Recovery of Platelet Count among Apheresis Platelet Donors

Abstract

INTRODUCTIONApheresis in greek (apairesos) literally means to take away [1]. For many years, platelets were obtained by two step centrifugation process (buffy coat and Platelet rich plasma methods) from whole blood donations. Apheresis platelets became available by year 1970 [2]. Platelets obtained from apheresis technique are termed as Single Donor Platelets (SDP). SDP have advantages over Random Donor Platelets (RDP) in various aspects [3]. Apheresis has an adverse effect on donor haematopoiesis with short term and long term effects like anemia, thrombocytopenia, lymphocytopenia [4]. The first Food and Drug Administration (FDA) guideline on Plateletpheresis, in 1983 limited the number of procedures to 12 in a year with no more than twice a week and minimum interval between two procedures must be 48 hours. In 1988, the FDA revised the upper limit to 24 procedures in a year. With blood centres collecting double dose and triple dose of platelets to meet the demand, FDA issued a draft guidance to limit the number of platelet components to be collected in a year to 24 rather than 24 procedures [5].With increased demand for apheresis platelets, higher platelet yield and higher donation frequencies were followed to meet the demand. This practice has raised concern on donor platelet depletion. The effects of apheresis donation on donor haematological parameters have been studied more in the west. There remains a conflicting picture on the effect of platelet apheresis on the donor with some studies concluding even repeated platelet apheresis is safe with no significant adverse effects [6] and some reporting significant effect on haematopoiesis [7]. AABB guidelines require an apheresis platelet to have a product count of more than 3x10 11 platelets / bag in atleast 90% of the products, whereas the 2007 council of Europe recommends >2 x10 11 platelets per haemostatic dose of SDP [8]. Donor can donate platelets at a minimum interval of 48 hours, not more than twice a week and not more than 24 times a year. AABB standards do not require a pre platelet count for single and double apheresis platelet collections. A Pre-donation count is required only if the frequency of donation is within 4 weeks of last donation [9]. The guidelines governing the frequency of plateletpheresis donations are derived from the west, it has to be determined to what extent these guidelines can be applied to Indian population by short term and long term follow-up of these donors. AImTo analyse the recovery of platelet count to baseline among apheresis platelet donors. mATeRIAls AND meThODsA prospective observational study carried out in Department of Transfusion Medicine during the period 2013-2014 with approval from Institutional ethics committee. Fifty apheresis platelet donors were included in the study. The sample size was arrived based on previous years experience on the number of apheresis procedures that were average 48 procedures per year.Standard operating procedure derived from Director General of Health Services (DGHS) guidelines for aphe...

Effect of plateletpheresis on hematocrit, hemoglobin and erythrocyte count: Meta-analysis 1980–2018

“…However, there are reports on the possible adverse effects of apheresis platelet donation. Some of these may be short-term, such as those related with the anticoagulant (ACD-A), and others are associated with the procedure, like the loss of red blood cells; although these are not considered significant due to the current availability of technology 1 , some authors report that plateletpheresis can have long-term consequences such as anemia, iron deficiency and thrombocytopenia 3 . Other authors present opposing data while stating that platelet donation by apheresis does not entail a significant loss of erythrocytes or of any other cell component 1–4 .…”

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“…Moreover, in vivo studies looking at non-regenerating myofibers remain to be conducted to obtain a better understanding whether plateletbased applications are effective at increasing performance. Additionally, platelet concentration typically takes up to 7 days to return to baseline in the blood after donation with prolonged storage of platelet releasate, supra-physiological levels of growth factors can be achieved [55].…”

Effect of Frequency of Platelet Apheresis on Coagulation Function in Donors: A Prospective Cohort Study

“…It was known that the clinical efficacy of plateletpheresis is significantly better than that by manual collection, therefore it has been widely used in the clinical practice for many years [2, 3]. As the clinical use of plateletpheresis has been increased [3, 4], the contradiction between clinical supply and demand of plateletpheresis has become increasingly prominent due to a limitation of donors. To help address this in the USA, the FDA increased the number of maximum donations in a year from 12 to 24 times in 1988 [4].…”

“…As the clinical use of plateletpheresis has been increased [3, 4], the contradiction between clinical supply and demand of plateletpheresis has become increasingly prominent due to a limitation of donors. To help address this in the USA, the FDA increased the number of maximum donations in a year from 12 to 24 times in 1988 [4]. However, this might be detrimental to donors [4, 5].…”

“…To help address this in the USA, the FDA increased the number of maximum donations in a year from 12 to 24 times in 1988 [4]. However, this might be detrimental to donors [4, 5]. Then concerned about the effect of multiple platelet product donation on donor health, the FDA proposed restrictions limiting the number of platelet products donated in 12 months in 2005 [5].…”