Asian Journal of Transfusion Science
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ORIGINAL ARTICLE  
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Demographics of plateletpheresis donors and session profile in a teaching institute of Punjab


1 Department of Transfusion Medicine, Post Graduate Institute of MedicalEducation and Research, Chandigarh, India
2 Department of Immunohematology and Blood Transfusion, Dayanand Medical College and Hospital, Ludhiana, Punjab, India

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Date of Submission27-Mar-2021
Date of Decision19-Nov-2021
Date of Acceptance07-Jan-2022
Date of Web Publication12-Dec-2022
 

   Abstract 

BACKGROUND: Over decades, increased demand of platelet transfusions for patients with various conditions led to accelerated use of technologically advanced plateletpheresis.
AIMS: Study the demographics of plateletpheresis donor and plateletpheresis session profile.
SETTING AND DESIGN: Prospective, cross-sectional, open label study.
MATERIALS AND METHODS: Plateletpheresis performed on Trima Accel (TA) and mechanical circulatory support (MCS) + during 2017–2018 on donors selected according to the guidelines.
STATISTICAL ANALYSIS: SPSS (version 17) for windows statistical package.
RESULTS: Two thousand eighty hundred and thirty-six plateletpheresis procedures were done, out of which 666 (23.48%) were done on TA while 2170 (76.51%) were done on MCS +. Maximum donors, 1437 (55.66%) were in the 21–30 years category; Mean age was 30.75 years ± 8.44 standard deviation (SD); range18–65 years. Maximum donors 1185 (41.78%) were in the 61–70 kg category with mean weight - 74.33 kg ± 9.80 SD and mean height - 170.46 cm ± 4.99 SD only 4 (0.15%) donors were females. Two thousand six (70.73%) donors were voluntary, with 1620 (57.12%) repeat donors. Mean platelet count was 272.98 ± 56.59 × 109/L with maximum donors having platelet count between 200 and 300 × 109/L and ranged from 157 to 508 × 109/L. Mean hemoglobin of donors - 14.87 g % ± 3.16 SD; total serum protein - 6.31 g/dl ± 4.8 SD. Mean platelet yield was 3.50 × 1011 ± 0.71 SD; ranged from 2.9 to 7 × 1011. Plateletpheresis session profile of reactors and nonreactors showed that acid citrate dextrose used in reactors was more - 353.44 ml as compared to nonreactors - 311.72 ml. Reactors showed more volume of whole blood processed - 2899.43 ml as compared to nonreactors - 2601.63 ml. Time taken for completing the session was more in reactors - 82.40 mins as compared to nonreactors - 70.80 min. Platelet yield was 3.79 × 1011 and 3.49 × 1011 and plasma volume was 275.6 ml and 261.2 ml in reactors and nonreactors respectively.
CONCLUSION: Demographics of plateletpheresis donors and session profile are vital for their safety.

Keywords: First time/repeat plateletpheresis donors, nonreactors, platelet yield, predonation platelet count, reactors, single donor platelets, voluntary/replacement plateletpheresis donor


How to cite this URL:
Bhardwaj HS, Kaur A, Kumar R, Gupta S. Demographics of plateletpheresis donors and session profile in a teaching institute of Punjab. Asian J Transfus Sci [Epub ahead of print] [cited 2023 Jan 28]. Available from: https://www.ajts.org/preprintarticle.asp?id=363229



   Introduction Top


Over decades, increased demand of platelet transfusions for patients led to accelerated use of technologically advanced plateletpheresis for preparing platelet concentrates (PC).[1] This has led to a trend in the increased use of single donor platelets obtained by automated cell separators. Multiple blood components can be collected concurrently which are cost-effective and more blood components can be collected from a limited donor pool.[2],[3] Progressive improvement in cell separators gives platelet concentrates with leukocytes <1 × 106.[4]

Aims and objectives

To study the plateletpheresis donor and plateletpheresis session profile in a Teaching Institute of Punjab.


