Blood component collection by apheresis

Abstract

Apheresis component collection is a rapidly growing area in the blood collection field. Several instruments with varying capabilities are available. This is a brief review of the equipment available for granulocyte and apheresis component collection and indications for their use. In the United States, granulocytes are collected with the Fenwal CS3000, Fenwal CS3000 Plus, COBE (Gambro) Spectra, Haemonetics LN9000, and Fresenius AS 104. The use of hetastarch for sedimenting agent and stimulation with G-CSF and G-CSF plus dexamethasone have substantially increased granulocyte yields. Plateletapheresis is performed in the United States on the Fenwal CS3000, Fenwal CS3000 Plus, Fenwal Amicus, COBE (Gambro) Spectra, Gambro Trima Version 4, Gambro Trima Accel (Version 5), and Haemonetics LN9000. Automated red blood cell (RBC) collections are performed with the Haemonetics MCS+LN8150, Gambro Trima Version 4, Gambro Trima Accel (Version 5), Amicus, and Baxter Alyx. The RBC can be collected concurrently (with other components) in some instruments or separately in others. Plasma is collected concurrently on several instruments. Plasmapheresis for plasma only is performed on the Fenwal Autopheresis C and Haemonetics PCS2. Granulocyte yields range from 0.46 x 10(10) to 1.0 x 10(10) for unstimulated donors and 2.1 x 10(10) to 2.6 x 10(10) for donors stimulated with dexamethasone or prednisone. The use of G-CSF and G-CSF with dexamethasone has substantially increased granulocyte yields with yields of 4.1 x 10(10) to 10.8 x 10(10) reported. Platelet collection rates of 0.045-0.115 x 10(11) plt/min have been reported. Collection efficiencies of 46-85.7% have been reported. Automated (apheresis) component collection has the advantages of controlled volumes or doses of component, efficient use of the donor, multiple components from the same donor, better inventory control, and better quality control due to less manipulation of the individual components. Disadvantages of automated component collection include the use of expensive equipment and disposables, the need for specially trained machine operators, and lower capacity to collect large volumes of blood compared to whole blood donation. The use of apheresis component collection is rapidly growing to provide the best blood components in the most efficient manner.

Exploratory studies of extended storage of apheresis platelets in a platelet additive solution (PAS)

“…Haemonetics collects whole blood into a spinning centrifuge bowl, and then either plasma or PAS is pumped into the bottom of the bowl to push the supernatant platelets into a collection bag for storage. 7 The Spectra has a dual-stage processing channel with the red and white cells removed in the first stage, and the platelets are concentrated in the second stage followed by transfer to a storage bag. 7 The Trima has a single-stage channel where the cells separate into layers according to specific gravity, and each component leaves by its own outlet into a storage bag.…”

Plateletpheresis: the Process, Devices, and Indicators of Product Quality

“…According to these reports, the single-needle Amicus and single-needle Trima Accel have the highest CE and CR [3,8,9,10,58]. Flesch et al [21] reported that the double-needle Amicus and the single-needle Trima Accel showed similar platelet yields and donation times.…”

“…Negatively charged platelet surfaces promote the activation of coagulation factors II and X [8,39]. Various studies have investigated platelet activation, which has been used to evaluate platelet quality during processing and storage of plateletpheresies products.…”

“…The processing time is approximately 1-2 hr [7,24]. Apheresis instruments are used with various settings, depending on the specific needs of different cases [8]. Cell separators employ either continuous flow centrifugation, which uses 2 venipunctures to collect blood, or intermittent flow centrifugation, which returns the unwanted blood components to the donor after it is temporarily collected in the cell separator.…”

“…Indeed, it provides larger quantities of components than does whole blood separation, produces consistent product volumes, makes efficient use of the same donor, reduces the donor's physical stress and blood cell count recovery times, and decreases the risk of bacterial contamination. By eliminating the recipient's exposure to multiple donors, apheresis addi--Review -tionally reduces the risks of human leukocyte antigen (HLA) alloimmunization and transfusion-transmitted diseases [3,8,15,24,41,63].…”