BACKGROUND Extracorporeal photopheresis (ECP) is an effective treatment. However, protocols differ widely, and some questions, such as the number of cells to be collected or the number of ECP treatment days per treatment cycle, are still unsolved. The aim of this study was to compare a multistep (offline) (Spectra Optia and Macogenic G2) against an integrated (inline) ECP system (Therakos Cellex system) with respect to mononuclear cell (MNC) collection. STUDY DESIGN AND METHODS The number and quality parameters of the MNC products collected were evaluated together with some machine parameters, such as collection time. Comparisons were made through paired sample analysis with the t test. RESULTS Fourteen patients underwent 15 double‐paired procedures using both ECP protocols. The average MNC collected in the multistep procedure was 77.4 × 108, four times more than in the integrated procedure (18.5 × 108). MNC purity (84.4% vs. 63.8%) and enrichment (27.9 vs. 5.9) in the product collected were also higher in the multistep procedure. The whole ECP time was higher in the multistep than in the integrated procedure (272 vs. 106 min), but the calculated time to collect 25 × 108 MNCs in the multistep was shorter compared with the one‐step procedure (77.8 vs. 172 min). All these differences between the two protocols were statistically significant. CONCLUSIONS These two ECP protocols are different with respect to MNC collection and length of procedure. Some unresolved questions, such as the better MNC dose to inactivate or the number of consecutive days that ECP should be performed for optimal clinical efficacy, require further review.

Skin disinfection and bacterial contamination of blood components: be simple_ 2513 5..8A donation of apheresis platelets was split to produce 2 platelet doses. The first was transfused into a male neurosurgery patient (head injury) with pre-existing ischaemic bowel, liver disease and sepsis. The patient died 11 hours post transfusion and death was thought to be due the sepsis from the ischaemic bowel. As a transfusion reaction was not suspected, the transfused pack was not retained for further investigation. However, blood cultures had been taken from the patient prior to his death. The second recipient was a male patient with AML with chemotherapy-related pancytopenia. Five minutes into the transfusion the patient became acutely unwell, requiring admission to ITU where he subsequently suffered a cardiac arrest and died. Blood cultures had also been taken from this patient prior to his death. The remains of the transfused pack were cultured at the hospital microbiology laboratory before being returned to the blood services.Blood cultures from both patients yielded Klebsiella pneumoniae, as did cultures of the unit transfused to the patient with AML, and all 3 isolates were found to be of a single strain. The case was concluded as a proven incident of bacterial contamination of two platelet units with K. pneumoniae. This probably resulted in the death of the first patient and contributed to the death of the second. The source of the organism was most likely the donor gut, transferred to the venipuncture site and from there to the donated component.