Calcium and magnesium levels during automated plateletpheresis in normal donors

It is well known that citrate induces ionized hypocalcaemia by the chelating effect during plateletpheresis. However, the kinetics of serum magnesium (Mg) ions has not been well documented. We, therefore, evaluated biochemical changes in healthy donors during plateletpheresis procedure. Ten healthy donors underwent plateletpheresis on continuous cell separator (CS3000, Baxter, Round Lake, IL, USA) and 10 on intermittent flow cell separator (MCS 3p, Hemonetics, Braintree, MA, USA). Serum levels of total and ionized calcium (tCa and iCa, respectively) and Mg (tMg and iMg, respectively) were measured before, during and after the procedures. Although, the fall in tCa (from 2.62 +/- 0.12 to 2.36 +/- 0.12 mmol L(-1)) and tMg (from 0.89 +/- 0.01 to 0.79 +/- 0.01 mmol L(-1)) was modest and not significant; drop in iCa (from 1.33 +/- 0.1 to 0.84 +/- 0.1 mmol L(-1)) and iMg (from 0.53 +/- 0.01 to 0.35 +/- 0.1 mmol L(-1)) was statistically significant (P < 0.001). There were no significant differences observed between the CS3000 and MCS 3p cell separators regarding the fall in Ca and Mg. None of the donors experienced any adverse reactions during the procedures. In the study, an acute ionized hypocalcaemia and hypomagnesaemia have been observed after the plateletpheresis; therefore, measurement of both the ions may be monitored. However, there is no justification for prophylactic supplementation of either of these elements.     

Comparative study of plateletpheresis using Baxter CS 3000 plus and Haemonetics MCS 3P

Platelet concentrates made from cell separators are used more frequently due to less donor exposure and leucodepletion. This retrospective study was done to compare plateletpheresis done on two cell separators: Baxter CS 3000 plus and Haemonetics MCS 3p. Plateletpheresis procedures, done from January 1997 to April 2002, were included in the study. One hundred and seven procedures were done on Haemonetics MCS 3p using SDP protocol, 49 procedures were done on Haemonetics MCS 3p using PLP protocol, and 107 were done on Baxter CS 3000 plus. Pre-procedure donor's platelet count and haemoglobin were comparable in all the groups. Platelet yield was comparable in PLP (6.44 x 10(11) platelets) and SDP (5.27 x 10(11)) protocols, but significantly less in Baxter (4.05 x 10(11) platelets, P < 0.001 for PLP and P < 0.05 for SDP). Efficiency of platelet removal was statistically significantly different in all the groups (P < 0.0001), however it was more in PLP (PLP-55.02%, SDP-47.38%, Baxter 38.98%). A significant number of products (19.51%) of Baxter failed to comply platelet count of product < or = 2,435 x 10(9)/l compared to 5.13% in PLP and 1.23% in SDP group; 36.96% of units from PLP and 28% from SDP qualified for split products compared to 1.18% of Baxter. PLP protocol of Haemonetics MCS 3p gives better platelet yield compared to Baxter CS 3000 plus and SDP protocol of Haemonetics MCS 3p.     

Therapeutic plateletpheresis in a case of symptomatic thrombocytosis in chronic myeloid leukemia

Extreme thrombocytosis is a frequent feature in myeloproliferative disorders which can predispose a person to thrombotic complications. As opposed to other myeloproliferative disorders, symptomatic thrombocytosis is rare in chronic myeloid leukemia. We describe a second case report of chronic myeloid leukemia (Ph chromosome positive) in a patient in chronic phase on hydroxyurea who presented with sudden onset digital cyanosis of the left hand, giddiness, headache and malaise due to extreme thrombocytosis. A 67% global reduction in the platelet count from 1553 x 10(9)/L to 513 x 10(9)/L after two therapeutic plateletpheresis procedures was seen. There was simultaneous improvement in all symptoms except cyanosis on the tip of the middle finger that progressed to dry gangrene. Dramatic reduction in the platelet count and ablation of symptoms by therapeutic plateletpheresis is an effective therapy and should begin as soon as possible.     

Plateletpheresis with the new Fresenius AS 104 blood cell separator

Among the many blood cell separators introduced into the international market in these last few years, the Fresenius AS 104 represents an advanced and safe thrombocytapheresis machine whose development took advantage of extensive worldwide experience with blood cell separation. Nonetheless the AS 104 has generated most interest in West Germany and most, if not all, the studies published on its platelet collection efficiency have been carried out in that country. It is normally reported that from 2.7 to 3.5 x 10(11) platelets can be collected in approximately 80 minutes. Since these results could not be duplicated routinely in our hemapheresis unit, we set up a study by modifying the standard procedure. It was possible to reduce the procedure time and to collect platelet concentrates containing more than 4 x 10(11) cells on a routine basis by using the following procedure: ACD-A/blood ratio 1:10; Interface position 6:2; blood flow rate always exceeding 65 mL/min; rpm 1750; cell collection from 4 to 7 mL/min; volume of blood processed 3.6 L followed by the rinsing of the system with 200 ml of saline; extraction of the content of the secondary separation chamber by the action of the plasma pump working at 20 mL/min for 2 min. With this procedure the platelet yield in 34 collections exceeded 3.1 x 10(11) and averaged 4.06 x 10(11). The procedure time was reduced to 56.5 minutes with a mean blood flow rate of 62.3 mL/min. The leukocyte and erythrocyte contamination of the products were in the range of 1 x 10(7) and 1 x 10(8) respectively.(ABSTRACT TRUNCATED AT 250 WORDS)     

