectra Optia predicted higher success rates when the donor platelet count was set at ≥ 205 × 103/µl and ≥ 237 × 103/µl for HD and DD collections. The MCS+ predicted better success when the donor platelet count was ≥ 286 × 103/µl for HD and ≥ 384 × 103/µl for DD collections. Increased donor weight helped counter the effects of lower donor platelet counts only for HD collections in both the equipment. Conclusions The donor platelet count and weight formed the strongest criteria for predicting high platelet yield donations. Success rates for collecting DD and HD products were higher in the Trima/Spectra Optia, as they require lower donor platelet count and body weight than the MCS+.

Evaluación de la eficacia en la colecta de plaquetas por un separador celular / Evaluation of the efficacy in the collection of platelets by a cell separator / Avaliação da eficiência da coleta de plaquetas por um separador de células separador de células

La aféresis es el procedimiento más utilizado para la obtención de concentrados plaquetarios de alto rendimiento, calidad y para mejorar las terapias transfusionales en pacientes trombocitopénicos, oncohematológicos,cirugias e incluso, en pacientes con factores clínicos adversos a la refractariedad. Objetivo. Determinar la eficacia de un separador celular en la colecta de plaquetas en un Instituto Nacional de Salud de Lima. Material y métodos. Estudio descriptivo; la muestra fue de 80 concentrados plaquetarios, obtenidos por plaquetoaferesis y utilizando el equipo de separador celular americano. La colecta de plaquetas se realizó en un servicio de Hemoterapia y Banco de Sangre de una institución de salud de Lima, durante los meses de febrero a julio de 2018. La eficacia se realizó evaluando el rendimiento, la eficiencia y el cumplimiento de estándares de calidad aprobados. Uno de los parámetros utilizados fue el recuento de plaquetas y leucocitos residuales, procesados en el analizador hematológico. Resultados. Las evaluaciones fueron: concentración promedio de plaquetas por concentrado plaquetario (rendimiento)= 3,4 x 1011 plaquetas /ml, recuento de leucocitos residuales = 0,07 x 10 6 leucocitos/ml, volumen promedio de sangre procesado = 2480 ml, volumen final promedio = 217,5 ml, eficiencia en la colecta = 56,9 a 63,9 %, el tiempo medio por procedimiento de colecta = 72 minutos. Conclusiones. Los concentrados plaquetarios obtenidos con el procedimiento de plaquetoaferesis cumplen con los estándares de calidad nacional e internacionales, por lo que, se concluye que este procedimiento es eficaz en la colecta de productos de alta calidad que logran la eficacia en la transfusión.

Apheresis is the most widely used procedure to obtain high yield and quality platelet concentrates and to improve transfusion therapies in thrombocytopenic patients, oncohematological patients, surgical patients and even patients with adverse clinical factors to refractoriness. Objective. To determine the efficacy of a cell separator in the collection of platelets in a National Health Institute in Lima. Material and methods. Descriptive study; the sample consisted of 80 platelet concentrates, obtained by plateletpheresis and using American cell separator equipment. The platelet collection was performed in a Hemotherapy and Blood Bank service of a health institution in Lima, during the months of February to July 2018. Effectiveness was performed by evaluating performance, efficiency and compliance with approved quality standards. One of the parameters used was the residual platelet and leukocyte count, processed in the hematological analyzer. Results. The evaluations were: average platelet concentration per platelet concentrate (yield)= 3.4 x 1011 platelets/ml, residual leukocyte count = 0.07 x 10 6 leukocytes/ml, average volume of blood processed = 2480 ml, average final volume = 217.5 ml, collection efficiency = 56.9 to 63.9 %, average time per collection procedure = 72 minutes. Conclusions. The platelet concentrates obtained with the plateletpheresis procedure comply with national and international quality standards, therefore, it is concluded that this procedure is effective in the collection of high quality products that achieve transfusion efficiency.

