Survey on the current use of leukapheresis and the collection of granulocyte concentrates.

This study was designed to define leukapheresis practice. A voluntary questionnaire on leukapheresis was sent to 280 FDA-registered blood-collecting establishments performing leukapheresis. Of the facilities questioned, 67.9 percent responded. The survey results indicate that most facilities use intermittent-flow blood cell separators, while 22.6 percent use more than one separation method. Establishments routinely use 6% hydroxyethyl starch (HES 450/0.70) and the majority using trisodium citrate as the anticoagulant. Forty-eight percent use corticosteroids, primarily dexamethasone, to pretreat the donor. The frequency of donation was not specified by 25.3 percent of the report. Forty-two percent chose an individual donation frequency of two times per week. A limit on the total number of donations allowed per donor was not specified by 78.4 percent of the facilities. Community blood banks (including regional centers) performed 55.6 percent of all leukocyte concentrate collections. The donor reaction incidence was of 3.64 percent. Hospitals, of all types, performed 37.8 percent of the collections. The adverse reaction rate ranged from 2.84 to 9.72 percent. Adverse reactions occurred in donors 54.9 times per 1000 procedures. Ninety-four percent of reported reactions were mild, whereas moderate and severe reactions accounted for 5.9 and 0.4 percent, respectively. Granulocyte yields varied by the type procedure and the use of corticosteroids as well as among facilities. The majority (56.3%) held leukocytes at 22 to 25 degrees C prior to transfusion, while most of the remainder stored at 4 degrees C.