Profile of adverse events in plateletpheresis and plasmapheresis donors in a tertiary care hospital of North India

Harnoor S. Bhardwaj; Rajni Bassi; Kanchan Bhardwaj

doi:10.18203/2320-6012.ijrms20240529

Authors

Harnoor S. Bhardwaj Department of Pathology, University of Iowa Hospitals and Clinics, USA
Rajni Bassi Department of Immunohematology and Blood Transfusion, Govt. Medical College, Patiala, Punjab, India https://orcid.org/0000-0003-3833-0374
Kanchan Bhardwaj Department of Immunohematology and Blood Transfusion, Govt. Medical College, Patiala, Punjab, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20240529

Keywords:

Apheresis donor, Donor related adverse events, Non donor related adverse events, Citrate reactions

Abstract

Background: Apheresis procedures are usually well tolerated. Adverse events (AEs) associated with the use of cell separators can be due to delivery of the anticoagulant, vasovagal, allergy, venous access or machines malfunction. Aim was to study the profile of adverse events of plateletpheresis and plasmapheresis donors.

Methods: Plateletpheresis and plasmapheresis procedures enrolled for donors during 2017-2018 were done after taking informed and written consent by using Trima Accel and MCS+cell separator. Donor related AEs were categorised according to severity, site and etiology. Non-donor related (NDR) AEs were kit, technique, or equipment related.

Results: 2859 procedures were done, 2836 (99.19%) plateletpheresis and 23 (0.8%) plasmapheresis. All 145 (5.07%) AEs were seen in plateletpheresis. Majority of AEs, 130 (4.54%) were DR. 15 (0.52%) were NDR. Commonest DR AEs was citrate related (CR) 76 (2.6%), followed by vasovagal reaction (VVR) in 31 (1.08%) and vascular injury in 23 (0.8%). Majority of the AEs were mild in 124 (4.33%), only 6 (0.20%) were moderate. 107 (3.74%) AEs were (VI) systemic, while 23 (0.80%) were local. In local AEs, hematomas were more common. First time donors had more AEs, 62/1234 (5.02%) as compared to the repeat donors 68/1625 (4.18%). CR AEs were more in repeat donors, 46 (2.8%) as compared to first time donors, 30 (2.43%). VVRs and VIs were more in first time as compared to the repeat donors. NDR AEs were 15 (0.52%).

Conclusions: Donor vigilance, trained technical personnel and specialists’ supervision are vital for donor safety hence affecting apheresis donor pool.

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References

Winters JL. Complications of donor apheresis. J Clin Apher. 2006;21:132-41.

Despotis GJ, Goodnough L, Dynis M. Adverse events in platelet apheresis donors: A multivariate analysis in a hospital-based program. Vox Sang. 1999;77:24-32.

Saran RK. Apheresis. Available at: https://dghs. gov.in/Uploaddata/Transfusion%20Medicine%20Technical%20Manual%202023.pdf. Accessed on 20 November 2023.

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.

Crookston KP, Novak DJ. Physiology of apheresis. In: Mcleod BC, Szczepiorkowski, Weinstein R, Winters JL, eds. Apheresis: Principles and Practice. 3rd ed. Maryland: AABB press; 2010:45-69.

Heuft HG, Moog R, Fischer EG, Zingsem J. German and Austrian Plateletpheresis Study Group. Donor safety in triple plateletpheresis results from the German and Austrian Plateletpheresis Study Group multicenter trial. Transfusion. 2013;53:211-20.

Crookes RL, Hillyer CD. Blood banking and transfusion medicine. 2nd ed. Philadelphia: Churchill Livingstone; 2009.

Philip J, Sarkar RS, Pathak A. Adverse events associated with apheresis procedures: Incidence and relative frequency. Asian J Transfus Sci. 2013;7:37-41.

Agência Nacional de Vigilância Sanitária. Available at: http://bvsms.saude. gov.br/bvs/saudelegis/gm/ 2011/prt1353 13 06 2011.html. Accessed on 20 November 2023.

Wollersheim J, Dautzenberg M, van de Griendt A, Sybesma B. Donor selection criteria to maximize double platelet products (DPP) by platelet aphereãsis. Transfus Apher Sci. 2006;34:179-86.

Bassi R, Thakur KK, Bhardwaj K. Plateletpheresis adverse events in relation to donor and plateletpheresis session profile. Iraqi J Hematol. 2017; 6:38-42.

Barbosa MH, Nunes da Silva KF, Coelho DQ, Tavares JL, Falcao da Cruz LF, Kanda MH. Risk factors associated with the occurrence of adverse events in plateletpheresis donation. Rev Bras Hematol Hemoter. 2014;36(3):191-5.

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.

Tomita T, Takayanagi M, Kiwada K, Mieda A, Takahashi C, Hata T. Vasovagal reactions in apheresis donors. Transfusion. 2002;42:1561-6.

Dogra K, Fulzele P, Rout D, Chaurasia R, Coshic P, Chaterjee K. Adverse events during apheresis procedures: audit at a tertiary care hospital. Indian J Hematol Blood Transfus. 2017;33:106-8.

Henriksson MM, Newman E, Witt V, Derfler K, Leitner G, Eloot S, et al. Adverse events in apheresis: an update of the WAA registry data. Transfus Apher Sci. 2016;54:2-15.

Crocco I, Franchini M, Garozzo G, Gandini AR, Gandini G, Bonomo P, et al. Adverse reactions in blood and apheresis donors: experience from two Italian transfusion centres. Blood Transfus. 2009;7: 35-8.

Sujatha P, Murthy S, Margam KS. Adverse events associated with apheresis procedures: incidence and relative frequency. MRIMS J Health Sci. 2016;4:208-10.

Khajuria K, Sawhney V, Sharma R, Gupta S. Adverse donor reaction during and after plateletpheresis in a tertiary care centre. Int J Res Med Sci. 2017;5:1221-3.

Bolan CD, Greer SE, Cecco SA, Oblitas JM, Rehak NN, Leitman SF. Comprehensive analysis of citrate effects during plateletpheresis in normal donors. Transfusion. 2001;41:1165-71.

Bueno JL. Do we really know the real risks of apheresis donation? ISBT Sci Ser. 2007;2:68-74.

Borges TS, Vidigal DC, Chaves JM. Cadernos Hemominas: assistência de enfermagem na coleta de sangue do doador e na hemotransfusão. Belo Horizonte: Fundacãi Hemominas; 2004.

Ogata H, Linum N, Nagashima K, Akabane T. Vasovagal reactions in blood donors. Transfusion. 1992;32:23-6.

Mercan D, Bastin G, Lambermont M, Duponz E. Importance of ionized magnesium measurement for monitoring of citrate-anticoagulated plateletpheresis. Transfusion. 1997;37:418-22.