Premium
Effects of high‐yield thrombocytapheresis on the quality of platelet products
Author(s) -
Julmy Friedgard,
Ammann Roland A.,
Mansouri Taleghani Behrouz,
Fontana Stefano,
Hirt Andreas,
Leibundgut Kurt
Publication year - 2008
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2007.01548.x
Subject(s) - apheresis , plateletpheresis , medicine , platelet , in vivo , platelet transfusion , aplastic anemia , surgery , bone marrow , microbiology and biotechnology , biology
BACKGROUND: The steadily increasing demands for single‐donor apheresis platelet (PLT) concentrates (APCs) are a challenge to the PLT supply system. Therefore, efforts to improve plateletpheresis yield, allowing apheresis products to be split into 2 or more units, are valuable strategies. No data to demonstrate in vivo transfusion efficacy of these high‐yield split‐APCs are currently available, however. STUDY DESIGN AND METHODS: The transfusion efficacy of APCs produced by two apheresis methods involving different harvest and storing procedures and varying PLT yields was investigated. Efficacy measures were the 1‐hour percent PLT recovery (PPR 1h ) and the 1‐hour corrected count increment (CCI 1h ). In total, 400 APCs, produced with either an Amicus device (Baxter) and stored in PLT additive solution (T‐Sol; Amicus method [AM], n = 107) or a Trima device (Gambro) and stored in plasma (Trima method [TM], n = 293), were transfused to 55 children (31 girls; median age, 9.5 years; range, 0.2‐18.5 years) with thrombocytopenia due to chemotherapy or aplastic anemia (median, 4 APCs per child; range, 1‐68). RESULTS: Transfusion efficacy was significantly lower for AM‐APCs than for TM‐APCs (median PPR 1h , 17 and 33%; median CCI 1h , 7.9 and 15.6, respectively; p < 0.001). Reduced transfusion efficacy correlated in a yield‐dependent manner with high apheresis PLT yields (≥6 × 10 11 ) for AM‐APCs (p < 0.001). CONCLUSION: Although in vitro validation of AM‐ and TM‐APCs has been performed, only by evaluating transfusion efficacy in vivo did the AM turn out to be not suitable for high‐yield thrombocytapheresis. This study recommends the implementation of in vivo transfusion efficacy studies for high‐yield APC apheresis donations.