   Materials and Methods Top


Prospective, observational, open-label study, in which plateletpheresis donors were enrolled after taking informed and written consent. Plateletpheresis procedures done during 2017–2018 were included in the study. Plateletpheresis was performed on Trima Accel (TA) (Terumo BCT, Lakewood USA), a continuous type of cell separator and mechanical circulatory support (MCS) + (Haemonetics Corp., Braintree, USA), an intermittent type of cell separator. All donations were collected using a 16-gauge needle inserted into a vein in the antecubital fossa using aseptic precautions. All the donors were selected according to the guidelines laid down by the Director-General Health Services, Ministry of Health, Govt. of India.[5] Data were compiled in a Microsoft Excel spreadsheet. Obtained data were presented as a mean ± standard deviation (SD), numbers, and percentage according to requirement. Results were analyzed using the Chi-square test. Statistical analysis was conducted using the SPSS version 17 (2008, IBM, Chicago, IL, USA.) for Windows statistical package.


   Results Top


Two thousand eighty hundred and thirty-six plateletpheresis procedures were done out of which 666 (23.48%) were done on TA while 2170 (76.51%) were done on MCS +.

Plateletpheresis donor profile

Maximum plateletpheresis donors, 1437 (55.66%) were in the 21–30 years category and the minimum were in the 51–60 years. age group, 69 (2.43%). The mean age was 30.75 years ± 8.44 SD with a range from 18 years to 65 years. Maximum plateletpheresis donors 1185 (41.78%) were in the 61–70 kg category followed closely by 71–80 Kg category with 1020 (36.28%) donors. Minimum donors 160 (5.59%) were in the 91–100 kg category. The mean weight of the donors was 74.33 kg ± 9.80 SD The mean height of the donors was 170.46 cm ± 4.99 SD The minimum height was 154 cm while the maximum was 182 cm. There were only 4 (0.15%) female plateletpheresis donors while the remaining plateletpheresis donors 2832 (99.85%) were males.

ABO Rh blood group distribution of plateletpheresis donors showed B positive donors constituting maximum donors, 1060 (37.37%) followed by O positive donors, 819 (28.87%) and A positive donors, 554 (19.53%). A negative and B negative donors contributed 31 (1.09%) donors each. Least found blood group among plateletpheresis donors was AB negative with only 9 (0.31%) donors.

Plateletpheresis donors were mainly voluntary, 2006 (70.73%) with replacement donors constituting 830 (29.26%) plateletpheresis donors. First-time and repeat plateletpheresis donor profiles showed repeat donors, 1620 (57.12%) were predominating with first-time donors constituted by 1216 (42.8%).

Predonation platelet count in plateletpheresis donors showed that the mean predonation platelet count was 272.98 ± 56.59 × 109/L with maximum donors having platelet count between 200 and 300 × 109/L ranging from 157 × 109/L to 508 × 109/L. The distribution of predonation platelet count of plateletpheresis donors on TA and MCS + is shown in [Table 1]. Mean predonation hemoglobin of apheresis donors was 14.87 g % ± 3.16 SD The mean predonation total serum protein was 6.31 g/dl ± 4.8 SD with a range from 6 g/dl to 7.6 g/dl.
Table 1: Predonation platelet count distribution of plateletpheresis donors

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Adverse event profile

Out of total of 2386 procedures, 145 (5.07%) procedures were associated with adverse events. Majority of adverse events, 130 (4.54%) were donor-related (DR). Very few, 15 (0.52%) were nondonor related. The incidence of DR adverse events showed that the most common adverse event was citrate related (CR), seen in 76 (2.6%) donors followed by vaso-vagal reactions (VVR) which were 31 (1.08%) and vascular injury (VI), in 23 (0.8%) donors. In CR adverse events, out of 76 (2.6%) donors, 52 (01.8%) donors developed numbness and tingling, while 24 (0.8%) donors developed perioral paraesthesias. CR adverse events were more in repeat donors, 46 (2.8%) as compared to first-time donors, 30 (2.43%). The VVR and VI were more in first-time donors, as compared to the repeat donors, 18 (1.48%) and 13 (0.8%), 14 (1.1%), and 9 (0.55%), respectively.

