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Complement activation during plasma production depends on the apheresis technique

J Sonntag1, M Emeis, A Vornwald

  • 1Department of Neonatology, Charité-Virchow-Medical Center, Humboldt University, Berlin, Germany.

Transfusion Medicine (Oxford, England)
|November 4, 1998
PubMed
Summary

Apheresis techniques for fresh frozen plasma impact anaphylatoxin levels. Combined centrifugation and filtration significantly increases complement activation compared to centrifugation alone, suggesting a need for improved apheresis methods.

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Area of Science:

  • Transfusion Medicine
  • Immunology
  • Biochemistry

Background:

  • Elevated anaphylatoxin levels (C3a, C5a, sC5b-9) are observed in fresh frozen plasma (FFP) produced by apheresis.
  • Anaphylatoxins are potent mediators of inflammatory and immune responses.

Purpose of the Study:

  • To investigate anaphylatoxin generation during apheresis production.
  • To compare two apheresis techniques: centrifugation alone versus combined centrifugation and filtration.
  • To identify potential strategies for preventing complement activation during apheresis.

Main Methods:

  • Measured concentrations of C3a, C5a, and sC5b-9 in 100 FFP packs post-apheresis and pre-freezing.
  • Analyzed 50 FFP packs produced by centrifugation alone and 50 by combined centrifugation and filtration.

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  • Collected blood samples from 100 donors pre-apheresis for baseline measurements.

    • Main Results:

    • Median C3a increased from 62 to 380 µg/L (centrifugation alone) and 70 to 992 µg/L (centrifugation + filtration).
    • Median C5a increased from 0.38 to 0.83 µg/L (centrifugation alone) and 0.29 to 4.9 µg/L (centrifugation + filtration).
    • sC5b-9 increased from 162 to 426 µg/L only with centrifugation and filtration, indicating more pronounced complement activation.

    Conclusions:

    • Apheresis using combined centrifugation and filtration leads to significantly higher anaphylatoxin generation compared to centrifugation alone.
    • The materials or construction of membrane-based separation units may contribute to complement activation.
    • Further research into apheresis device design is needed to minimize complement activation and ensure FFP safety.