A aférese é o procedimento mais utilizado para obter concentrados plaquetários de alto rendimento e alta qualidade e para melhorar as terapias transfusionais em pacientes trombocitopênicos, oncohematológicos, cirúrgicos e até mesmo pacientes com fatores clínicos adversos à refratariedade. Objetivo. Para determinar a eficácia de um separador de células na coleta de plaquetas em um Instituto Nacional de Saúde em Lima. Material e métodos. Estudo descritivo; a amostra consistiu de 80 concentrados de plaquetas, obtidos por plaquetaferese e utilizando equipamento separador de células americano. A coleta de plaquetas foi realizada em um serviço de Hemoterapia e Banco de Sangue de uma instituição de saúde em Lima, durante os meses de fevereiro a julho de 2018. A eficácia foi avaliada através da avaliação do desempenho, eficiência e conformidade com os padrões de qualidade aprovados. Um dos parâmetros utilizados foi a contagem residual de plaquetas e leucócitos, processada no analisador hematológico. Resultados. As avaliações foram: concentração média de plaquetas por concentrado de plaquetas (rendimento) = 3,4 x 1011 plaquetas/ml, contagem de leucócitos residuais = 0,07 x 10 6 leucócitos/ml, volume médio de sangue processado = 2480 ml, volume final médio = 217,5 ml, eficiência da coleta = 56,9 a 63,9%, tempo médio por procedimento de coleta = 72 minutos. Conclusões. Os concentrados de plaquetas obtidos com o procedimento de plaquetférese atendem aos padrões de qualidade nacionais e internacionais, portanto, conclui-se que este procedimento é eficaz na coleta de produtos de alta qualidade que alcançam eficiência transfusional.

Melhores práticas no cuidado durante a doação de plaquetas por aférese: protocolo de revisão de escopo / Best care practices during apheresis platelet donation: a scoping review protocol / Mejores prácticas de atención durante la donación de plaquetas por aféresis: un protocolo de scoping review

OBJETIVO: mapear, na literatura científica, as melhores práticas na gestão do cuidado, durante o processo de doação de plaquetas por aférese. MÉTODO: esta revisão de escopo seguirá a metodologia proposta pelo Joanna Briggs, sendo norteada pela questão de pesquisa: Quais as melhores práticas na gestão do cuidado durante o processo de doação de plaquetas por aférese? Serão considerados artigos originais, independente do desenho do estudo; em português, inglês, francês e espanhol; entre os anos 2017 e 2021; que forneçam texto completo. Como critérios de exclusão: estudos relacionados à terapêutica de aférese plaquetária ou pesquisas que envolvam animais. Após seleção dos descritores, será realizada busca prévia nas bases MEDLINE, via PubMed, e CINAHL. Os dados selecionados para revisão serão exibidos no fluxograma PRISMA para revisões de escopo.

OBJECTIVE: to map, in the scientific literature, the best care practices during platelet donation by apheresis. METHOD: this scoping review will follow the Joanna Briggs Institute's framework, guided by the research question: What are the best care practices during platelet donation by apheresis? Original articles will be considered, regardless of the study design, in Portuguese, English, French, and Spanish, published from 2017 to 2021, with full text available. As exclusion criteria: studies related to platelet apheresis therapy or animal research. After selecting the descriptors, a previous search will be conducted in MEDLINE via PubMed and CINAHL. Studies selected for review will be displayed in the PRISMA flowchart for scoping reviews.

La Donación de Sangre / Blood donation

La donación de sangre es un procedimiento muy común en medicina, por eso tiene relevancia el estudio de las complicaciones frecuentes en los donantes y en especial las asociadas con la ferropenia. El procedimiento reporta beneficios tanto por la utilidad futura del producto como por los efectos favorables para la salud del donante; sin embargo, se han descrito complicaciones recurrentes derivadas tanto de la extracción de sangre total como de sus componentes por separado. En este artículo de revisión se encuentra la información relacionada con los factores de riesgo asociados con esta práctica y las principales complicaciones que pueden aparecer como es la depleción de hierro, con el fin de ilustrar al lector sobre los factores predisponentes en donantes iniciales y habituales. Se concluye que las reacciones más frecuentes son las vasovagales y algunas otras que pueden conllevar a síntomas indeseados, pero es la disminución de los niveles de hierro una de las complicaciones más alarmantes. Hay evidencia de factores como sexo, edad, nivel socioeconómico, dieta y tipo de sangre que favorecen la probabilidad de desarrollar complicaciones por deficiencia de hierro en los donantes.

