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Sahoo D, Noushad S, Basavarajegowda A, Toora E. Feasibility of high-yield plateletpheresis in routine practice: Experience from tertiary health center from South India. Asian J Transfus Sci 2023; 17:34-40. [PMID: 37188018 PMCID: PMC10180781 DOI: 10.4103/ajts.ajts_103_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/13/2021] [Accepted: 10/17/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVES High-yield plateletpheresis donations can reduce donor exposure and be economically beneficial as well. However, obtaining a high-yield plateletpheresis from a maximum number of donors with low basal platelet count and its effect on postdonation platelet count of donors undergoing high-yield plateletpheresis has been a matter of concern. This study aimed to assess the feasibility of making high-yield platelet donation as a routine practice. METHODS It was a retrospective observational study to determine the effect of high-yield plateletpheresis on donor reactions, efficacy, and quality parameters. It was conducted from January 1, 2019 to June 30, 2021, at the Department of Transfusion Medicine in a tertiary care hospital of South India. RESULTS Out of the 669 procedures, 564 (84.3%) of the collection had a platelet yield of ≥5 × 1011, 468 (70%) of the collection had a platelet yield of 5.5 × 1011, whereas 284 (42.5%) met the target of 6 × 1011 by coulter. The mean drops in platelet count were 95 ± 16 × 103/μl (77,600-113,000/μl), mean platelet recruitment was 1.31 ± 0.51. The mean collection efficiency of the procedure for the 669 cases was shown to be 80.21 ± 15.34, and the mean collection rate was 0.07 × 1011 ± 0.02 per minute. Only forty donors (5.5%) experienced adverse donor reactions. CONCLUSIONS High-yield plateletpheresis can be done in routine practice with no added adverse donor reaction with effective quality products.
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Affiliation(s)
- Dibyajyoti Sahoo
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Shahida Noushad
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Esha Toora
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Chopra S, Kaur P, Bedi RK, Kaur G. Effect of double dose plateletpheresis on target yield and donor platelet recovery. Hematol Transfus Cell Ther 2023; 45:16-24. [PMID: 34294601 PMCID: PMC9938487 DOI: 10.1016/j.htct.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/20/2021] [Accepted: 05/02/2021] [Indexed: 02/06/2023] Open
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.
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Affiliation(s)
- Sapna Chopra
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Paramjit Kaur
- Government Medical College and Hospital, Sector 32, Chandigarh, India.
| | - Ravneet Kaur Bedi
- Government Medical College and Hospital, Sector 32, Chandigarh, India
| | - Gagandeep Kaur
- Government Medical College and Hospital, Sector 32, Chandigarh, India
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Malodan R, Murugesan M, Nayanar SK. Predicting donor-related factors for high platelet yield donations by classification and regression tree analysis. Hematol Transfus Cell Ther 2022:S2531-1379(22)00044-X. [PMID: 35418353 DOI: 10.1016/j.htct.2022.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 01/21/2022] [Accepted: 02/13/2022] [Indexed: 11/30/2022] Open
Abstract
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+.
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Augustine M, Murugesan M, Nayanar SK, Padmanabhan M. Adopting a vein assessment tool improves procedural outcomes in double dose platelet collections - A prospective study. Transfus Apher Sci 2021; 60:103198. [PMID: 34187772 DOI: 10.1016/j.transci.2021.103198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study aims to determine the phlebotomy and procedural outcomes using a vein assessment tool (VAT) in Double Dose Platelet (DDP) collections by apheresis. METHODS VAT was based on assessing vein visibility, palpation and size with maximum score of 12 and the least being 0 and the scores were graded as adequate and inadequate. A vein-viewer was used for studying cubital vein patterns (type 1-5). Phlebotomy outcome was defined based on need for re-puncture. Procedural outcomes in terms of target yield attained and RBC reinfusion completed. Chi square test and Mann- Whitney U test were used to assess the vein score and pattern against phlebotomy and procedural outcome. RESULTS Out of 200 DDP collections, the phlebotomy was successful in 88 % with good procedural outcome in 94 % donations. The cut off in VAT scores for successful phlebotomy was ≥8 (AUC: 70 %). Median vein scores of the arm selected for phlebotomy was 9 and graded adequate in 154 (77 %) donations.Odds for successful phlebotomy was 3.7 times higher when donors had an adequate VAT grades(p = 0.003). Procedural outcomes was favourable when at least one arm had adequate VAT grade when compared to both arms being inadequate (98 % vs 82 %; p < 0.001). Phlebotomy failure was more with first time apheresis donors than repeat apheresis donors (p = 0.014). CONCLUSION This study indicated that a VAT score with a cut off of ≥8 had better phlebotomy and procedural outcomes in DDP collections and that donor with at least one arm having the VAT score of ≥8 are preferred for DDP collections.
