Effect of double dose plateletpheresis on target yield and donor platelet recovery

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.

Prospective comparison of high-dose plateletpheresis with the latest apheresis systems on the same donors

BACKGROUND

To improve productivity of automated platelet (PLT) collection, the industry has introduced new instruments or modifications to existing equipment.

STUDY DESIGN AND METHODS

With the same 8 donors for double (DDC) and triple-dose PLT collection (TDC), the Baxter Amicus (AM), the Haemonetics MCS Plus (MCS+), and the Gambro Trima Accel (TA) were evaluated focusing on yield, duration, and citrate donor load. Target endpoints were set at 5.5 x 10(11) to 6.0 x 10(11) PLTs (DDC) and 7.5 x 10(11) to 8.0 x 10(11) PLTs (TDC) in up to 100 and 120 minutes' donation time, respectively.

RESULTS

TA was the most efficient system (74.5 +/- 3.9%) with significant differences from AM (71.1 +/- 3.9%; p = 0.028) and MCS+ (64.0 +/- 7.7%; p = 0.002). TA had advantages over AM for collection rate (10.9 x 10(9) +/- 2.2 x 10(9) vs. 10.1 x 10(9) +/- 1.5 x 10(9) PLTs/min; p = 0.382), whole blood processed (3928 +/- 611 mL vs. 4219 +/- 727 mL; p = 0.382), and time to obtain an established standard dose (TSD 2.5(EU), 30.2 +/- 5.6 vs. 37.7 +/- 5.5 min; TSD 3.5(US), 42.2 +/- 7.8 min vs. 52.7 +/- 7.7 min; p = 0.015), whereas AM was slightly superior in PLT yield (2.81 x 10(11) +/- 0.21 x 10(11) vs. 2.76 x 10(11) +/- 0.31 x 10(11)/unit; p = 0.645). Owing to the lowest draw (42.3 +/- 3.2 mL/min; p < 0.001) and collection rates (6.0 x 10(11) +/- 1.5 x 10(11)/min; p = 0.021), MCS+ was the slowest significantly (p < 0.001) but compensated with fewer citrate reactions owing to lower citrate infusion rates (0.78 +/- 0.11 mL/min/L; p = 0.028).

CONCLUSION

High-dose plateletpheresis was performed efficiently and safely with all three instruments. AM had advantages in PLT yield, and MCS+, in donor comfort. TA was the fastest in obtaining an established standard dose and, because of this advantage, the machine with the highest practical impact in routine use.

Frequently used plateletpheresis techniques result in variable target yields and platelet recruitment of donors

BACKGROUND

Standard plateletpheresis techniques and effects on platelet (PLT) donors were investigated to provide an informative basis for advancement of apheresis software.

STUDY DESIGN AND METHODS

Three paired groups with 33 male and 22 female blood donors were prospectively investigated by analyzing blood counts of donors and products. Four apheresis platforms, the COBE Spectra LRS and the Trima v4 (Gambro BCT) and the AS.TEC204 and the COM.TEC (Fresenius Hemocare), were compared. Deviations of the collected from programmed PLT targets and donor PLT recruitment were calculated for single-unit PLT concentrates (SU-PCs; 3 x 10(11) PLTs) and double-unit PLT concentrates (DU-PCs; 6 x 10(11) PLTs).

RESULTS

Regarding SU-PCs, the productivity of the COM.TEC machine was superior to the AS.TEC204 machine, because of shorter processing time (54 min vs. 67 min) and higher yields (2.90 x 10(11) PLTs vs. 2.75 x 10(11) PLTs). Compared to the Spectra machine, the Trima v4 machine showed higher collection efficiencies (CEs) and shorter processing time and complied better with the programmed target (SU-PCs, 3.24 x 10(11) PLTs vs. 3.70 x 10(11) PLTs; DU-PCs, 6.87 x 10(11) PLTs vs. 7.56 x 10(11) PLTs). Harvests of the Spectra machine (DU-PCs) exceeded the target by 40 percent, which resulted in high PLT loss for donors. A longer processing time resulted in some higher CEs (SU-PCs, 53%; DU-PCs, 58%), which could contribute to this result. PLT recruitment compensated PLT loss to some extent.

CONCLUSION

The major finding was that the newer devices (COM.TEC and Trima) gave more predictable yields than the older devices (AS.TEC204 and Spectra) and resulted in lower PLT deficit. PLT software should be improved to minimize relevant variations of collected yields regarding the programmed target.