Blood donation is a very common medical procedure, thus, it is important to review the most frequent complications indonors, especially blood-donation-induced iron deficiency. The procedure is beneficial both for the future usefulness of blood and blood products as well as the favorable health effects for the donors; however, recurrent complications derived from the collection of whole blood and blood components separately, have been described. This review article contains information related to the risk factors associated with this practice and the main complications that may appear, such as iron depletion, in order to enlighten the reader on the predisposing factors among first-time and repeat donors. It was concluded that vasovagal reactions are the most frequent reactions as well as other reactions that can lead to unwanted symptoms, but the decrease in iron levels is one of the most alarming complications. Sex, age, socioeconomic level, diet and blood type have been evidenced as factors that favor the probability of developing complications due to iron deficiency in donors.

Hallazgos hematológicos en donantes preseleccionados a plaquetoferesis sanguínea en un hospital de Lima, 2019 / Hematological findings in preselected donors to blood plateletpheresis in a Lima hospital, 2019

Objetivo: Describir los hallazgos hematológicos en donantes preseleccionados a plaquetoferesis sanguínea en el Hospital Nacional Edgardo Rebagliati Martins (HNERM) de Lima, Perú. Materiales y métodos: Estudio de tipo observacional, descriptivo y transversal, realizado entre Mayo-Julio 2019. Se incluyeron hemogramas de donantes que resultaron ̈Aptos ̈ a la entrevista médica, con resultado ̈Negativo ̈ a marcadores serológicos y que fueron diferidos en donar por presentar alteración hematológica. Los datos fueron recolectados del sistema informático del servicio de medicina transfusional del HNERM. Se utilizó estadística descriptiva y analítica (U de Mann Whitney y Chi-cuadrado de Pearson) considerándose un valor p<0,05 como significativo. Resultados: Se analizaron los hemogramas de 330 donantes preseleccionados diferidos, entre los cuales el recuento absoluto de eosinófilos (14,2%), el hematocrito (14,2%) y el recuento de plaquetas (33,9%) fueron las de mayor presencia. Asimismo, en las observaciones la fórmula leucocitaria invertida (20,6%) fue la más frecuente. Además, se observó diferencia estadística significativa (p<0,05) entre la hemoglobina, el hematocrito, la hemoglobina corpuscular media (HCM) y la fórmula leucocitaria invertida de acuerdo al sexo del donante. Conclusiones: La alteración hematológica observada más frecuentemente en esta población fue la plaquetopenia. Además, algunos parámetros de la serie roja y la distribución leucocitaria en el hemograma estuvieron asociados con el género del donante. (AU)

Objective: To describe the hematological findings in preselected donors to blood plateletpheresis at the Edgardo Rebagliati Martins National Hospital (HNERM) in Lima, Peru. Materials and methods: Observational, descriptive and cross-sectional study, carried out between May-July 2019. Blood counts were included from donors that were ̈Approved ̈ to the medical interview, with a ̈Negative ̈ result for serological markers and that were deferred in donating for present hematological alteration. The data was collected from the computer system of the HNERM transfusion medicine service. Descriptive and analytical statistics (Mann Whitney's U and Pearsonʼs Chi-square) were used, considering a p<0.05 as significant. Results: The blood counts of 330 delayed preselected donors were analyzed, among which the absolute eosinophil count (14.2%), the hematocrit (14.2%) and the platelet count (33.9%) were those with the highest presence. Likewise, in observations, the inverted white blood cell formula (20.6%) was the most frequent. In addition, a statistically significant difference (p<0.05) was observed between hemoglobin, hematocrit, mean corpuscular hemoglobin (MCH) and the inverted leukocyte formula according to the sex of the donor. Conclusions: The hematological alteration most frequently observed in this population was plateletpenia. In addition, some parameters of the red series and the leukocyte distribution on the blood count were associated with the gender of the donor. (AU)