Plateletpheresis session profile

The mean platelet yield of all plateletpheresis sessions was 3.50 × 1011 ± 0.71 SD with a range from 2.9 × 1011 to 7 × 1011. The platelet yield [Table 2], showed the majority of the donors, 1233 (43.47%) and 1231 (43.40%) with a yield of <3 × 1011 and 3.1–4 × 1011 respectively. Maximum platelet yield of >6 × 1011 was seen in 22 (0.77%) donors. Plateletpheresis session profile on TA and MCS + is shown in [Table 3].
Table 2: Platelet yield of plateletpheresis sessions

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Table 3: Plateletpheresis session profile

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Donors of the 145 procedures, where adverse events were reported, were termed as reactors. Plateletpheresis session profile of reactors and nonreactors showed that the amount of acid citrate dextrose (ACD) used in reactors was more, 353.44 ml as compared to non-reactors, 311.72 ml. The reactors processed more amount of whole blood, 2899.43 ml in comparison with nonreactors, 2601.63 ml. The time taken for completing the session was more in reactors, 82.40 min as compared to nonreactors, 70.80 min. The platelet yield of reactors and nonreactors was 3.79 × 1011 and 3.49 × 1011. The plasma volume of reactors and nonreactors was 275.6 ml and 261.2 ml respectively.


   Discussion Top


Plateletpheresis donor profile

The potential plateletpheresis donor should meet several requirements to be accepted as a suitable candidate for blood component donation.[6] Criteria such as hematocrit or hemoglobin levels, age, weight, and minimum platelet count are important for the safety of the donor.[7]

In the present study, most of the plateletpheresis donors 1437 (55.66%) were in the age group of 21–30 years. The mean age was 30.74 years ± 8.44 SD with a range from 18 years to 65 years. This is similar to the study of Bassi et al.[8] where maximum apheresis donors (68.07%) were in the age group between 21 and 30 years, minimum age being 19 years and maximum age being 60 years. In the study conducted by Barbosa et al.[9] the mean age was 40 years (SD = 8.9), with the most prevalent age group being between 40 and 49 years (40.8%).

In the present study, most of the plateletpheresis donors 2832 (99.83%) were male. Only 4 (0.15%) donors were female. This was similar to the study of Bassi et al.[8] where all the donors were male. Females did not fulfill the criteria for the selection of apheresis donors. Most of the females were anemic, underweight, or had poor veins. Alloimmunization due to repeated pregnancies also makes the females unfit for donation.[10] Several studies show a common profile for donation, in which there are larger number of male donors.[10],[11],[12],[13]

Weight or body mass is indicated as the criterion to maximize plateletpheresis donation because higher platelet yields can be obtained from larger donors with higher blood volume.[11] In the present study, weight-wise distribution of plateletpheresis donors showed maximum donors, 1185 (41.78%) in the 61–70 kg category followed closely by 71–80 kg category with 1029 (36.28%) donors. The maximum weight was 100 kg while the minimum weight was 60 kg. The mean weight of the donors was 74.33 kg ± 9.80 SD This was similar to the results of Bassi et al.[8] where maximum donors (47.88%) were in the 61-70 kg category; the weight of donors ranged from 60 kg to 115 kg. In the study conducted by Barbosa et al.[9] the mean weight of the donor was 78.7 kg which was close to the findings of the present study.

In the present study, ABO Rh blood group distribution of plateletpheresis donors showed B positive donors constituting maximum donors, 1060 (37.37%) followed by O positive donors, 819 (28.87%)., which correlates with the known fact, that the most common blood group in north India is B positive, followed by O positive. In a study conducted by Agrawal et al.[14] where they compared 5 different regions of India, north, south, east, west, and center, among these five regions studied, O was the most prevalent group in all the regions of the country except north where B was the predominant group, followed by O group.

