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Reducing white cells in platelet units
G Marx1, A Blankenfeld, R Gorodetsky
1Magen David Adom Blood Services, Tel Hashomer, Israel.
Abstract:
White cells (WBCs) constitute a significant contaminant of platelet concentrates (PCs). Various technologies, including apheresis and filtration, are currently being developed to minimize the carryover of WBCs into platelets. The aim is to reduce contamination of less than 10(8) WBCs per platelet unit. As part of quality control monitoring of the blood bank operations, the centrifugation protocols employed in the preparation of platelet-rich plasma (PRP) have been evaluated for their impact on the WBC content of the PCs. The WBC content, which is expressed throughout the PRP volume as well as in the PC, reflects the degree of braking. For example, after centrifugation (2500 rpm, 4 min) of whole blood into packed red cells (RBCs) and PRP, braking-induced mixing increases the WBC content of the expressed PRP. Variations in the braking rates of the centrifuges used also correlate with the WBC carryover into packed platelets. An alternative centrifugation protocol to minimize WBC carryover is suggested. Whole blood is centrifuged at 2500 rpm for 1.5 minutes (rather than 4 min) and allowed to stop with no braking. This procedure adds some 3 minutes to the total centrifugation time, but the relative integral of this centrifugation program is approximately 50 percent smaller than that of the normally employed centrifugation protocol (with braking). It was observed that the WBC content throughout the expressed PRP, or in the entire PC, is reduced by about 75 percent. These results show that an effective method of significantly decreasing the WBC content of platelet units is simply to prepare PRP with reduced centrifugation time and with the braking programs disengaged.
Insights
Reducing white blood cell (WBC) contamination in platelet concentrates (PCs) is crucial. A modified centrifugation protocol significantly decreases WBCs in platelet-rich plasma (PRP), enhancing platelet product safety.
Area of Science:
- Transfusion Medicine
- Hematology
- Blood Banking
Background:
- White blood cells (WBCs) are a significant contaminant in platelet concentrates (PCs).
- Minimizing WBC contamination to less than 10^8 WBCs per unit is a key goal in blood banking.
- Current methods like apheresis and filtration aim to reduce WBCs, but optimizing preparation protocols is also vital.
Purpose of the Study:
- To evaluate the impact of centrifugation protocols on WBC content in platelet-rich plasma (PRP) and subsequent platelet concentrates (PCs).
- To identify an optimized centrifugation method for reducing WBC contamination during PC preparation.
Main Methods:
- Analysis of WBC content in PRP and PCs prepared using standard centrifugation (2500 rpm, 4 min with braking).
- Comparison with an alternative protocol: reduced centrifugation time (1.5 min) with no braking.
- Quantification of WBCs in relation to centrifugation parameters, including braking effects.
Main Results:
- Standard centrifugation with braking leads to increased WBC content in PRP due to mixing.
- The alternative protocol (1.5 min, no braking) reduced WBC content in PRP and PCs by approximately 75%.
- This modified protocol resulted in a ~50% smaller relative integral of the centrifugation program.
Conclusions:
- Centrifugation time and braking significantly influence WBC carryover into platelet products.
- Optimizing centrifugation by reducing time and disengaging braking is an effective strategy to decrease WBC contamination in PCs.
- This simple modification enhances the safety and quality of platelet transfusion products.