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Affiliation(s)
- Merline Augustine
- Transfusion Medicine, Malabar Cancer Centre, Thalassery, Kerala, India
| | | | | | - Maya Padmanabhan
- Clinical Research and Biostatistics, Malabar Cancer Centre, Thalassery, Kerala, India
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Cienfuegos-Pecina E, Ayala-De la Cruz S, Leal-Nava ER, Pérez-Olvera JA, Llaca-Díaz JM, Avilés-Rodríguez LE, Pérez-Chávez F, Díaz-Chuc EA. Assessment of software-derived predictive algorithms for platelet yield and blood cell count after apheresis. J Clin Apher 2020; 36:94-100. [PMID: 33016510 DOI: 10.1002/jca.21846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/22/2020] [Accepted: 09/17/2020] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Algorithms have been developed to predict the platelet yield after apheresis from the donor's data, as well as the effect on the blood cell count, to extract an acceptable platelet number without affecting the donor. However, the evaluation of these algorithms has not been widely reported. This study aimed to assess the accuracy of the predictive algorithms of the Trima Accel v. 6 blood collection system. METHODS Platelet concentrates (PCs) obtained by apheresis were analyzed. Platelet count and hematocrit were compared pre- and post-apheresis. Calculated post-apheresis platelet count (CPAPC), hematocrit (CPAH), and platelet yield (CPY), and their actual values were correlated. The bias of the algorithms was assessed with Bland-Altman plots, and the prediction of the extraction of single or double platelet products was evaluated. RESULTS Two hundred and seventy-nine PCs were analyzed. Post-apheresis platelet count (PAPC) and hematocrit were decreased. A moderate correlation was observed between CPY and the actual yield, with a negative bias, and a trend to increase alongside the magnitude of the measurements. CPAPC and CPAH were strongly correlated with their actual values without bias. Prediction of single or double platelet product extraction showed a significant agreement with the actual outcomes. CONCLUSIONS The predictive algorithm for the platelet yield showed bias, and a trend to underestimate the actual platelet yields when they are higher. The algorithms for the prediction of the PAPC and hematocrit did not show bias, proving their accuracy. Prediction of a single or double platelet product extraction has a strong agreement with the APY.
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Affiliation(s)
- Eduardo Cienfuegos-Pecina
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Nuevo León, Mexico.,Liver Unit, Department of Internal Medicine, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Nuevo León, Mexico
| | - Sergio Ayala-De la Cruz
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Nuevo León, Mexico
| | - Erika R Leal-Nava
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Nuevo León, Mexico
| | - Jorge A Pérez-Olvera
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Nuevo León, Mexico
| | - Jorge M Llaca-Díaz
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Nuevo León, Mexico
| | - Luz E Avilés-Rodríguez
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Nuevo León, Mexico
| | - Fernando Pérez-Chávez
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Nuevo León, Mexico
| | - Erik A Díaz-Chuc
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Nuevo León, Mexico
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Kumawat V, Goyal M, Marimuthu P. Analysis of Donor Safety in High Yield Plateletpheresis Procedures: An Experience from Tertiary Care Hospital in South India. Indian J Hematol Blood Transfus 2020; 36:542-549. [PMID: 32647430 DOI: 10.1007/s12288-020-01266-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 02/17/2020] [Indexed: 02/06/2023] Open
Abstract
The apheresis platelets are the preferred blood components for the thrombocytopenic hemato-oncology patients. The one of the important factors for post transfusion increment is the dose of the platelet product infused. The minimum platelet product yield is defined but the amount of maximum possible platelets collection from a single donor is not universally defined. There is lots of apprehension in our country for apheresis procedures harvesting more than a standard unit. This retrospective observational study was conducted to determine safety of high yield plateletapheresis collection among Indian donors This retrospective observational study was conducted for a period of 15 months including all consecutive plateletapheresis procedures. The informed consent had been obtained from all donors including high yield plateletapheresis (Yield ≥ 5 × 1011). The apheresis product was subjected to platelet count. The donor adverse reactions were recorded along with procedural details. Post procedure complete blood count was done for the donors who consented for post procedure blood sample draw A total 569 procedures were performed during this period including 174 high yield procedure. The 526 procedures were analyzed for adverse donor reactions. The 43 were excluded for adverse donor reaction analysis due to yield less than 3 × 1011 (n = 43). The adverse reactions rate between high yield procedures (18/174, 10.34%) and normal yield (20/352, 5.68%) were not statistically different (p = 0.052). The phlebotomy related complication (3.23%) followed by citrate toxicity (2.28%) were the two most common adverse reaction observed. The adverse reactions associated with high yield plateletapheresis procedures are comparable to normal yield procedures in term of overall adverse reactions observed and post procedural platelet counts. This can be beneficial to patients by providing products of greater yield.
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Affiliation(s)
- Vijay Kumawat
- Department of Transfusion Medicine, Citizens Hospital, Nallagandla, Serilingampally, Hyderabad, 500019 India.,Transfusion Medicine & Haematology, NIMHANS, Bengaluru, 560029 India
| | - Manu Goyal
- Department of Hematopathology and Genetics, AMPATH at Citizens Hospital, Nallagandla, Serilingampally, Hyderabad, 500019 India
| | - Palniappan Marimuthu
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bengaluru, 560029 India
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