Influence of multicomponent apheresis on donors’ haematological and coagulation parameters, iron storage and platelet function

Abstract

Background and Objectives Multicomponent collection (MCC) enables production and processing of various blood components during one apheresis session. In this prospective crossover study, the effects of donating platelets (PLTs) and packed red blood cells (PRBCs) on donor’s blood cell count, coagulation, PLT function and iron state were analysed. Materials and Methods Forty‐eight MCCs were performed using two different cell separators (Fenwal Amicus®, CaridianBCT Trima Accel®). Two units of platelet concentrates and one unit of PRBCs were collected during each session. Full blood cell count and iron status were obtained on day 0 before and after apheresis, day 2, day 14 and day 42. PLT function was analysed by aggregometry and rotation thromboelastometry in parallel with coagulation tests before and after MCC and at day 2. Results Multicomponent collection was well tolerated without adverse side effects. Blood cell count and iron parameters declined and most of them (haemoglobin, haematocrit, transferrin, transferrin saturation and ferritin) were significantly below baseline values until at least day 42 after donation. Absent iron stores were seen in 31·3% of the donors. In contrast, PLTs significantly exceeded pre‐donation values after 14 days and remained significantly increased for 42 days. After 2 days, coagulation parameters were only slightly (P > 0·05) altered, whereas PLT function was significantly reduced. Conclusion Multicomponent collection is an obviously safe procedure; however, the significant long‐term impact on the donor’s blood count and iron store, as well as impaired PLT function, has to be considered in regard to donor safety.

Thromboelastography as a tool to evaluate blood of healthy volunteers and blood component quality: a review

“…This could not be related to levels of fibrinogen or antithrombin III, which did not change significantly. Post‐multicomponent apheresis, lower clot strength (~5%) was observed, the net result of lower PLT count (~30%) and fibrinogen levels (~16%) and lower haematocrit (~9%) . Post‐RBC apheresis, again a small hypercoagulable shift was detected.…”

“…A systematic review describes eight studies, but only studies were included which combined thromboelastography measurements with at least one conventional parameter of haemostasis. For the current review, only studies were included that have used citrate as anticoagulant .…”

Red Cell Apheresis with Automated In-Line Filtration

“…Regarding post-procedure changes in Hb, Macher et al [15] using Amicus and Trima Accel V5.2 to collect single RBC units with PLT units, showed changes very similar to those shown here, a 9% average decrease in donor Hb post-procedure which was unchanged 14 days later but returned to within 3% of the pre-procedure level within 6 weeks.…”

Impact of Plateletpheresis on the Hemoglobin, Hematocrit, and Total Red Blood Cell Count: An Updated Meta-Analysis

“…Refs. [2,13,16,20,[24][25][26]29] A funnel plot was used to rule out publication bias, which did not observe the statistically significant publication bias. The p value for hemoglobin was 0.57 and 0.47 for hematocrit, and the p value for erythrocyte count was found to be 0.09, which showed that there was no publication bias (Figures 5-7).…”