In the present study, maximum plateletpheresis donors, 2006 (70.73%) were voluntary while 830 (29.26%) were replacement. This was similar to the study of Bassi et al.[8] where 136 (63.84%) were voluntary and 77 (36.15%) were replacement donors. In the present study, maximum plateletpheresis donors, 1620 (57.12%) were repeat donors while 1216 (42.8%) were first-time donors. It may be because voluntary donors were repeat donors.

In the present study, mean predonation hemoglobin of plateletpheresis donors was 14.87 g % ± 3.16 SD whereas in the study conducted by Bassi et al.[8] the predonation mean hemoglobin was 13.76 g/dl in plateletpheresis donors. In the study conducted by Barbosa et al.[9] the mean values of predonation hemoglobin and hematocrit were 14.8 g/dl and 44%, respectively in plateletpheresis donors. In the present study, predonation PC of plateletpheresis donors showed maximum donors, 939 (33.11%) with PC of 250–300 × 109/L followed by 914 (32.22%) with PC of 200–250 × 109/L. The mean predonation PC was 272.98 ± 56.59 × 109/L with maximum plateletpheresis donors having PCs between 200 and 300 × 109/L. The predonation PCs ranged from 157 × 109/L to 508 × 109/L. Literature showed similar results with the mean preprocedural PC as 281 × 109/L, maximum donors (31.92%) having preprocedural PC between 201 and 250 × 109/L, preprocedural PCs ranging from 170 to 450 × 109/L.[8]

Plateletpheresis session profile

Comparison of plateletpheresis session profile in the present study with various studies is shown in [Table 4]. The findings in the present study were closer to those of Barbosa et al.[9] where all the procedures were done on MCS +. In the present study 666 (23.48%) plateletpheresis procedures were done on TA while 2170 (76.51%) were done on MCS +. However in the study conducted by Bassi et al.[8] all the procedures were done on TA.
Table 4: Comparison of plateletpheresis session profile in various studies

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The platelet yield of all plateletpheresis sessions shows the majority of the donors, 1233 (43.47%) and 1231 (43.40%) with a yield of <3 × 1011 and 3.1–4 × 1011 respectively. The mean platelet yield was 3.50 × 1011 ± 0.71 SD with a range from 2.9 × 1011 to 7 × 1011. In the study conducted by Bassi et al.,[8] in 53.52% donations, platelet yield was 3 × 1011. In 15.02% donations, platelet yield was 6 × 1011. While platelet yield of >6 × 1011 was seen in only 0.77% plateletpheresis donors.

In the present study, the plateletpheresis session profile of reactors and nonreactors showed that amount of ACD used and whole blood processed in reactors was more, as compared to nonreactors. This is similar to the study done by Patidar et al.[15] which showed that total blood volume processed and ACD infused were higher in reactors as compared to non-reactor plateletpheresis donors [Table 5].
Table 5: Comparison of plateletpheresis session profile of reactors and nonreactors in various studies

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In the present study, meantime taken for completing the plateletpheresis session was higher (82.40 min) in reactors, as compared to non-reactors (70.80 min). Similar to the present study, Yuan et al.[12] revealed that adverse events occurred in apheresis procedures which took more time (mean: 77.1 min) and had a higher infusion of ACD (mean: 301.5 ml) compared to those without adverse events.

Bassi et al.[8] reported that the mean volume of blood processed, the mean amount of ACD used, and the duration of run was more in plateletpheresis donors with low platelet count as compared to donors with high platelet count with the same platelet yield. This is because the machine has to process more blood volume with more infusion of ACD to the plateletpheresis donor to achieve the same platelet yield in donors with low platelet count, thus more adverse events (CR).


