Preparative leukapheresis impairs autologous donor hemostasis and platelet function

Area of Science:

• Transfusion Medicine
• Hematology
• Cellular Therapy

Background:

• Preparative apheresis is crucial for producing blood and stem cell products.
• Bleeding is a rare but serious complication of apheresis due to loss of platelets and coagulation factors.

Purpose of the Study:

• To comprehensively analyze hemostasis in autologous donors undergoing preparative apheresis.
• To assess the incidence and characteristics of bleeding complications in this patient cohort.

Main Methods:

• A prospective observational study involving 79 autologous donors (50 for hematopoietic stem cells, 29 for lymphocytes).
• Quantification of cellular components and coagulation factors immediately before and after apheresis.
• Assessment of platelet aggregation function post-apheresis.

Main Results:

• A median loss of Factor XIII (15%), fibrinogen (17.9%), antithrombin (13.9%), and von Willebrand factor (VWF) antigen (18.7%) and activity (18.2%) was observed.
• Platelet count decreased by a median of 25.6%, with reduced platelet aggregation.
• Global coagulation parameters remained largely unaffected, but one patient with FXIII deficiency experienced bleeding requiring intervention.

Conclusions:

• Apheresis compromises hemostasis and platelet function in autologous donors, despite stable global coagulation tests.
• Findings are valuable for managing apheresis procedures and mitigating bleeding risks.