Analysis of Iron Stores in the Plateletpheresis Donors / 中国实验血液学杂志

OBJECTIVE@#To understand the iron stores of the plateletpheresis donors, so as to provide some new experimental data for further exploration and more perfect health examination criteria of the plateletpheresis donors.@*METHODS@#A total of 297 plateletheresis donors conformed to standard in October 2018 were selected by the cross sectional study. The related factors affecting iron stores were analyzed; the effect of plateletpheresis times of donation on the levels of the hemoglobin(Hb) and serum ferritin(SF) as well as the iron deficency rate in the blood donors was also analyzed; the iron stores in the blood donors was evaluated.@*RESULTS@#The SF level in plateletpheresis donors negatively correlated with annual plateletphersis times of donation（r=-0.416, P＜0.001）; The SF level decreased with the increase of annual times of donation（P＜0.05）; The iron deficiency rate in plateletpheresis donors showed the increase trend with the increase of annual times of donation. The iron deficiency rate in male and femal with 18-23 times of donation was 12.5%(8/64) and 40%(6/15) respectively.@*CONCLUSION@#The blood center should reduce recruitment frequency and increase the testing of SF for regularly plateletpheresis donors.

Size Estimation of HLA -Ⅰ class Typed Platelet Apheresis Donor Bank / 中国实验血液学杂志

OBJECTIVE@#To estimate the size of HLA -Ⅰ class typed platelet apheresis donor bank.@*METHODS@#A total of 16062 blood samples from Chinese Han voluntary unrelated marrow donors in Jiangsu were included in this study. Luminex-SSO was used to detect the HLA -Ⅰ class(A,B locus) antigens. The probability of finding at least one HLA matched unrelated donor was calculated based on the HLA -I class phenotype frequency.@*RESULTS@#The population genetic data of HLA -Ⅰ class in Jiangsu were obtained, the optinal bans size in HLA typed apheresis plateler donor registry databane hrad been estimated by evaluating the population genetic data of HLA-1 class same donor.@*CONCLUSION@#The establishment of HLA-1 class typed apheresis platelet donor bank with a total size of 1500 persons is acceptable, which can satisty the patients with phenotype freguency>0.002 to find at least 1 phenotype same donor in 95% probavility.

Discharge and Contents of Exosome from Leukocyte-Reduced Apheresis Platelet Stored for Different Storage Time / 中国实验血液学杂志

OBJECTIVE@#To explore the effect of storage time on discharge and content of exosome from leukocyte-reduced apheresis platelets (LRA-Plt).@*METHODS@#Exosome (EXO) from LRA-Plt were acquired by ExoQuick, and its' morphology, immunological marker and particle size distribution were detected by transmission electron microscopy (TEM), Western blotting and dynamic light scattering (DLS), respectively. The changes in particle size distribution of EXO from LRA-Plt with different storage time were detected by DLS. The changes in content of protein and RNA of EXO from LRA-Plt with different storage time were detected by Nanodrop® ND-2000.@*RESULTS@#EXO from LRA-Plt was acquired successfully, which was characterized by cup-like shape, CD63/TSG101 enriched and Calnexin negative, and the particle size of which ranged from 30 to 200 nm. At early stored stage (stored for 1 day and 2 days), particle size of EXO from LRA-Plt was small and ranges from 30 to 40 nm. Meanwhile, the contents of protein and RNA were low. The particle size distribution, contents of protein and RNA of EXO from LRA-Plt were not significanty different ammg groups (P＞0.05). At middle-late stored stage (stored for 3, 4 and 5 days), the particle size of EXO from LRA-Plt was larger than that of early stored stage, which ranges was from 130 to 200 nm. Meanwhile, the contents of protein and RNA were higher than those of early stored stage. Particle size distribution, contents of protein and RNA of EXO from LRA-Plt stored for middle-late stage were significant higher than those of early stored stage (P＜0.05).@*CONCLUSION@#Morphology of EXO from LRA-Plt stored for middle-late stage was different from that stored for early stored stage. Moreover, the particle size distribution, contents of protein and RNA of EXO from LRA-Plt stored for middle-late stage were higher than those of early stored stage. A large amount of protein and RNA contained in EXO from LRA-Plt may participate in the multiple functions caused by platelet transfusion.

