Apheretic platelets are better quality blood components which reduce donor exposure and chances of TTIs to transfusion recipients when compared to the whole blood derived components. Though safe, these apheretic donations are associated with donor adverse events. We evaluated the incidence of such adverse events associated with the modern apheresis procedures that would provide an insight as well as help formulating preventive steps to avoid frequent occurrences of such events. This prospective audit-based observational study was conducted over 1 year. Donors for plateletpheresis were selected as per the standard operating procedure of the Apheresis Lab. The apheresis procedures were done on the MCS? (Haemonetics Corp.), Trima Accel (Terumo BCT) and COM.TEC (Fresenius Kabi AG). 1740 apheresis procedures were performed, out of which 1708 were plateletpheresis and 32 therapeutic plasma exchange (TPE) procedures for 7 patients. A total of 102 adverse events were noted; of which, 80 (78.43 %) events were associated with donors, 15 (14.71 %) were owed to equipment related problems and 7 (6.86 %) were technical aberrations. All the events associated with donors were mild. No adverse events were reported with any of the 32 TPEs. Apheresis procedures are associated with adverse events which can be reduced by meticulous donor-vigilance, superior training modules for the technical personnel and continued supervision of experienced transfusion medicine specialists. Continued efforts towards making the donor's experience with apheresis more pleasant give a forward thrust to the noble vision of preparing a voluntary apheresis donor pool in India.
Background: A significant imbalance in access to safe blood is seen between the developing and developed countries. Donor selection has a pivotal role in preventing transfusion related complications and provide safety to the recipients. In this study, we aimed to find out rate and causes of blood donor rejection in our hospital. Methods: A retrospective study conducted in a tertiary care hospital involving both the voluntary and replacement donors during the period September 2017 to December 2018. We included all those donors who were considered unfit for blood donation. All those who came for blood donation at our hospital were asked to fill up an enrolment form for a blood donor. A general and systemic examination were done. We calculated the rejection rate, listed the reasons for donor rejection, and analyzed the data.Results: Among 150 rejected blood donors, most were males [129 (86%)], and the rest were females [21 (14%)]. The rejection rate in our study was 3.29%. We found that the rejection rate of donors was different among voluntary and replacement donors. It showed that the most common reason for the temporary rejection of blood donation was low hemoglobin level, followed by abnormal blood pressure. Conclusions: A vast majority of donors were rejected temporarily [132 (88%)], while the rest of them were rejected permanently [18 (12%)]. Low Hb in females and abnormal blood pressure in males were the commonest causes of blood donor rejection. Many factors affect the similarities and variations between the most typical causes of blood donor rejection, such as geographical area, cultural, socio-economic, and educational factors.
Familial hypercholesterolemia (FH) is an autosomal dominant disorder due to mutation of apolipoprotein-B receptor gene causing severe dyslipidemia. Lifestyle modification and medical treatment attenuate the disease progression, but as these fail to control the blood cholesterol levels, low-density lipoprotein (LDL) apheresis comes forth as a treatment option. To the best of our knowledge, the following is the very first case of pediatric FH being treated by LDL-apheresis to be reported from India. A severely malnourished female child presented with yellowish skin lesions over different parts of the body, viz., bilateral Achilles tendon, both knees, elbows, both pinnae, and outer canthus of both eyes. She had a strong family history of borderline hypercholesterolemia and was diagnosed as a case of FH. She was maintained on diet modification. LDL-apheresis was planned as the cholesterol levels were not controlled with the diet modificationt. However, unavailability of an appropriate kit in India for LDL-apheresis led to the use of the modified PL1 kit meant for therapeutic plasma exchange procedures. We conducted two sessions of LDL-apheresis. After the first session, the LDL-cholesterol (LDL-C) level fell by 75.9% and the total cholesterol fell by 73.5%. A second procedure led to a decline in total cholesterol level by 18.6% and LDL-C by 19.46%. Subsequently, she was advised diet modification and statin therapy with regular follow-up after every 6 months. Thus, the cascade filtration technique is a safe and effective treatment option for removing the undesired lipoproteins.
Background: Despite the advent of many synthetic and semi-synthetic products, the importance of biological blood products cannot be undermined in the current era. The blood donors are the backbone of any health care delivery system that has a well-organized blood transfusion service.Methods: A prospective study conducted for the period of 16 months aimed to find out various complications and their frequencies before, during or after the blood donations. The donors who developed any complications were followed up for at least three weeks to assess the late reactions if any. Blood donation was carried out with proper precautions and asepsis by experienced phlebotomists.Results: Out of 10346 blood donations, 9887 were from replacement donors, while 459 were from voluntary donors. Total donation associated complications were 113, out of which the majority were VVRs (n=74), followed by venous hematomas (n=34) and arterial punctures (n=5). Of the 74 donors who had a VVR after blood donation, the incidence was higher in females (1.64% versus 0.69%). A higher incidence of VVRs was seen among the donors who had a history of previous blood donation.Conclusions: This study strengthened the fact that though blood donation is relatively safe, it still has a complication rate of nearly 1%. To encourage for blood donation at a regular interval, all the possible steps should be taken to minimize the rate of complications. More medical attention should be given to the “at-risk” donors.
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