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Quantitative assessment of the anticoagulant in plasma units collected by plasmapheresis
Author(s) -
Vurro Filippo,
Merolle Lucia,
Marraccini Chiara,
Parisi Maura,
Canovi Laura,
Erta Barbara,
Santachiara Annalisa,
Bonvicini Laura,
Giorgi Rossi Paolo,
Baricchi Roberto,
Pertinhez Thelma A.
Publication year - 2019
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/trf.15244
Subject(s) - plasmapheresis , anticoagulant , plasma volume , medicine , multivariate statistics , statistics , immunology , mathematics , antibody
BACKGROUND To date, the quantification of the anticoagulant (ACD‐A) in plasma units has been based on theoretical calculations. An accurate quantification could help minimize the risks associated with plasmapheresis, given that the total ACD‐A used during the procedure is distributed between the donor and the plasma unit. Our aim was to experimentally quantify the volume of ACD‐A in units collected by plasmapheresis. STUDY DESIGN AND METHODS We used proton nuclear magnetic resonance spectroscopy to measure the ACD‐A volume in 295 plasma units collected by the Azienda USL‐IRCCS of Reggio Emilia, Italy. We analyzed the determinants of the differences between estimated and measured ACD‐A through multivariate regression models. RESULTS The experimentally measured ACD‐A in plasma units was variable, with 45% of the samples showing a discrepancy of more than 15 mL compared to the manufacturer's estimate. ACD‐A was underestimated for higher density of the units (p < 0.0005); a weak association was also observed with triglycerides (underestimated for higher levels, p = 0.015) and sex (overestimated in females, p = 0.008), but our model explained only 35% of the individual variability. CONCLUSION The manufacturer's algorithms do not accurately estimate the ACD‐A in units collected by plasmapheresis. Donor‐related characteristics may affect ACD‐A distribution between donor and plasma unit, thereby explaining the discrepancies between estimate and measurement. Errors in the estimate of the ACD‐A actually received by donors could hamper studies on dose–response relationship between anticoagulant and adverse reactions. Our work should stimulate research on tailored procedures aimed at minimizing the anticoagulant received by donors and increasing plasmapheresis safety.