Effect of Highvolume Platelet Reduction Therapy on White Blood Cell Count and Hemoglobin Level in Patients with Thrombocytosis / 中国实验血液学杂志

OBJECTIVE@#To explore the effect of high volume platelet reduction therapy on the white blood cell (WBC) count and hemoglobin (Hb) level in patients with thrombocytosis.@*METHODS@#Thirty-two plateletphoreses were performed for patients with thromocytosis by using ELP or MNC program of blood component isolator of COBE spectra continuous flow concentrifugation and the ACD-A preservation solution for blood as blood anticoagulant. In each treatment of patients, 2.5-3.0 tines total blood volume (TBV) were circulated, then the platelet suspension of 1/5-1/4 time TBV was prepared and collected.@*RESULTS@#A single plateletpheresis took (212.53±41.54) minutes in which (8 812.63±2087.15) ml blood were treated, and (798.84±190.77) ml platelet suspension was collected. In the suspension, the platelet count was 4 486.50 (3 058.50-5 279.50)×10/L, containing 3 455.50 (2 288.68-4 226.71)×10. WBC count was 13.79 (10.21-20.72)×10/L, containing 11.90(7.81-14.40)×10. Hemoglobin concentration was (3.28±1.25) g/L，containing (2.62 ± 1.17) g. Before and after plateletpheresis, the patients' platelet count was 1 263.00 (1 052.50-1 807.50)×10/L and (778.83±247.25)×10/L（Z=4.94, P＜0.01), WBC count was 9.96(6.44-14.01)×10/L and 8.59(5.37, 13.12)×10/L (Z=13.31, P＜0.05), Hemoglobin concentration was (112.63 ± 24.56)g/L and (109.55 ± 24.46)g/L (t=1.68，P＞0.05).@*CONCLUSION@#Using continuous flow centrifugation and blood component separating in plateletpheresis for the patients with thrombocytosis can obviously decrease the high ratio of platelets, and improve the effect of plateletpheresis. The high volume platelet reduction therapy can lead to decrease of WBC count to some alent, degree but WBC count still in the normal range, moreover not affect the hemoglobin level significantly.

Key Preparation Technique and Clinical Application of Frozen Platelets / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the key technique for preparation of the frozen platelet and efficacy of its clinical application.</p><p><b>METHODS</b>The influences of the donators' peripheral platelet count, starting time of freeze, injection rate and evenness of the freeze-protective agent, storage mode, re-melting temperature and the capacity of water-bath etc. on the quality of the frozen platelets were analyzed retrospectively in 3 257 samples of frozen platelets before platelet pheresis. Then, the platelet counts were examined in 150 cases transfused with frozen platelets at the time-points of 1, 24, 48 and 72 hrs after transfusion, 90 cases suffered from the obstetrical bleeding were transfused with 200 parts of the re-melting frozen platelets, and then the peripheral blood platelet count, platelet increasing index(CCI), bleeding time and blood clot retraction rate etc. were observed for determining the clinical efficiency of the frozen platelets.</p><p><b>RESULTS</b>The floccule in the re-melting frozen platelets from the donators with (175-250)×10(9)/L platelets were decreased significantly(P<0.01). The quality of frozen platelets was influenced by the following factors, such as injection of DMSO at a too fast and heterogeneous rate, blood bags stored in a multilamminar space, and re-melting in a water-bath of small capacity etc. The routine storage for 0 and 3 days did not influence the quality of the frozen platelets. The recovery rate of one year-freezing platelets all was higher than 80%. The effects of the frozen platelets transfused into the patients with obstetrical bleeding displayed good haemostatic results, and the blood transfusion reaction did not occur. However, the frozen platelets immediately were exhausted and displayed their function, but the counting after 48 hrs could not display a good effect of raising platelet number.</p><p><b>CONCLUSIONS</b>The peripheral platelet count before platelet pheresis, the injection rate and evenness of the protective agent, the number of stratum for blood bags and the capacity of re-melting water-bath etc. all are the key factors influencing the quality of the frozen platelets. The frozen platelets prepared in this study shows a good efficacy of clinical application.</p>

