Leukotrap,a device for white cell poor platelets quality control studies In vitro and In vivo |
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| Affiliation: | 1. Neurosurgery Department, The Second Affiliated Hospital of Soochow University, Suzhou, China;2. Neurosurgery Department, Northern Jiangsu People''s Hospital, Yangzhou City, China;3. Spine Department, Northern Jiangsu People''s Hospital, Yangzhou City, China;1. Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland;2. Department of Surgery, Welfare District of Forssa, Forssa, Finland;1. Department of Orthopaedic Surgery, Tianjin Hospital, Tianjin, China;2. Department of Sports Medicine and Arthroscopic Surgery, Tianjin Hospital, Tianjin, China;3. Department of Internal Medicine, First People''s Hospital of Jingdezhen City, Jingdezhen, China;4. Department of Orthopaedic Surgery, Second Affiliated Hospital of Soochow University, Suzhou, China;1. Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan;2. Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan;3. Department of Neurology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan;4. College of Medicine, Taipei Medical University, Taipei, Taiwan;5. National Yang-Ming University, Taipei, Taiwan;6. Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan;7. Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;1. Hematology Stem Cell Transplant Transfusion Medicine and Cellular Therapy, Campus Bio-Medico University Hospital, Rome, Italy;2. Division of Urology, Campus Bio-Medico University Hospital, Rome, Italy;3. Division of Urology, Tor Vergata University Hospital, Rome, Italy;4. Stem Cell Transplant Unit, Department of Hematology, Tor Vergata University, Rome, Italy;5. Division of Hematology and Transplant, Sant’Eugenio Hospital, Rome, Italy;6. Division of Blood Bank, Department of Immunohematology, Tor Vergata University, Rome, Italy;1. Department of Education, Taipei Medical University Hospital, Taipei, Taiwan;2. Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;3. Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan;4. Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan |
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| Abstract: | Most febrile transfusion reactions are due to leucoagglutinins. Cutter's Leukotrap platelet pooling bag has a distal conic pouch for depleting the platelets of white blood cells by centrifugation. We tested 33 Leukotraps each containing six platelet units in vitro and 32 in vivo. The mean in vitro platelet count was 3.7 ± 0.5 × 1011 platelets before, and 3.0 ± 0.5 × 1011 after spinning, representing a platelet recovery of 80.2 ± 9.6% Mean white blood cells were 3.8 ± 0.6 × 108 before, and 0.6 ± 0.1 × 108 after centrifugation, this constituting a white cell removal of 83.5 ± 7.7%. pH ranged from 7.37 for 24-h platelets to 7.19 for 96-h platelets. 24-h after platelet pooling, all Leukotraps were sterile. Platelet aggregation with physiologic agents showed little change compared to individual platelet units. Glucose ranged between 418 and 336 mg/dL, pCO2 between 27.8 and 19.1 mmHg, but pO2 dropped drastically from 74.8 mmHg to 11.6 mmHg. Hypotonic osmotic recovery was satisfactory. In vivo studies were carried out with pooled, leucocyte-poor platelets which were transfused to six bone marrow transplant patients with no splenomegaly or septicemia at the outset. These patients had all demonstrated febrile transfusion reactions to standard donor units. The mean platelet increment was 16.8 × 109/L. A single febrile transfusion reaction witnessed in one patient, was accompanied by an adequate platelet response. Hence Leukotrap is a useful clinical tool for reducing febrile transfusion reactions related to white blood cells. |
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