Comparison of Blood Donor Reactions in Whole Blood Donations, Plasmapheresis and Plateletpheresis / 대한수혈학회지

BACKGROUND: Several kinds of adverse reactions can occur during blood donation such as vasovagal reaction (VVR), hematoma, citrate toxicity, etc. These adverse reactions are not common, but they are important because they cause a decrease in re-donation. The cost for maintaining a repeat donation is very low compared to that for securing first-time donors. Whole blood donation differs from apheresis in some aspects, and this could have an influence on blood donor reactions. We compared whole blood donation with apheresis for blood donor reactions. METHODS: From January to December in 2007 at Busan Red Cross Blood Center, 109,004 donations were investigated for blood donor reactions. 76,098 (69.8%) donations were from male donors and 32,906 (30.2%) were from females. 77,813 (71.3%) donations were for whole blood, 25,224 (23.2%) were for plasmapheresis and 5,967 (5.5%) were for plateletpheresis. RESULTS: The frequencies of VVR were 0.10% (75/77,813) for the whole blood donations, 0.15% (37/25,224) for plasmapheresis and 0.03% (2/5,967) for plateletpheresis (P<0.05). The frequency of hematoma was 0.05% (37/77,813) for whole blood donation, 0.25% (62/25,224) for plasmapheresis and 0.27% (16/5,967) for plateletpheresis (P<0.05). Citrate toxicity was extremely rare. VVR was most common in plasmapheresis, and it was rare in plateletpheresis. CONCLUSION: The kinds of donated blood components had an influence on blood donor reactions. Understanding these characteristics helps to prevent adverse reaction. Having people re-donate is essential for keeping a large sized donor pool. So, appropriate management to prevent donor reactions is very important.

Effect of Interrupted Agitation and Removal of Leukocyte on Platelet Quality during the Storage of Platelet Concentrates / 대한진단검사의학회지

BACKGROUND: This study aimed to analyze the influence of the interruption of agitation and removal of leukocytes on platelet concentrates (PCs), and determine the maximum amount of time the agitation could be interrupted without impairing PCs' effectiveness during the storage period. METHODS: Four ABO-identical random donor platelets agitated for 24 hr were pooled, and divided into 4 units, and 2 units of them were leukoreduced. Then 52 pooled units were categorized into 4 groups, non-leukoreduced continuous agitation (Non-LRCA), non-leukoreduced interrupted agitation (Non-LRIA), leukoreduced continuous agitation (LRCA), and leukoreduced interrupted agitation (LRIA), and preserved for 6 days (total 7 days). Mean platelet volume (MPV), pH, HCO3-, pO2, pCO2, CD62P, CD61, glucose, lactate, ammonia and free fatty acid were measured during the period. RESULTS: Starting from the Day 4, the pH and HCO3- of Non-LRIA group begun to decrease while the amount of lactate production, glucose consumption, and MPV increased compared to the Non- LRCA group (P<0.01). An increase in pO2 level was observed in the interrupted agitation groups as the storage period prolonged (P<0.01). The pH levels of all the units in the agitation groups remained higher than 6.4 up to Day 7, while those of the non-leukoreduction group did so only up to Day 2, but those of leukoreduction in the interrupted agitation groups did so up to Day 4. CONCLUSIONS: The interruption of agitation reduced the platelet's capacity to utilize oxygen, increasing lactate amount and reducing pH level. However, the in vitro parameters of the Non-LRIA and Non-LRCA groups on Day 2 were similar to each other and the pH level remained at 6.4 or higher, making one day of agitation interruption possible after 24 hr of agitation. With leukocytes removed, the effective agitation interruption period may become longer.

Platelet Activation of Stored Platelets with Storage / 대한수혈학회지

BACKGROUND: Effects of storage period on platelet activation of random-donor platelets (RDP) prepared from whole blood units and single-donor platelets (SDP) prepared from single-donor apheresis collections have been investigated in this study. We also analyzed the correlation between amount of blood cells and platelet activation in random-donor platelets. METHODS: RDP and SDP were collected at 1 day, 3 day, or 5 day during storage. In case of SDP, whole blood was also collected just before apheresis. The platelet activation in RDP and SDP was measured by flowcytometry using monoclonal antibodies against CD41a, CD61 and CD62p. RESULTS: In SDP, MCFI against CD62p has been significantly increased during storage and any significant differences are not found according to the kinds of pheresis machines. In RDP, no significant differences in MCFI against CD62p were found with storage period and showed a increased MCFI dependent only on the number of platelets. CONCLUSION: Single-donor platelets should be used as soon as possible for transfusion due to progressive platelet activation with storage period. On the other hand, a proper number of platelets should be maintained under strict quality control system to minimize platelet activation in RDP.

Factors Affecting pH Changes in Preserving Platelet Concentrates / 대한수혈학회지

BACKGROUND: The purpose of this study is to examine whether the blood cells in the platelet concentrate (PC) and the PC arrangement method can affect the pH which is one of the important factors influencing the survival and function of the preserved PCs. METHOD: Two groups of CPDA-1 added PC were preserved at 20 ~ 24degrees C for 7 days. The PCs in group I were overlapped one another while those in group II were not overlapped and arranged separately during the preservation period. The number of RBC, WBC and platelets were measured at the first day of the preservation period while the pH was measured at the 1st, 3rd, 5th and 7th day. RESULTS: The number of blood cells in the PC was 0.6x109 for WBC, 1.6x109 for RBC and 800x109 for platelet. As for the average pH, the 1st day's average pH was 7.4 for group I and 7.3 for group II, while at the 7th day, both decreased by 0.6. According to the correlation analysis between the blood cells and the pH changes, as for group I, the more the number of platelets were, the lower the pH decreased, and as for group II, the more the WBC and platelets were, the lower the pH decreased. (p<0.01) CONCLUSION: This study indicates that the major parameter affecting the pH of the preserved PCs is the number of platelets. In addition to platelet, the number of WBCs affected the pH when PCs were overlapped during storage. Conclusionally the key factor which affects pH of stored PCs was the number of platelets. And the number of contaminated WBCs also were thought to be an important factor.

Qualitative and Quantitative Measurements of Anti-HCV Positive Blood Donor Group / 대한수혈학회지

BACKGROUND: To determine the positivity of hepatitis C virus-ribonucleic acid (HCV-RNA), we tested blood specimens of donor both positive in enzyme immunoassay (EIA) and in immunoblot assay, and those positive in EIA but indeterminate in immunoblot assay by nucleic acid amplification test (NAT). After quantifying HCV-RNA of specimens positive in NAT, we compared the titers of HCV-RNA between blood donor group and patient group. METHOD: One hundred twenty blood specimens positive both in screening test and in confirmative test, and 20 specimens positive in screening test but indeterminate were tested by qualifying NAT. After testing the specimens positive in this test by quantifying NAT, we classified specimens into 3 groups, normal group whose ALT values were within 45 IU/L, abnormal group whose values were higher than 45 IU/L and patient group who admitted into hospital to treat chronic hepatitis C and then compared HCV-RNA among groups. RESULTS: 81% of specimens both positive in screening test and in confirmative test was positive in NAT. Only 10% of specimens positive in screening test but indeterminate in confirmative test was positive in NAT. Ages of patient group were highest among groups and titers of HCV-RNA of patient group were lower than any other group. Correlation of AST/ALT values with the titers of HCV-RNA was not shown. CONCLUSION: It is concluded that the study groups show no difference of HCV-RNA titers whether they have symptoms of liver disease or not. The titer of HCV-RNA has no correlation with AST/ALT values.