Polymorphism of Platelet Specific Antigens (HPA-1-5, 15) in Han Donors in the North Area of Henan Province / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To study the gene polymorphism distribution characteristics of human platelet HPA-1-5 and 15 blood group antigens and construct a certain scale of platelet HPA database in the north area of Henan Province so as to provide platelet apheresis for clinical departments.</p><p><b>METHODS</b>Using polymerase chain reaction with sequence-specific primers (PCR-SSP), the genotyping of HPA-1-5 and 15 system was carried out; the periperal blood of 500 healthy Han donors in north area of Henan Province was collected randomly, the gene and genotype frequencies were detected by direct counting method, and the population distribution frequncy of HPA genes was analyzed by Hardy-Weinberg balance test, and compared with other regions and ethnics by using χ(2) test.</p><p><b>RESULTS</b>There was statistically significant (P < 0.05) of increase HPA-3b and HPA-5a in North area of Henan Province, compared with Chinese Han population; the HPA-3b and 5a increase and HPA-2a decrease were statistically significant (P < 0.05), compared with Ethnic minority of China. There was partly increase of HPA-1a, 2a, 3a and 5a, compared with different regions and ethnic in abroad. HPA allele genes of 500 Han donors in the North area of Henan Province were as follows: 0.985 and 0.015 for 1a and 1b; 0.924 and 0.076 for 2a and 2b; 0.469 and 0.531 for 3a and 3b; 1.000 and 1.000 for 4a and 5a; 0.532 and 0.468 for 15a and 15b, respectively. HPA allele gene frequencies were 1aa0.970, 1ab0.030; 2aa0.848, 2ab0.152; 3aa0.222, 3ab0.494, 3bb0.284; 4aa1.000; 5aa1.000; 15aa0.282, 15ab0.500, 15bb0.218. Compared with other regions and ethnic, HPA gene frequencies partly had statistical significance.</p><p><b>CONCLUSION</b>Distribution of HPA allele frequencies in the North area of Henan province is in accordence with the Hardy-Weinberg law. There are race and regional differences in HPA allele gene frequencies, compared with other regions and countries. And the HPA systems HPA-3 and 15 display the genetic polymorphisms, which provides a theoretical basis for the relevant research of the same type platelet infusion and alloimmune thrombocytopenia.</p>

Analysis of the Physiological Activities and Functions in Vitro of Apheresis Platelets during Storage / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the changes of physiological activities and functions in vitro of apheresis platelets during storage.</p><p><b>METHOD</b>17 units of apheresis platelets were randomly chosen and stored at 20 °C to 24 °C with agitation. Platelet counting (Plt), mean platelet volume (MPV), blood gases, pH value, glucose (Glu) concentration, lactate (LA) concentration, LDH concentration, thromboelastogram (TEG), hypotonic shock response (HSR), CD62p expression rate and anew expression rate were measured on days 0, 1, 3, 5 after platelet storage. Changes of physiological activities and functions in vitro were systematically evaluated by above-mentioned indexes.</p><p><b>RESULTS</b>During storage, Plt, MPV and HSR were not significantly changed; but pH value, blood gases, Glu, LA, LDH, HSR, expression rate of CD62p and anew expression rate were significant differenty. Among thromboelastogram indexes, R value increased obviously with prolongation of storage time; K value and αAngle were not significantly changed; MA was not significantly changed on day 1 and 3, but was slightly increase on day 5.</p><p><b>CONCLUSION</b>The physiological activities and functions in vitro of apheresis platelets are kept well during storage. For clinical transfusion of apheresis platelet during storage, clinical effect of transfusione is not influenced.</p>

