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[Platelet collection by apheresis with reduced use of citrate: quantitative and qualitative evaluation of three
J Moh-Klaren1, N Berriot, C Lecrubier
1Poste d'Hémobiologie-Transfusion de l'Hôtel-Dieu, Secteur d'Hémobiologie-Transfusion, Paris Centre.
Insights
Optimizing platelet collection protocols using the Cobe Spectra apheresis system enhances platelet yield and function. Protocol 2 offers improved efficiency and in vitro platelet function compared to the standard method, despite a higher white blood cell count.
Area of Science:
- Transfusion Medicine
- Hematology
Background:
- Platelet apheresis is crucial for transfusion support.
- Optimizing collection efficiency and platelet quality is an ongoing challenge.
- Citrate concentration impacts apheresis procedures and outcomes.
Purpose of the Study:
- To compare the efficiency and in vitro platelet function of different apheresis protocols.
- To determine the optimal anticoagulant/whole blood ratio for Cobe Spectra apheresis.
- To evaluate the trade-offs between platelet yield, function, and leukocyte contamination.
Main Methods:
- Comparison of three apheresis protocols on Cobe Spectra with varying citrate concentrations.
- Determination of optimal anticoagulant/whole blood flow ratio to prevent clotting.
- In vitro platelet function assessment using aggregometry.
- Quantification of leukocyte contamination in collected platelet concentrates.
Main Results:
- Protocol 2 demonstrated higher platelet collection efficiency (59%) than the standard protocol 1 (52%).
- A less citrated environment (Protocol 2) preserved superior in vitro platelet function.
- Protocol 3 showed higher efficiency but was rejected due to a 5% clotting risk.
- Protocol 2 resulted in a higher number of platelet concentrates with >10(6) leukocytes.
Conclusions:
- Protocol 2 represents an improved method for platelet apheresis on the Cobe Spectra.
- Reduced citrate concentration enhances platelet collection efficiency and preserves in vitro platelet function.
- Careful consideration of leukocyte contamination is necessary when implementing Protocol 2.
Abstract:
Three protocols of platelet collection by apheresis on Cobe Spectra with different citrate concentrations were compared. First we determined until what level we could diminish the ratio anticoagulant/whole blood flow to enhance the efficiency without clotting in the cell separator by platelet aggregates. We found that protocol 2 had a better platelet collection efficiency than the standard protocol 1: respectively 59% versus 52%. Protocol 3 had even a better efficiency but, due to the risk of clotting (5% of the procedures) we rejected it for routine use. We compared in vitro platelet functions of protocols 1 and 2 by aggregometry in vitro. The results with the different aggregating agents indicated that the less citrated environment kept the platelets more functional in vitro. A disadvantage of protocol 2 compared to the standard protocol is the more important number of platelet concentrates that contain more than 10(6) leucocytes.