1
|
Hoad VC, Castrén J, Norda R, Pink J. A donor safety evidence literature review of the short- and long-term effects of plasmapheresis. Vox Sang 2024; 119:94-101. [PMID: 37641582 DOI: 10.1111/vox.13512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/31/2023]
Abstract
Many blood establishments are expanding plasmapheresis collection capacity to achieve increasing plasma for fractionation volume targets, driven by immunoglobulin product demand. Some adverse events occur in both apheresis and whole blood collection, such as venepuncture-related trauma and vasovagal reactions. Others are specifically related to the apheresis procedure, such as citrate reactions, haemolysis, infiltration and air embolism. Whilst plasmapheresis procedures are generally well tolerated, theoretical longer term donor health considerations, such as the effects on donor plasma protein levels, bone mineral density, iron deficiency and malignancy also require consideration. An evidence-based framework that supports a safe and sustainable increase in the collection of plasma is essential. Our review demonstrates a lack of high-quality evidence on risks and outcomes specifically in plasmapheresis. Whilst conservative procedural controls and donor harm minimization policies will mitigate risk, high-quality evidence is needed to facilitate practice change that is safe and sustainable and maximizes the potential of individual donor differences.
Collapse
Affiliation(s)
- Veronica C Hoad
- Donor and Product Safety (DAPS) Policy Unit, Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| | | | - Rut Norda
- Clinical Immunology and Transfusion Medicine, Uppsala University Hospital, Uppsala, Sweden
| | - Joanne Pink
- Donor and Product Safety (DAPS) Policy Unit, Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| |
Collapse
|
2
|
Schroyens N, D'aes T, De Buck E, Mikkelsen S, Tiberghien P, van den Hurk K, Erikstrup C, Compernolle V, Van Remoortel H. Safety and protection of plasma donors: A scoping review and evidence gap map. Vox Sang 2024; 119:110-120. [PMID: 37814964 DOI: 10.1111/vox.13544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/13/2023] [Accepted: 09/17/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND AND OBJECTIVES As part of a large-scale project to safely increase plasma collection in Europe, the current scoping review identifies the existing evidence (gaps) on adverse events (AEs) and other health effects in plasmapheresis donors, as well as factors that may be associated with such events/effects. MATERIALS AND METHODS We searched six databases and three registries. Study characteristics (publication type, language, study design, population, outcomes, associated factors, time of assessment, duration of follow-up, number and frequency of donations, convalescent plasma [y/n], setting and location) were synthesized narratively and in an interactive evidence gap map (EGM). RESULTS Ninety-four research articles and five registrations were identified. Around 90% were observational studies (57 controlled and 33 uncontrolled), and most of them were performed in Europe (55%) or the United States (20%). Factors studied in association with donor health included donor characteristics (e.g., sex, age) (n = 27), cumulative number of donations (n = 21), donation frequency (n = 11), plasma collection device or programme (n = 11), donor status (first time vs. repeat) (n = 10), donation volume per session (n = 8), time in donation programme (n = 3), preventive measures (n = 2) or other (n = 9). CONCLUSION The current scoping review provides an accessible tool for researchers and policymakers to identify the available evidence (gaps) concerning plasmapheresis donation safety. Controlled prospective studies with long-term donor follow-up are scarce. Furthermore, additional experimental studies comparing the health effects of different donation frequencies are required to inform a safe upper limit for donation frequency.
Collapse
Affiliation(s)
- Natalie Schroyens
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Tine D'aes
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
| | - Emmy De Buck
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Pierre Tiberghien
- Etablissement Français du Sang, Saint-Denis, France
- Université de Franche-Comté, EFS, INSERM, UMR Right, Besançon, France
| | - Katja van den Hurk
- Donor Medicine Research - Donor Studies, Sanquin Research, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Veerle Compernolle
- Belgian Red Cross, Blood Services, Mechelen, Belgium
- Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Hans Van Remoortel
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| |
Collapse
|
3
|
Mortier A, Khoudary J, van Dooslaer de Ten Ryen S, Lannoy C, Benoit N, Antoine N, Copine S, Van Remoortel H, Vandekerckhove P, Compernolle V, Deldicque L. Effects of plasmapheresis frequency on health status and exercise performance in men: A randomized controlled trial. Vox Sang 2024; 119:134-143. [PMID: 37997609 DOI: 10.1111/vox.13569] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND AND OBJECTIVES Most research studies on the effects of repeated plasma donation are observational with different study limitations, resulting in high uncertainty on the link between repeated plasma donation and health consequences. Here, we prospectively investigated the safety of intensive or less intensive plasma donation protocols. MATERIALS AND METHODS Sixty-three male subjects participated in this randomized controlled trial and were divided into low-frequency (LF, once/month, n = 16), high-frequency (HF, three times/month, n = 16), very high-frequency (VHF, two times/week, n = 16) and a placebo (P, once/month, n = 15) groups. Biochemical, haematological, clinical, physiological and exercise-related data were collected before (D0), after 1½ months (D42) and after 3 months (D84) of donation. RESULTS In VHF, red blood cells, haemoglobin and haematocrit levels decreased while reticulocyte levels increased from D0 to D84. In both HF and VHF, plasma ferritin levels were lower at D42 and D84 compared to D0. In VHF, plasma levels of albumin, immunoglobulin G (IgG), immunoglobulin A (IgA) and immunoglobulin M (IgM) dropped from D0 to D42 and remained lower at D84 than at D0. In HF, plasma IgG, IgA and IgM were lower at D42, and IgG and IgM were lower at D84, compared to D0. Few adverse events were reported in HF and VHF. Repeated plasma donation had no effect on blood pressure, body composition or exercise performance. CONCLUSION VHF plasmapheresis may result in a large reduction in ferritin and IgG levels. HF and VHF plasmapheresis may result in little to no difference in other biochemical, haematological, clinical, physiological and exercise-related parameters.