   Conclusions Top


Demographics of plateletpheresis donors determine the outcome of plateletpheresis session profile and plateletpheresis donor safety.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Dogra K, Fulzele P, Rout D, Chaurasia R, Coshic P, Chatterjee K. Adverse events during apheresis procedures: Audit at a tertiary hospital. Indian J Hematol Blood Transfus 2017;33:106-8.  Back to cited text no. 1
    
2.
Waxman DA. Multicomponent donor apheresis in the Americas. Ther Apher Dial 2004;8:93-6.  Back to cited text no. 2
    
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Popovsky MA. Multicomponent apheresis blood collection in the United States: Current status and future directions. Transfus Apher Sci 2005;32:299-304.  Back to cited text no. 3
    
4.
Murphy S. Preservation and clinical use of platelets. In: Beutler E, Coller BS, Lichtman MA, Kipps TJ, Seligsohn U, editors. Williams Hematology. 6th ed. New York: Mc Graw-Hill; 2001. p. 1905-16.  Back to cited text no. 4
    
5.
Saran RK. Apheresis. In: Transfusion Medicine Technical Manual. New Delhi: Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India; 2003. p. 229-43.  Back to cited text no. 5
    
6.
Brasil. Agência Nacional de Vigilância Sanitária. Portaria MS no. 1.353, de 13.06.2011. Brasília: Agência Nacional de Vigilância Sanitária; 2011. Available from: http://bvsms.saude.gov.br/bvs/saudelegis/gm./2011/prt1353 13 06 2011.html. [Last accessed 2012 May 18].  Back to cited text no. 6
    
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Fundacao Hemominas. Manual de Normas e Procedimentos de Atendimento ao Doador; 2012.  Back to cited text no. 7
    
8.
Bassi R, Thakur KK, Bhardwaj K. Plateletpheresis adverse events in relation to donor and plateletpheresis session profile. Iraqi J Hematol 2017;6:38-42.  Back to cited text no. 8
  [Full text]  
9.
Barbosa MH, da Silva KF, Coelho DQ, Tavares JL, da Cruz LF, Kanda MH. Risk factors associated with the occurrence of adverse events in plateletpheresis donation. Rev Bras Hematol Hemoter 2014;36:191-5.  Back to cited text no. 9
    
10.
Middelburg RA, Van Stein D, Zupanska B, Uhrynowska M, Gajic O, Muñiz-Diaz E, et al. Female donors and transfusion-related acute lung injury: A case-referent study from the International TRALI Unisex Research Group. Transfusion 2010;50:2447-54.  Back to cited text no. 10
    
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Wollersheim J, Dautzenberg M, van de Griendt A, Sybesma B. Donor selection criteria to maximize Double Platelet Products (DPP) by platelet apheresis. Transfus Apher Sci 2006;34:179-86.  Back to cited text no. 11
    
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Yuan S, Gornbein J, Smeltzer B, Ziman AF, Lu Q, Goldfinger D. Risk factors for acute, moderate to severe donor reactions associated with multicomponent apheresis collections. Transfusion 2008;48:1213-9.  Back to cited text no. 12
    
13.
Guo N, Wang J, Ness P, Yao F, Dong X, Bi X, et al. Demographics of apheresis platelet donors in five blood centers in China. Transfusion 2012;52:560-6.  Back to cited text no. 13
    
14.
Agrawal A, Tiwari AK, Mehta N, Bhattacharya P, Wankhede R, Tulsiani S, et al. ABO and Rh (D) group distribution and gene frequency; the first multicentric study in India. Asian J Transfus Sci 2014;8:121-5.  Back to cited text no. 14
[PUBMED]  [Full text]  
15.
Patidar GK, Sharma RR, Marwaha N. Frequency of adverse events in plateletpheresis donors in regional transfusion centre in North India. Transfus Apher Sci 2013;49:244-8.  Back to cited text no. 15
    

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Correspondence Address:
Harnoor Singh Bhardwaj,
4-A, Dhillon Marg, Model Town, Patiala - 147 001, Punjab
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajts.ajts_39_21




 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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