Institute for Clinical Chemistry and Laboratory Medicine, University Hospital Regensburg, Regensburg, Germany.
Department of Surgery, University Hospital Regensburg, Regensburg, Germany.
Transfusion. 2021 Nov;61(11):3161-3173. doi: 10.1111/trf.16666. Epub 2021 Sep 21.
Plateletpheresis using a leukocyte reduction system (LRS) traps donor WBCs in the LRS chamber, which may lead to lymphopenia, especially in frequent plateletpheresis donors. It seems plausible that this might cause adverse effects. However, current knowledge about potential confounders and donor health impacts is incomplete.
Recent platelet donors and donations collected at University Hospital Regensburg from 2016 to 2019 using the Terumo BCT Trima Accel LRS system were retrospectively analyzed and compared with historical platelet donors and donations collected mainly with Fresenius Kabi Amicus non-LRS system from 2010 to 2013. Additionally, recent donors were prospectively surveyed using a health-related topics questionnaire.
Analysis of 819 recent donors with 11,254 blood counts and 1464 questionnaires and 1011 historical donors with 12,848 blood counts revealed that increased annual platelet donation frequencies were associated with decreased lymphocyte counts in both groups. Median lymphocyte counts in recent donors with no versus ≥24 previous annual donations declined from 2.0 to 1.2 × 10 /μL (p < 2.2 × 10 ), and those in historical donors with no versus ≥24 previous annual donations decreased from 2.0 to 1.5 × 10 /μL (p = 6 × 10 ), respectively. The questionnaire results showed that donation frequency and lymphopenia were not associated with upper respiratory tract infection (URTI) incidence or duration, but platelet donors who concomitantly donated granulocytes had significantly shorter URTI durations than those who did not (p = .008).
This study confirmed that plateletpheresis-associated lymphopenia occurs in LRS and to a lesser degree in non-LRS platelet donors, but revealed no evidence of a negative impact on donor health.
使用白细胞减少系统(LRS)进行血小板单采术会将供体 WBC 困在 LRS 室中,这可能导致淋巴细胞减少症,尤其是在频繁进行血小板单采术的供体中。这似乎有可能导致不良反应。然而,目前关于潜在混杂因素和供体健康影响的知识并不完整。
回顾性分析了 2016 年至 2019 年期间在雷根斯堡大学医院使用 Terumo BCT Trima Accel LRS 系统采集的最近血小板供体和捐赠物,并与主要使用 Fresenius Kabi Amicus 非 LRS 系统于 2010 年至 2013 年采集的历史血小板供体和捐赠物进行比较。此外,最近的供体还使用与健康相关的主题问卷调查进行了前瞻性调查。
对 819 名最近的供体(共 11254 次血常规计数和 1464 份调查问卷)和 1011 名历史供体(共 12848 次血常规计数)进行分析发现,两组中,每年增加血小板捐献次数与淋巴细胞计数降低相关。在最近的供体中,无≥24 次既往年度捐赠者的淋巴细胞计数中位数从 2.0 降至 1.2×10 /μL(p < 2.2×10 ),而在历史供体中,无≥24 次既往年度捐赠者的淋巴细胞计数中位数从 2.0 降至 1.5×10 /μL(p = 6×10 )。问卷调查结果显示,捐献频率和淋巴细胞减少症与上呼吸道感染(URTI)的发生或持续时间无关,但同时捐献粒细胞的血小板供体的 URTI 持续时间明显短于未捐献者(p =.008)。
本研究证实,LRS 相关的血小板单采术引起的淋巴细胞减少症不仅在 LRS 血小板供体中发生,而且在非 LRS 血小板供体中也有发生,但没有证据表明这对供体健康有负面影响。