Collapse
Affiliation(s)
| | - Jina Khoudary
- Blood Services, Belgian Red Cross, Mechelen, Belgium
| | | | - Camille Lannoy
- Institute of Neuroscience, UCLouvain, Louvain-la-Neuve, Belgium
| | - Nicolas Benoit
- Institute of Neuroscience, UCLouvain, Louvain-la-Neuve, Belgium
| | - Nancy Antoine
- Institute of Neuroscience, UCLouvain, Louvain-la-Neuve, Belgium
| | - Sylvie Copine
- Institute of Neuroscience, UCLouvain, Louvain-la-Neuve, Belgium
| | - Hans Van Remoortel
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
- Department of Public Health and Primary Care, Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium
| | - Philippe Vandekerckhove
- Blood Services, Belgian Red Cross, Mechelen, Belgium
- Department of Public Health and Primary Care, Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium
| | - Veerle Compernolle
- Blood Services, Belgian Red Cross, Mechelen, Belgium
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Louise Deldicque
- Institute of Neuroscience, UCLouvain, Louvain-la-Neuve, Belgium
- Center of Investigation in Clinical Nutrition, UCLouvain, Louvain-la-Neuve, Belgium
| |
Collapse
|
4
|
Fransen M, Becker M, Hershman J, Lenart J, Simon TL. Why do US source plasma donors stop donating? Transfusion 2023; 63:1904-1915. [PMID: 37622403 DOI: 10.1111/trf.17522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND In the United States, source plasma (SP) donors can donate up to 104 times per year. Considering the global need for SP and plasma-derived medicinal products, it is critical to maintain the health of frequent donors. This study explores SP donors' self-reported reasons for a lapse in donating. STUDY DESIGN AND METHODS There were 5608 SP donors from 14 SP centers who enrolled in a longitudinal cohort study to assess self-reported functional health and well-being. Donors were assigned to one of four groups, according to the frequency of SP donation in the 12 months before enrollment. One thousand four hundred forty-eight SP donors who lapsed in donating during 6 months or greater during the study follow-up were asked to complete a survey. RESULTS There were 545 lapsed SP donors who returned surveys (37.6%); 63% were female. Most responses given for stopping SP donation were categorized as convenience reasons (69.1%). Self-reported health concerns, including being deferred multiple times, which were categorized as possibly related or unable to determine a relationship to plasmapheresis, represented 45.5% of the responses. DISCUSSION Primary reasons US SP donors report for a lapse in donation were categorized as convenience (e.g., schedule conflicts/lack of time). Donor responses categorized as health concerns which have a possible or uncertain relationship to plasmapheresis were less frequent but present in all frequency groups. This study adds to the body of evidence that SP donors cease donating for a variety of self-reported reasons with the majority not directly related to a perceived negative impact on their health.