Assessment of Serum Ferritin Levels in Plateletpheresis Donors / 대한수혈학회지

BACKGROUND: While plateletpheresis donation results in less red blood cell loss and therefore less depletion of storage iron, repeated plateletpheresis can also lead to iron depletion. To determine the safety of regular plateletpheresis donations, this study estimated donor's iron status according to age, gender, number of donations, and donation interval. METHODS: The study population included 5,109 plateletpheresis donors (4,824 males, 285 females), who passed the hemoglobin (Hb) criteria for plateletpheresis donation of 12.0 g/dL or more in an inclusion period (September 2013~November 2013). During donor screening, serum ferritin levels were measured for assessment of iron status of plateletpheresis donors. RESULTS: Mean age of donors was 30.4 years (range: 17~59). Donors with a history of donation of more than 3 years accounted for 89.3% and 74.0% in males and females, respectively. Mean donation interval and annual donation number in male (female) donors was 11.9 (7.2) weeks and 4.2 (8.7) times, respectively. Approximately 37.8% of male donors and 64.2% of female donors had a serum ferritin level of less than 15 ng/mL. Serum ferritin levels showed correlation with donation interval, as the percentage of donors with a low ferritin level decreased with increase in donation interval (rho: 0.191~0.438, P<0.001). Serum ferritin levels also showed correlation with annual plateletpheresis number (rho: -0.261~-0.411, P<0.001). CONCLUSION: Depleted iron store was observed in nearly 40% of donors who had acceptable Hb levels for plateletpheresis donation. Hb pre-donation screening is not sufficient to reduce the risk of iron deficiency in regular plateletpheresis donors.

Korean Red Cross HLA-Matched Platelet Donor Registry / 대한수혈학회지

BACKGROUND: Transfusion of HLA-matched platelets is required when development of platelet refractoriness occurs after repeated platelet transfusion. This study was conducted to establish a HLA-matched platelet donor registry to supply matched platelets to patients who develop platelet refractoriness. METHODS: HLA-matched platelet donors were recruited among plateletpheresis donors. HLA-A and HLA-B antigen types of recruited donors were tested using a polymerase chain reaction-sequence specific oligonucleotide probe method. RESULTS: A total of 1,029 plateletpheresis donors were recruited. HLA-A and HLA-B antigen frequencies of recruited donors were similar to those of previously reported HLA antigen frequencies of Koreans. During the study period, a patient with platelet refractoriness recovered after receiving six units of HLA-matched platelets. CONCLUSION: During this study 1,029 donors were registered as HLA-matched platelet donors and a patient with platelet refractoriness received HLA-matched platelets using this registry. Supply of HLA-matched platelets will be facilitated by continuous expansion of the number of registered HLA-matched platelet donors, development of a program for management and searching for HLA-matched donors, and establishment of a request-supply system between hospitals and the Korean Red Cross through further studies.

Risk factors associated with the occurrence of adverse events in plateletpheresis donation

OBJECTIVE: To recognize the profile of platelet donors and the profile of the plateletpheresis session as well as to investigate the main adverse events of platelet donation using plateletpheresis and associated risk factors. METHODS: This retrospective, cross-sectional and analytical study was performed with a quantitative approach by analyzing 316 donation files from February 2010 to December 2011. The IBM SPSS Statistics program was used for data processing and analysis. The chi-square test was used to verify whether there was an association between factors related to the procedure and the donor, and the adverse events that occurred. RESULTS: The mean age of platelet donors was 40 years old (standard deviation = 8.9), with the prevalent age group being between 40 and 49 years old; the prevalent blood type was O positive (53.8%), the mean duration of the procedure was 73 min and the mean amount of anticoagulant used was 360 mL. The association between procedure duration and the volume of anticoagulant was inverse and statistically significant; the longer the procedure and the greater the volume of anticoagulant used, the less adverse reactions occurred. CONCLUSION: The low incidence of adverse events indicates that the procedure is well tolerated by donors. Obtaining data regarding the incidence of adverse events is a way of promoting a dynamic review of medical and nursing teams to improve the safety and comfort of the donor. .

