Improved red cell quality after erythroplasmapheresis with MCS-3P.

The cell separator MCS-3P is an apheresis system offering the flexibility to collect standardized red blood cells, plasma, and/or platelets from one donor. Two different programs were used for the red cell apheresis--RBCP (collection of one unit of red cells and two units of plasma) and RBCPS (one unit of red cells and one unit of plasma). The quality of the red cell concentrates (RCC resuspended in SAG-Mannitol) during the storage time of 42 days was measured by biochemical (ATP, 2,3-DPG, pH, free Hb, free potassium, glucose, lactose, p50, hemoglobin derivatives) and rheological (morphological index, filtration/rigidity index) parameters. The donation time with 53 donors was 20 min for 355 ml RCC-SAGM and 440 ml plasma and 7 min for 335 ml RCC-SAGM and 239 ml plasma. The donor tolerance was analogous to plateletpheresis or plasmapheresis. Twenty units of the RCC-SAGM were in-line filtered within 6 or 24 hours after donation. The results obtained for red blood cell storage are at least as good as with standard collection (free hemoglobin, free potassium, glucose, lactose, hemolysis) or better (ATP, 2,3-DPG, p50, hemoglobin derivatives, filtration/rigidity index) owing to prevention of collection lesion. All blood preparations were sterile after storage (red cells 42 days, plasma after freezing). The erythroplasmapheresis with MCS-3P can be especially recommended for application in an autologous blood program because the application of autologous blood donation in hospitals is often limited by the preconditions of component separation. The erythroplasmapheresis data with MCS-3P are encouraging for the development of a new blood collection methodology.

[Haemonetics MCS-3 pump system: improved production quality in thrombocytapheresis with a discontinuous cell separator]. / Haemonetics-MCS-3-Pumpen-System: Verbesserte Produktqualität bei Thrombozytapheresen mit diskontinuierlichem Zellseparator.

With the new cell separator MCS-3P (Haemonetics) platelet concentrates were collected in 90 min with an average yield of 3 x 10(11) platelets in 280 ml (53 donations). The most important advantage is the reduced residual leukocyte contamination of approximately 2.4 x 10(6).

[Large volume lymphocytapheresis for the collection of peripheral stem cells]. / Grossvolumige Lymphozytapherese zur Sammlung peripherer Stammzellen.

We performed 29 large-volume leukaphereses of 20 patients for collection of peripheral blood stem cells. All patients have been pretreated with cytokines after chemotherapy. In 9 patients with precounts of > or = 3 x 10(9) mononuclear cells/l we achieved a sufficient transplantation doses with one LVL. If the MNC precount was < or = 3 x 10(9)/l we had to perform more than one LVL. On 16 patients we compared a standard apheresis procedure with the LVL procedure. It seems that especially patients with a lower MNC precount can profit from LVL. From patients with higher MNC precounts we harvested the double amount of MNCs, from patients with lower MNC precounts the triple amount.

[Rejuvenation of autologous blood preserved by washing in glucose- adenine- phosphate- and citrate-containing solution]. / Rejuvenation von Eigenblutkonserven durch Waschen mit glukose-adenin-phosphat-citrathaltiger Lösung.

Outdated red cell concentrates (RCC-SAGM) were washed with a chloride-free, glucose-adenine-phosphate-citrate preservation solution. After resuspension of the red cells in this solution a hypothermic storage for additional 63 days was performed. Quality parameters (2,3-DPG, glucose, lactose, free hemoglobin, pH, chloride, pO50, shape quality index, filtration index) of the preserved red blood cells became normal within 7-11 days after the rejuvenation procedure. The data prove that a rejuvenation of outdated blood by a simple washing procedure allows a post-storage time of 21 days.

[Mechanical donation of whole blood simultaneous extraction of concentrated erythrocytes and fresh plasma using MCS-3P]. / Maschinelle Vollblutspende mit gleichzeitiger Gewinnung von Erythrozytenkonzentrat und Frischplasma mittels MCS-3P.

The new 'Multi-Component System-3 pump' (MCS-3P) is an apheresis system giving the flexibility to collect red blood cells, plasma, and platelets in one step. The objective was to perform an automated donation of red cells and plasma (erythroplasmapheresis), collecting in less than 20 min 350 ml red cells including 80 ml of SAG-M and 400 ml plasma. For this study we have evaluated 32 donations. The results obtained for red blood cells (42 days) and plasma (after freezing) are as good as with standard collection (parameter such as Hb, Hk, MCV, MCHC, 2,3-DPG, ATP, free Hb and potassium, glucose, lactose, protein).

[Stem cell pheresis and deep temperature preservation--a problem of transfusion medicine?]. / Stammzellapherese und -tieftemperaturkonservierung--eine Aufgabe der Transfusionsmedizin?

In Germany, Transfusion Medicine belongs to various medical disciplines. We would like to demonstrate our model of interdisciplinary collaboration in stem cell transplantation. Since 1989 we performed 339 leukaphereses in 53 patients. On average we got 1.4 x 10(8) MNC/kg body weight from one single apheresis procedure. To observe graft quality we measured the content of CD34-positive cells and the amount of CFU-GM. Despite diagnosis and therapeutical regimen the content of CD34+ cells was found to be 3.3% (0-20). The proliferation was 21.7 GM-CFU per 1 x 10(5) MNC seeded (0-393). The results of the first 17 transplantations showed a fast haematological recovery (WBS 1.0 Gpt/l after 9 days Plt 20 Gpt/l after 11 days). Close collaboration of Transfusion Medicine and Haematology leads to optimization of stem cell transplantation.

