Anticoagulation, bleeding, and clotting at donor plasmapheresis

Evers, Josef; Taborski, Uwe

doi:10.1002/jca.21626

Cited by 2 publications

(8 citation statements)

References 8 publications

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“…Beeck et al have already shown in a prospective study that a TSC:blood flow ratio of 1:16 gives the best results for the production of coagulation factors V, VIII, and IX without activation of hemostasis 33 . This is consistent with our experience that if the venipuncture was performed correctly and the TSC:blood flow ratio at 1:16 was correct, no anticoagulation or bleeding problems would occur 14 …”

Section: Discussionsupporting

confidence: 91%

“…This resulted in an average CIR between 0.33 and 0.37 mg/kg/min. It follows that the calculated CIR is in agreement with the earlier reports, 10,29 and that an individualized dosing of TSC in plasma donations with a low flow ratio of TSC 1:16 to blood is not required 14 …”

Section: Discussionsupporting

confidence: 88%

“…The data that support the findings of this study are available from References 7‐10,14 or the corresponding author upon reasonable request.…”

Section: Data Availability Statementsupporting

confidence: 66%

“…DP was carried out with the automated Plasma Collecting System 2 (PCS2) (Haemonetics Corporation, Braintree, MA) via a single‐needle technique. The venipuncture was performed as we recently described elsewhere 14 . PCS2 operates in a discontinuous flow manner with four to five repetetive cycles of draw and collection phases alternating with return phases.…”

Section: Methodsmentioning

confidence: 99%

“…The venipuncture was performed as we recently described elsewhere. 14 PCS2 operates in a discontinuous flow manner with four to five repetetive cycles of draw and collection phases alternating with return phases. TSC AC (Haemonetics) is added in the withdrawal phase in a low flow ratio of 1:16 to blood at the inlet line to the tubing set prior to the apheresis centrifuge.…”

Section: Donor Plasmapheresismentioning

confidence: 99%

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Impact of saline infusion and citrate infusion rate during donor plasmapheresis

Evers

Schreiber

Taborski

2022

J of Clinical Apheresis

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The purpose of our research was to evaluate the effects of saline infusion to counteract incidents of severe hypotension during donor plasmapheresis (DP; synonym with plasma donation), and on immunoglobulin G (IgG) content in collected plasma, and on donor hematological values. It examines the clearance (Cl) of IgG during DP without saline to calculate the distribution of citrate and citrate infusion rate (CIR) during DP. It is based on three studies: an observation of saline infusion in donors with severe drops in blood pressure at DP, and two crossover trials of 32 repeat plasma donors each on saline infusion during DP. We observed 50 cases with a significant drop of mean systolic blood pressure ≤90 mm Hg in 1 year, predominantly in young, female first‐time donors. In trial 1, there was a reduction of IgG concentration in collected plasma related to the average IgG serum concentration without saline to 85.5% vs to 80.5% with saline (P < .001). In trial 2, there was an important 11%‐12% increase of the donor hematological values without saline during DP. An average of 84.6% of citrate was removed in retained plasma; our calculated minimal CIR of 0.16 ± 0.17 mg/kg/min was confirmed by other empirical studies. Our research has led to significant improvements in the practice of DP: (a) Saline should be infused at DP as clinically indicated in agreement with the donor. (b) Young, female first‐time donors require special care. (c) The long‐time effects of minimal amounts of citrate on bone metabolism are improbable.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 88%

“…The data that support the findings of this study are available from References 7‐10,14 or the corresponding author upon reasonable request.…”

Section: Data Availability Statementsupporting

confidence: 66%

Section: Methodsmentioning

confidence: 99%

Section: Donor Plasmapheresismentioning

confidence: 99%

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Impact of saline infusion and citrate infusion rate during donor plasmapheresis

Evers

Schreiber

Taborski

2022

J of Clinical Apheresis

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A donor safety evidence literature review of the short‐ and long‐term effects of plasmapheresis

Hoad,

Castrén,

Norda

et al. 2023

Vox Sanguinis

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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.

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Anticoagulation, bleeding, and clotting at donor plasmapheresis

Cited by 2 publications

References 8 publications

Impact of saline infusion and citrate infusion rate during donor plasmapheresis

Impact of saline infusion and citrate infusion rate during donor plasmapheresis

A donor safety evidence literature review of the short‐ and long‐term effects of plasmapheresis

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