Collapse
Affiliation(s)
- Michelle Fransen
- Plasma Protein Therapeutics Association, Annapolis, Maryland, USA
| | | | - Janet Hershman
- Takeda/BioLife Plasma Services LP, Bannockburn, Illinois, USA
| | - James Lenart
- Takeda/BioLife Plasma Services LP, Bannockburn, Illinois, USA
| | | |
Collapse
|
5
|
Almutairi H, Salam M, Batarfi K, Alharbi D, Wani F, Almutairi A, Al-Shammari B, Al–Surimi K. Incidence and severity of adverse events among platelet donors: A three-year retrospective study. Medicine (Baltimore) 2020; 99:e23648. [PMID: 33350744 PMCID: PMC7769365 DOI: 10.1097/md.0000000000023648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 11/11/2020] [Indexed: 11/25/2022] Open
Abstract
Adverse events (AEs) are unfortunate consequences of platelet donation. This study reports the incidence and severity of AEs and the associated risk factors in platelet donation at a major blood donation center in Riyadh, Saudi Arabia.A review of donation records was conducted between 2014 and 2017. Eligible study participants were 5007 platelet donors who had donated 7969 times. Each donation was accounted for as a single study subject. Participants' characteristics were described and analyzed as potential contributing factors to adverse events.The average age of platelet donors was 30.0±7.3 years. First-time donors comprised (n = 3,100, 61.9%) of the sample, and 1907 (38.1%) were multiple donors (periodic/routine). Their average BMI was 28.6 ± 4.9 kg/m2. Most donors have blood type "O" and Rheo "positive". The range of blood volume processed was 0 to 5273 ml, while the procedure duration ranged from 0 to 90 minutes. The average platelet yield was 3.8 ± 3.5 ∗1011 platelets per unit, and the average collected volume was 257.6 ± 86.1 ml. Incidence of AEs was 4.2%, of which 91.3% were mild and 8.7% were severe. AEs were vascular injuries (65.3%), vasovagal reactions (11.6%), and citrate toxicity (5.3%). AEs were associated with first-time donation, adj.OR (95%CI) = 1.5 (1.1-1.8) and lower BMI, adj. OR (95% CI) = 1.4 (1.1-1.8). Citrate toxicity was present in severe forms, unlike vascular injuries and vasovagal reactions that tended to be milder. Donors with hemoglobin levels above 16 g/dl, adj. OR (95% CI) = 1.3 (1.1-1.7) and platelet levels below 250,000, adj. OR (95% CI) = 1.3 (1.1-1.6) were more likely to contract AEs than others.Reporting adverse events is essential to establish a benchmark for the annual incidence rates to be compared against local and international figures. Blood donor centers should also take notice of blood donors characteristics that are associated with higher incidence and more severe forms of AEs during or after platelet donation.
Collapse
Affiliation(s)
| | - Mahmoud Salam
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | | | | | - Faisal Wani
- Department of Pathology and Laboratory Medicine
| | - Adel Almutairi
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Khaled Al–Surimi
- Department of Health System Management, College of Public Health and Health Informatics, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| |
Collapse
|
6
|
Malekzadeh MM, Alizadeh R, Aghsaeifard Z, Sahraian MA. Thrombotic Microangiopathy in Interferon-beta-Treated Multiple Sclerosis Patient. Clin Case Rep 2020; 8:1061-1064. [PMID: 32577265 PMCID: PMC7303857 DOI: 10.1002/ccr3.2808] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 02/09/2020] [Accepted: 02/29/2020] [Indexed: 01/10/2023] Open
Abstract
A 43-year-old man who was treated with interferon-beta for multiple sclerosis was presented with hypertension, headache, nausea/vomiting, blurred vision, and renal dysfunction. The treatment with drugs and dialysis relieved the symptoms. Despite plasmapheresis is known to cause improvement in renal function, no such improvement was seen in patient.
Collapse
Affiliation(s)
- Masoud Mohammad Malekzadeh
- Digestive Disease Research Center Digestive Disease Research Institute Shariati Hospital Tehran University of Medical Sciences Tehran Iran
| | - Reza Alizadeh
- Department of Anesthesiology and Intensive Care AJA University of Medical Sciences Tehran Iran
| | - Ziba Aghsaeifard
- Department of Internal Medicine School of Medicine Sina Hospital Tehran University of Medical Sciences Tehran Iran
- Urology Research Center Tehran University of Medical Sciences Tehran Iran
| | | |
Collapse
|
7
|
Blood donors' physical characteristics are associated with pre- and post-donation symptoms - Donor InSight. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2016; 15:405-412. [PMID: 27416579 DOI: 10.2450/2016.0023-16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 04/06/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Observational data suggest that some donors might benefit from donating while others may be harmed. The aim of this study was to investigate the prevalence and potential, routinely measured, determinants of pre- and post-donation symptoms. MATERIALS AND METHODS In Donor InSight, questionnaire data from 23,064 whole blood donors (53% female) were linked to routinely measured data on donors' physical characteristics (haemoglobin, blood pressure, body mass index and estimated blood volume) from the Dutch donor database. Absolute and relative associations between donors' physical donor and the presence of pre- and post-donation symptoms were studied using multivariable logistic regression. RESULTS Pre-donation symptoms (lack of energy, headaches) were reported by 3% of men and 3% of women. Five percent of men and 4% of women reported positive post-donation symptoms (feeling fit, fewer headaches). Negative symptoms (fatigue, dizziness) were more common, occurring in 8% of men and 19% of women. All the studied donors' physical characteristics were positively associated with pre- and positive post-donation symptoms and negatively associated with negative symptoms. Body mass index was most consistently and independently associated with symptoms. DISCUSSION Donors' physical characteristics, in particular body mass index, were consistently associated with pre- and post-donation symptoms. This indicates that subgroups of donors more and less tolerant to donation might be identifiable using routinely measured data. Further research is warranted to study underlying mechanisms and potential strategies to predict and prevent donor reactions.
Collapse
|