Incidence and severity of adverse events among platelet donors

Abstract

Adverse events (AEs) are unfortunate consequences of platelet donation. This study reports the incidence and severity of AEs and the associated risk factors in platelet donation at a major blood donation center in Riyadh, Saudi Arabia. A review of donation records was conducted between 2014 and 2017. Eligible study participants were 5007 platelet donors who had donated 7969 times. Each donation was accounted for as a single study subject. Participants’ characteristics were described and analyzed as potential contributing factors to adverse events. The average age of platelet donors was 30.0±7.3 years. First-time donors comprised (n = 3,100, 61.9%) of the sample, and 1907 (38.1%) were multiple donors (periodic/routine). Their average BMI was 28.6 ± 4.9 kg/m 2 . Most donors have blood type “O” and Rheo “positive”. The range of blood volume processed was 0 to 5273 ml, while the procedure duration ranged from 0 to 90 minutes. The average platelet yield was 3.8 ± 3.5 ∗10 11 platelets per unit, and the average collected volume was 257.6 ± 86.1 ml. Incidence of AEs was 4.2%, of which 91.3% were mild and 8.7% were severe. AEs were vascular injuries (65.3%), vasovagal reactions (11.6%), and citrate toxicity (5.3%). AEs were associated with first-time donation, adj.OR (95%CI) = 1.5 (1.1–1.8) and lower BMI, adj. OR (95% CI) = 1.4 (1.1–1.8). Citrate toxicity was present in severe forms, unlike vascular injuries and vasovagal reactions that tended to be milder. Donors with hemoglobin levels above 16 g/dl, adj. OR (95% CI) = 1.3 (1.1–1.7) and platelet levels below 250,000, adj. OR (95% CI) = 1.3 (1.1–1.6) were more likely to contract AEs than others. Reporting adverse events is essential to establish a benchmark for the annual incidence rates to be compared against local and international figures. Blood donor centers should also take notice of blood donors characteristics that are associated with higher incidence and more severe forms of AEs during or after platelet donation.

56-year-old man • increased heart rate • weakness • intense sweating • horseradish consumption • Dx?

“…❚ The loss of consciousness may be caused by an emotional trigger (eg, sight of blood, cast removal, 8 blood or platelet donations 9,10 ), a painful event (eg, an injection 11 ), an orthostatic trigger 12 (eg, prolonged standing), or visceral reflexes such as swallowing. 13 In approximately 30% of cases, loss of consciousness is associated with memory loss.…”

Lateral ST-elevation myocardial infarction after donation of COVID-19 convalescent plasma in a naïve donor

“…Patients can commonly develop tingling or numbness around lips, jaw, neck and shortness of breath. Occasionally, profound hypotension and life-threatening arrhythmias can ensue, 19 which can generally confound physicians to be 'citrate reaction'. Citrate is used as a primary anticoagulant during apheresis procedures and makes calcium unavailable for coagulation cascade by chelation.…”