[The safety of apparative cytapheresis]

In a retrospective analysis 1568 platelet apheresis procedures and 652 leukocytophereses performed from April 1976 to June 1986 were examined. 886 procedures were performed using the Fenwal CS 3000, 777 with the IBM 2997, and 293 with the Haemonetics V50, whereas in 264 procedures the Model 30 was used. The study aims to answer 3 donor-related questions: To what extent are the blood cells changed by the donation? How does the donor respond to the technical requirements of the donation, such as length of the procedure, blood volume processed, amount of concentrate removed during the donation? How often did side-effects or undesired reactions occur? We found that thrombocytapheresis led to a decrease in platelets in the peripheral blood of between 20% (CS3000) and 33.7% (IBM), and an increase in leukocytes of between 4.24% (IBM) and 17.8% (Model 30), whereas erythrocytes, hemoglobin and hematocrit showed a similar decrease within a range of between 1.1% and 2.67% in all systems. Following leukocytapheresis the leukocyte counts of the peripheral blood were decreased by up to 12%, erythrocyte counts by up to 5% and platelets between 15% (IBM) and 29% (Model 30). The list of irregularities included technical problems and donor reactions (e.g., citrate reactions, reactions of blood circulation, and blood flow in the donor). There were no serious side-effects. Early terminations of 42 (= 1.9%) donations were for prophylactic reasons exclusively. Few moderate undesired reactions occurred (4 = 0.2%), but none of the donors contributing to the more than 2,000 donations were ever hospitalized, demonstrating the safety of cytapheresis with all separators.