Platelet apheresis with Vivacell BT798 DEA, haemonetics V-50 and PCS-Plus: preparation efficiency and product quality using identical donors.

Different platelet apheresis techniques were used for preparing platelet concentrates: the continuous flow method with Vivacell BT 798 DEA, the discontinuous flow method with V-50 of Haemonetics, and their plasmapheresis device PCS-Plus. 20 of our donors underwent all three procedures. All platelet separations led to suitable platelet concentrates of 3 x 10(11) platelets within less than 90 min. However, the contaminating leukocytes reached 2 x 10(8). Due to less intense citrate reactions and a shorter donation time the donor acceptance of the continuous flow method was higher as compared with the discontinuous flow method.

Age-dependent regeneration of plasma proteins after donor plasmapheresis.

To analyze age-dependent effects of a plasma donation on the regeneration of plasma proteins two groups of first time plasma donors were selected (less than 25 years, greater than 50 years). By measurements of hematological and biochemical parameter, immunoglobulins, procoagulators and inhibitors of coagulation before and after a plasma donation the kinetic of regeneration until three weeks was followed up. It can be concluded that a single plasma donation affects the generation in younger and older donors in a different way. Procoagulators and inhibitors show the same behavior, except the donation related elevation of fibrinogen in young donors. Especially the retarded regeneration of cholinesterase and immunoglobulins in the male young group should be taken into consideration for frequent plasma donations and autologous preoperative plasma donations.

Age-dependent regeneration of plasma proteins after donor plasmapheresis.

To analyze age-dependent effects of a plasma donation on the regeneration of plasma proteins, two groups of first-time plasma donors were selected (< 25 and > 50 years). The regeneration kinetics of different plasma proteins until 3 weeks after donation was followed up. It can be concluded that a single plasma donation has an age-dependent effect on regeneration, especially on the prolonged regeneration of cholinesterase and immunoglobulins.

[Hemorheologic findings in hyperviscosity syndrome and their modification by plasmapheresis]. / Hämorheologische Befunde beim Hyperviskositätssyndrom und deren Beeinflussung durch Plasmapherese.

A patient suffering from refractory immunocytoma was treated with therapeutical plasmapheresis. To estimate the hemorheological risk during and at the end of the therapy, hemorheological measurements were performed. Hematocrit, aggregation index, filtration index, plasma viscosity, colloid osmotic pressure and protein concentrations were analyzed. The efficiency of the plasmapheresis treatment is demonstrated by the reduction of the plasma viscosity from 5.5 to 2.3 mPa (57% reduction) and of the filtration index from 43.9 to 29.7 (32% reduction). The colloid osmotic pressure decreased from 3.4 to 2.5 kPa (26% reduction), plasma protein concentration from 106 to 86 g/l (19% reduction) and IgM concentration from 100 to 82 g/l (18% reduction), while the albumin concentration remained constant.

[Efficiency of mechanical plasmapheresis]. / Zur Effizienz maschineller Plasmapheresen.

In a clinical study the automated donor plasmapheresis devices Autopheresis-C A 100, Plasmapur-Monitor, and Ultralite-PCS were tested. Including also manual plasmapheresis, we analyzed the efficiency of donor plasmapheresis, the reliability and breakdown susceptibility of the methods, the quality of the collected fresh plasma, and the suitability of the different machine plasmapheresis devices for routine application, using a total of 2,372 donor plasmaphereses. We also studied the behavior of some individual laboratory parameters due to plasmapheresis with Plasmapur-Monitor. The data allow us to recommend machine plasmapheresis for routine operation (Ultralite-PCS greater than Autopheresis-C A 100 greater than Plasmapur-Monitor).

[Mechanical plasmapheresis by means of the Haemonetics-ultralite- plasma collection system: 2. Generation of platelet-rich plasma]. / Maschinelle Spenderplasmapherese mittels Haemonetics-Ultralite-Plasmasammelsystem: 2. Gewinnung von plättchenreichem Plasma.

70 plateletpheresis were performed in a clinical study to evaluate the quality of platelet-rich-plasma prepared by the new developed Haemonetics-Ultralite-Plasmacollection system. The procedure took in average 54 minutes, resulting in a platelet content of 1.6 X 10(11) platelets. Platelets function (hypotonic stress response, ADP- and collagen-induced aggregation) was well maintained. The after differential centrifugation prepared platelet concentrate may be stored in the collection bag for 1 day at room temperature with acceptable functional recovery.

[Mechanical donor plasmapheresis using the Haemonetics Ultralite plasma collection system. 1. Collection of fresh plasma]. / Maschinelle Spenderplasmapherese mittels Haemonetics-Ultralite-Plasmasammelsystem. 1. Die Gewinnung von Frischplasma.

In a clinical study altogether 449 machine donor plasmapheresis for collection of platelet poor fresh plasma were carried out using the new developed Haemonetics-Ultralite-Plasma-Collection-System. The average time of donation for 600 g of plasma amounted to 36 min. In comparison to other automated plasmapheresis-systems an effective plasma flow is recorded for the Ultralite-machine. All plasmapheresis procedures were well tolerated by the donors. The collected plasma is equivalent to the requirements for fresh frozen plasma. Complications due to the device or donors are small with 2.9% of the performed procedures.