Background: Platelet transfusion is required to treat haemo-oncology or trauma patients. Platelet apheresis (PPH) performed with apheresis equipment has increased rapidly in recent years. Leucocyte-reduced platelet apheresis (LRPH) can reduce the risk of platelet refractoriness and febrile nonhemolytic transfusion reactions (FNHTRs) for transfusion. Accordingly, this study aimed to investigate and compare the platelet metabolic and functional responses between PPH performed with Haemonetics and LRPH performed with Trima Accel cell separator.
Methods: The qualities of platelets collected through PPH and LRPH were evaluated in terms of visual appearance, morphology, platelet-aggregation changes, metabolic activities, and bacterium-screening test during 5-day storage. Statistical analyses included two-sample t-test and generalised estimating equation(GEE) method.
Results: During 5-day storage in LRPH, residual leucocytes were all <1.0×106, and the parameters of platelet function were as follows: platelet aggregated to agonists such as adenosine 5′-diphosphate (ADP) and collagen, and the extent of shape change and pO2 showed no statistically significant difference between PPH and LRPH. The hypotonic shock reaction (HSR) on days 0, 1, and 3 were significantly higher in LRPH than in PPH (71.78±6.92 vs. 64.10±7.42; p=0.002; 71.53±8.98 vs. 62.96±9.84; p=0.007; 68.05±7.28 vs. 57.76±6.80; p<0.0001, respectively). Values of mean platelet volume (MPV) were statistically larger in PPH than in LRPH on days 0, 1, and 3. On day 5, the swirling score was higher in LRPH than in PPH. The mean lactate levels had no statistically significant difference between PPH and LRPH. Moreover, no growth was observed through bacterium-screening test conducted on 40 samples.
Conclusion: Comparison of LRPH and PPH products collected from the Trima Accel and Haemonetics automated blood-collection systems, respectively, revealed that both products possessed good platelet qualities even though additional processes are needed to reduce leucocytes. Furthermore, investigating the outcomes of other apheresis instruments with focus on the safety of donors, products, and recipients is necessary.Le texte complet de cet article est disponible en PDF.
Keywords : platelet apheresis (PPH), leucocyte-reduced platelets apheresis (LRPH), platelet qualities, bacterium-screening test