Das Sudipta Sekhar, Chaudhary Rajendra, Verma Sunil Kumar, Ojha Shashank, Khetan Dheeraj
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Blood Transfus. 2009 Jul;7(3):188-92. doi: 10.2450/2009.0064-08.
Although automated cell separators have undergone a lot of technical refinements, attention has been focused more on the quality of platelet concentrates than on donor safety. We planned this prospective study to observe the effects of automated plateletpheresis on normal haematological values of healthy donors and to determine whether the haematological alterations had any clinical consequences.
The study was conducted on 457 healthy, first-time plateletpheresis donors over a period of 26 months. The plateletpheresis procedures were performed using five different cell separators and various pre- and post-donation haematological values such as haemoglobin concentration (Hb), haematocrit (Hct), platelet and white blood cell (WBC) counts, mean platelet volume and platelet distribution width were measured in all donors.
We observed that the Hb, Hct, platelet and WBC counts decreased significantly in the donors (p<0.01) after each procedure, without there being significant changes in mean platelet volume or platelet distribution width. The decreases in Hb and Hct were significantly greater with the CS 3000 and Amicus machines, while the decreases in platelet and WBC counts were significantly greater with the CS 3000 and Fresenius separators.
Although a significant drop in complete blood count was observed in all donors, none manifested features of thrombocytopenia or anaemia. Nevertheless, more prospective studies on this aspect are required in order to establish guidelines for donor safety in apheresis and also to help in assessing donor suitability, especially given the present trend of double product apheresis collections.
尽管自动细胞分离器在技术上有了很多改进,但人们更多地关注血小板浓缩物的质量,而不是供体安全。我们开展这项前瞻性研究,以观察自动血小板单采术对健康供体正常血液学指标的影响,并确定血液学改变是否有任何临床后果。
本研究在26个月内对457名首次进行血小板单采术的健康供体进行。使用五种不同的细胞分离器进行血小板单采术,并测量所有供体献血前后的各种血液学指标,如血红蛋白浓度(Hb)、血细胞比容(Hct)、血小板和白细胞(WBC)计数、平均血小板体积和血小板分布宽度。
我们观察到,每次操作后供体的Hb、Hct、血小板和WBC计数均显著下降(p<0.01),而平均血小板体积或血小板分布宽度无显著变化。使用CS 3000和Amicus机器时,Hb和Hct的下降幅度显著更大,而使用CS 3000和费森尤斯分离器时,血小板和WBC计数的下降幅度显著更大。
尽管所有供体的全血细胞计数均显著下降,但均未表现出血小板减少症或贫血特征。然而,鉴于目前双份成分单采采集的趋势,需要在这方面进行更多的前瞻性研究,以制定单采术中供体安全指南,并有助于评估供体的适宜性。