单采血小板献血者铁蛋白状况调查与分析

目的 调查单采血小板献血者(以下简称献血者)的铁储存状况,为制定科学献血策略及服务献血者提供依据.方法 对北京市红十字血液中心3 444例单采血小板献血者进行血浆铁蛋白检测结果 分析,分别从性别、年龄、献血状态和近1年献血次数评估献血者铁蛋白状况.结果 3 444例单采血小板献血者铁蛋白低值率为26.63％,其中男性为...     

单采冰冻血小板临床应用疗效的分析

目的:探讨单采血小板冰冻保存前后的计数变化及临床应用疗效.方法:检测单采血小板在-80℃保存前后的血小板计数;将患者随机分为两组,分别输注冰冻血小板与新鲜血小板,观察患者输注前后血小板计数上升值及临床止血情况.结果:输注单采冰冻血小板和单采新鲜血小板均有明显止血疗效,冰冻血小板输注总有效率为87.5%,对外科手术中大出血患者的输注有效率达100%;新鲜血小板输注总有效率为97.5%.结论:冰冻血小板有明显止血疗效,最适合在手术或急症患者因血小板减少而引起大出血的及时治疗性输注.     

复方利多卡因乳膏对单采血小板静脉穿刺镇痛效果

目的观察复方利多卡因乳膏在单采血小板静脉穿刺中的镇痛效果。方法将95例捐献血小板的献血者分为两组。A组为复方利多卡因乳膏作用30min,B组为复方利多卡因乳膏作用1h,同一献血者的右臂设为实验组,左臂为对照组（穿刺位置涂抹等量的护手霜）。按视觉模拟评分法（VAS）评估献血者静脉穿刺时的疼痛程度。结果A组50例献血者中显效20例,中效18例,有效率为76．00％,实验组、对照组镇痛效果差异有显著性（x2=28．83,P〈0．01）。B组45例献血者中显效25例,中效13例,有效率为84．44％,实验组、对照组镇痛效果差异有显著性（x2=24．51,P〈0．01）。但A组与B组有效率比较差异无显著性（P〉0．05）。结论复方利多卡因乳膏可减轻献血者单采血小板静脉穿刺时的疼痛感,可作为一种良好的镇痛剂,为了减少献血者的等待时间实际工作中选择作用30rain即可。     

The effect of continuous-flow automated plateletpheresis on fibrinolytic activity of donor plasma

Blood circulating in extracorporeal circuit of the apheresis sets has a contact with an artificial surface. The data on the influence of plateletpheresis on fibrinolytic activity are very limited and difficult to interpret. The aim of our study was to estimate the effect of plateletpheresis on the activation of fibrinolysis. Plateletpheresis was performed in 17 healthy blood donors using continuous-flow cell separator COM.TEC (Fresenius, Bad Homburg, Germany). Before and after plateletpheresis, blood samples were taken and markers of fibrinolysis (PAP, t-PA, PAI-1) as well as factor XII activity have been measured. We observed statistically significant decrease in t-PA and factor XII activities after plateletpheresis. There were no significant changes in concentrations of t-PA, PAI-1 and PAP as well as PAI-1 activity after plateletpheresis. Plateletpheresis performed by COM.TEC cell separator has very little, if any, effect on the activation of fibrinolysis. The mechanism of the inhibition of t-PA activity needs further investigations.     

National audit of citrate toxicity in plateletpheresis donors

Citrate toxicity complicating plateletpheresis is not uncommon. However, the scale and severity of the problem have never been formally addressed. In order to answer these questions we undertook a national audit of 13 070-platelet procedures throughout 17 apheresis centres in England over a 3-month period from 1 April to 30 June 2000. A standard form was distributed to each centre to record the symptoms/signs of citrate toxicity which were then graded (grades 1-5) according to their severity. The following variables were studied to determine whether they influenced the frequency and severity of citrate toxicity: 1. The type of manufacturer's cell separator used (Cobe Spectra, Haemonetics, Baxter Amicus and Trima). 2 The type of procedure: single needle, dual needle, single, double or triple dose. 3 The way in which donors were instructed to report symptoms of citrate toxicity. OUTCOME: Plateletpheresis is a relatively safe procedure provided that donors who experience severe reactions receive appropriate treatment. The incidence of severe citrate toxicity (0.03% procedures) is comparable to that of severe faints following whole blood donation, indicating a comparable margin of safety. Donors should be warned of the symptoms of citrate toxicity at their first attendance only. More frequent reminders encourage donors to over-report symptoms of mild citrate toxicity.