Qualitative analysis of platelet rich plasma prepared by acute plateletpheresis in patients undergoing heart surgery / 中国实验血液学杂志

This study was aimed to evaluate the efficiency and effectiveness of platelet-rich plasma(PRP) prepared by acute plateletpheresis in patients undergoing open heart surgery, and to analyze the quality of prepared platelet-rich plasma. Whole blood from 20 patients with ASAII-III was collected and PRP was harvested by machine after induction of anesthesia. Platelet count (Plt), mean platelet volume (MPV), platelet distribution width (PDW), plasma pH, plasma lactic acid (LA) concentration, and lactic dehydrogenase (LDH) concentration, germiculture result, CD62p and PAC-1 positive rate of inactivated and activated platelets by ADP in the whole blood before plateletpheresis (T1) , in the PRP after plateletpheresis (T2) and PRP before back-transfusion (T3) were determinated. The results showed that as compared with whole blood the platelet count in the PRP at T2 was (783 ± 184) ×10(9)/L, MPV, PDW and pH significantly decreased (P < 0.01) , while the plasma LDH, LA concentration, CD62p and PAC-1 positive rate of inactivated platelets were not significantly different from the whole blood at T1. In the PRP at T3, the platelet count, MPV, PDW and pH significantly decreased (P < 0.01) , while plasma LDH concentration, CD62p and PAC-1 positive rate of inactivated platelet significantly increased (P < 0.05 or P < 0.01) compared with the whole blood at T1. There were no significant difference among the CD62p and PAC-1 positive rate of activated platelets in the whole blood and PRP. It is concluded that PRP can be efficiently obtained from the patients undergoing open heart surgery by acute plateletpheresis, and the platelets in PRP are not activated during the preparing process. Some platelets in PRP are activated during the preserving process, but the whole activating function of platelets keeps normal.

Concentrados de plaquetas obtenidos a partir de sangre entera vs por aféresis / Platelet concentrates: random vs apheresis

En la actualidad disponemos de tres tipos de concentrados de plaquetas (CP): CP procesados por el método de plasma rico en plaquetas (CP-PRP) o por el método de capa leucocitaria "buffycoat" (CP-BC) a partir de unidades de sangre entera donadas al azar (CPR) y CP obtenido por aféresis (CP-aféresis). La calidad y caracerísticas de las plaquetas durante el almacenamiento se afectan por una serie de factores, tales como el anticoagulante, la centrifugación y procesamiento después de la colecta, y el agrupamiento antes o después del almacenamiento. Por último, el uso de cada uno de estos componentes ya sean originales, o leucorreducidos, o suspendidos en solución de almacenamiento, o procesados con una técnica de inactivacion de patógenos agrega nuevos factores de complejidad para compararlos. Aunque está claro que el CP-BC retiene mucho más funciones in vitro que el CP-PRP, lo que indica que no se debería utilizar más este último, es mucho más difícil encontrar diferencias con los CP-aféresis. Otro factor que puede afectar la decisión política es la aparición de reacciones adversas en los receptores. Si se consideran solamente los datos comparables, por ejemplo CPR leucorreducida en comparación con CP-aféresis leucorreducida, hay pruebas de que este último está más asociado con reacciones adversas en los receptores. Muy pocos estudios se han publicado comparando la eficacia clínica de los CPR frente a CP-aféresis, considerando como resultado final principalmente el incremento del recuento corregido de plaquetas (IRC). De manera similar a los estudios in vitro, aunque el CP-PRP muestra IRC más bajos, no existe una diferencia clara entre CP-BC y CP-aféresis. Otros aspectos que pueden afectar la decisión es el hecho de que el uso de CP-aféresis en lugar de CPR reduce la exposición total de los pacientes a los donantes, lo cual se considera crítico en algunos países para reducir el riesgo de transmisión de infecciones transmisibles por la sangre...

Serum ferritin in donors with regular plateletpheresis / 中国实验血液学杂志

This study was aimed to evaluate the impact of regular donating platelets on serum ferritin (SF) of donors. A total of 93 male blood donors including 24 initial plateletpheresis donors and 69 regular plateletpheresis donors were selected randomly. Their SF level was measured by ELISA. The results showed that the SF level of initial plateletpheresis donors and regular plateletpheresis donors were 91.08 ± 23.38 µg/L and 57.16 ± 35.48 µg/L respectively, and all were in normal levels, but there was significant difference between the 2 groups (p < 0.05). The SF level decreased when the donation frequency increased, there were no significant differences between the groups with different donation frequency. Correlation with lifetime donations of platelets was not found. It is concluded that regular plateletpheresis donors may have lower SF level.