Plasma lipemia: When the blood donor becomes a patient.

Lipemic plasma donations are not a strange phenomenon to blood bankers. According to quality standards for plasma fractionation, lipemic plasma donations must be discarded. Beyond quality control and inventory aspects, plasma lipemia is also an important risk factor for cardiovascular diseases, acute pancreatitis and is associated with overall mortality, however little attention is given to the management of these donors in the literature. A retrospective analysis of every whole blood donation that yielded lipemic plasma between January 1st 2018 and December 31st 2019 was made. The medical examination and donor history for the respective donation was reviewed and the available data was collected regarding hour of donation, gender, age, drugs and coexisting pathologies. Whether the donor was called back for a follow up evaluation regarding the lipemic plasma was also noted. Our blood center received 18274 whole blood donations of which 115 (0,63 %) were reported as having plasma lipemia, in the period of this study. Of these 115 donors, 103 (89,57 %) were male. The average age was 47,63 ± 10,65 years. A clear peak in lipemic plasma donations 4 hours after the classic lunch hours is visible. For 88,70 % of the donors, this was the first time their hypertriglyceridemia was identified. The nonfasting elevation of plasma triglycerides in these donors represents a true metabolic derangement. This is a golden opportunity for early intervention and follow up evaluation is indicated. More attention must be given during the medical evaluation to properly identify donors at risk of lipemic donations.

Topic platelet gel application in chronic diabetic foot ulcers.

In this observational study performed during 45 months we evaluated patients with chronic and recalcitrant diabetic ulcers who were treated with homologous platelet gel. METHODS: platelet gels were obtained from homologous platelet concentrates that were aliquoted and freezed, being then activated with calcium gluconate and applied in the ulcer after cleaning and debridement. We evaluated patient's comorbidities, wound characteristics (size, tissue, inflammatory signs, pain), number and time of treatment as well as outcome (classified as complete epithelialization; partial improvement- 50% reduction in wound size or pain relief; no evolution). RESULTS: Fifty-two patients (42 males, 10 females), with a median age of 65 years (range 43-85) were proposed for platelet gel. The following associated comorbidities were observed: hypertension (n = 41), dyslipidemia (n = 29), polyneuropathy (n = 30), peripheral arteriopathy (n = 32), retinopathy (n = 21), nephropathy (n = 15), cardiac ischemic disease (n = 14), obesity (n = 9). Thirty-eight patients presented with 3 or more associated comorbidities. The more frequent ulcer locations were sole of the foot (n = 13) and heel (n = 10). The median number of applications was 16, during 8.5 weeks. Nineteen patients (44%) achieved complete healing, 3 patients (7%) had a partial response and 21 (49%) had no progression. We did not observe a statistically significant relationship between patient age and response nor between number of comorbidities and response. We observed a more favorable evolution in patients with good compliance and good glycemic control. CONCLUSION: Platelet gel is an effective therapeutic alternative, provided compliance and effective metabolic control are ensured.