Frequent platelet apheresis donations in volunteer donors with hemoglobin < 125 g/l are safe and efficient

For safety reasons, volunteer whole blood donation requires a minimal hemoglobin (Hb) concentration of > 125 g/l. Since the first generation of apheresis devices caused significant RBC loss, the same Hb eligibility criterion was applied for apheresis donors (APH-D). However, this may exclude many suitable platelet donors (PLT-D) due to low hemoglobin concentration.

Covering a three year period (1999-2001), the APH-Ds having Hb < or = 125 g/l and donating platelet concentrates (PLC) were retrospectively analyzed focusing on donor safety and donation efficacy. The apheresis procedures were performed using AMICUS and CobeSpectra devices, targeting a PLT yield of 3 x 10(11) PLT per donation. Predonation PLT- and Hb-concentrations were investigated by regression analysis. In addition, hematological changes due to repetitive apheresis donation (APH) were assessed.

From 1999 to 2001, 1864 volunteer PLT-Ds donated 13,716 PLCs. Three hundred and two PLT-Ds (16%) donating 2013 PCs (14.7%) had predonation Hb < or = 125 g/l at the initial donation and constituted the study population. Ninety-five percent were women. Despite repetitive APHs of up to 20 procedures per PLT-D and with donation intervals of <60 days, the individual Hb concentration did not change significantly throughout the observation period. There was no statistically significant reverse correlation between predonation PLT concentration and the degree of anemia.

The eligibility criterion of Hb > or = 125 g/l for APH-D is not justified and leads to exclusion of mainly female volunteer apheresis donors. Repetitive PLT-APH does not negatively affect Hb concentration. Selective recruitment of borderline anemic donors into a PLT-APH program can be done safely and offers an alternative donation opportunity to otherwise excluded volunteer blood donors.