ABSTRACT
The effects on platelet function of intermittent-flow centrifugation pheresis were measured employing platelets collected from ten donors by combined platelet-leukapheresis with hydroxyethyl starch (LP) and from ten by plateletpheresis (PP) by similar techniques except without starch. Greater numbers of platelets were produced by LP than by PP. Aggregation of platelets collected by both LP and PP was normal (did not differ from prepheresis baseline) to collagen and to 10(-5)M adenosine diphosphate (ADP). Slight impairment to aggregation with 2 X 10(-6)M ADP and 5.5 X 10(-5)M epinephrine occurred with both techniques. These abnormalities, however, were significantly less severe in platelets collected by LP. Platelet morphology by electron microscopy was nearly normal, although glycogen granules were absent in LP platelets. Thus, hydroxyethyl starch, at doses currently used during a single LP, does not enhance abnormalities of platelet aggregation over those expected to result from PP alone. Actually, LP platelets function better in vitro than those collected by PP. Large numbers of platelets can be harvested by LP, and their use as a component that is comparable to PP platelets may mean improved efficiency and reduced costs for pheresis centers.
Subject(s)
Blood Platelets/cytology , Cell Separation , Leukapheresis , Plateletpheresis , Adenosine Diphosphate/pharmacology , Blood Platelets/physiology , Blood Platelets/ultrastructure , Blood Transfusion , Centrifugation , Humans , Hydroxyethyl Starch Derivatives , Platelet Aggregation , Platelet Count , Platelet Transfusion , Time FactorsABSTRACT
Platelet dysfunction and prolonged bleeding have been seen in man when glucose polymer solutions, such as dextran, are used to volume replacement. Hydroxyethyl starch (HES) is a glucose polymer slightly different from dextran, which is used as a sedimenting agent in leukapheresis procedures. This controlled study was performed to evaluate the effect of HES on platelet function in centrifugation leukapheresis donors. Plateletpheresis using the same machines and techniques but without HES was the control. Platelet function was assessed by bleeding time, platelet count, adhesiveness to glass beads and aggregation to collagen, epinephrine and several concentrations of ADP, before and after the pheresis procedures. Except for a decrease in platelet count after both procedures, no other major changes in platelet function were seen. After one exposure in previously unpheresed donors, HES does not induce platelet dysfunction.
