Hematological changes induced by erythrocytapheresis
Main Article Content
Keywords
Blood donors, Erythrocytes, Blood banks, Blood component removal
Abstract
Background: Although automated cell separators (apheresis) have undergone a lot of technical refinements, the effect of the procedure on hematological indices of donors is rarely taken into account. The purpose of this study is to identify potential hematologic changes in donors undergoing erythrocytapheresis.
Methods: 30 apparently healthy adult donors were evaluated. Erythrocytapheresis procedure was performed using automated equipment. Hematologic measurements (hemoglobin, hematocrit, white blood cells counts and platelets) were analyzed before and after erythrocytapheresis in all donors.
Results: We observed a significant decrease in the donors in hemoglobin (p <0.0001), hematocrit (p <0.0001), leukocytes (p <0.0001), lymphocytes (p = 0.0267), and platelets (p <0.0001). On the other hand, we found no changes in segmented, monocytes, eosinophils and basophils post erythrocytapheresis.
Conclusion: In this study we found a significant drop in complete blood count in blood donation procedure by erythrocytapheresis; there are hematological changes in both red and white cells in all donors; however, none of donors manifested symptoms of thrombocytopenia or anemia. This study demonstrates hematological changes post-donation and therefore requires larger multicenter studies, in order to establish guidelines for donors’ safety in apheresis and also help in assessing donor suitability, especially given the present trend of double product apheresis collections.
References
Strauss RG. Safety of donating multiple products in a single apheresis collection: are we expecting too much?. J Clin Apher 2003; 18: 135-140.
McLeod BC, Price TH, Drew MJ. Apheresis: Principles and Practice. Chapter 2: Introduction to apheresis donation including history and general principles. AABB. Bethesda, Maryland, USA 1997; p. 27-44.
Romero T, Hernández D, Sojo A, Jiménez A, Ospino C, Dávila Z, et al. Manual de técnicas y procedimientos en bancos de sangre. Editorial Prado. Tercera edición. México. 2010; p. 221-224.v
Wong EC, Balogun RA. Therapeutic apheresis in pediatrics: technique adjustments, indications and nonindications, a plasma exchange focus. J Clin Apher. 2012; 27: 132-137.
Rehácek V, Bláha M, Jirousová H, Cernohorská J, Papousek P. Therapeutic erythrocytapheresis in the initial treatment of hereditary hemochromatosis. Acta Medica (Hradec Kralove). 2012; 55:180-185.
Conte D, Brunelli L, Bozzani A, Tidone L, Quatrini M, Bianchi PA. Erythrocytapheresis in idiopathic haemochromatosis. Br Med J (Clin Res Ed). 1983; 286: 93-99.
Fontana S, Rados L, Schmid P, Leibundgut EO, Taleghani BM. Recruitment of platelets, white blood cells, and hematopoietic progenitor cells during high-yield plateletpheresis. Transfusion. 2011; 51: 2034-2043.
Salvin HE, Pasricha SR, Marks DC, Speedy J. Iron deficiency in blood donors: a national cross-sectional study. Transfusion. 2014;54:2434-2444.
NOM-253-SSA1-2012 Para disposición de sangre humana y sus componentes con fines terapéuticos. Secretaria de Salud. México. (http://www.dof.gob.mx/normasOficiales/4917/salud3a/salud3a.html). (Revisado enero de 2014)
Chaudhary R, Sekhar DS, Agarwal P, Shanker SJ. Quality systems in automated plateletpheresis in hospital-based blood transfusion service in north India. J Clin Apher. 2005; 20: 81-85.
Bower JD, Ackerman PG, Toto G, eds., “Evaluation of Formed Elements of Blood,” in Clinical Laboratory Methods. St. Louis, MO, USA: The C.V. Mosby Company, 1974.
Das SS, Chaudhary R, Verma SK, Ojha S, Khetan D. Pre- and post-donation haematological values in healthy donors undergoing plateletpheresis with five different systems. Blood Transfus. 2009; 7:188-192.
Lewis SM, Anderson NA, Pamphilon DH. Comparability of haematological and biochemical parameters before and after apheresis of volunteer donors. Vox Sang. 1991; 61: 78-82.
Beyan C, Cetin T, Kaptan K, Nevruz O. Effect of plateletpheresis on complete blood count values using three different cell separator systems in healthy donors. Transfus Apher Sci 2003; 29: 45-47.
Lazarus EF, Browning J, Norman J, Oblitas J, Leitman SF. Sustained decreases in platelet count associated with multiple, regular plateletpheresis donations. Transfusion. 2001; 41: 756-761.
Beutler E, Waalen J. The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration? Blood 2006; 107: 1747-1750.
Mendez A, Wagli F, Schmid I, Frey BM. Frequent platelet apheresis donations in volunteer donors with haemoglobin < 125 g/L are safe and efficient. Transfus Apher Sci 2007; 36: 47-53.
González ML, Maia S, Mesquita P, Bessa M. Study of serum ferritin in donors of two red blood cells units collected by apheresis. Transfus Apher Sci. 2013 SII: S1473-S1475.
Das SS, Chaudhary R, Verma SK, Ojha S, Khetan D. Pre- and post-donation haematological values in healthy donors undergoing plateletpheresis with five different systems. Blood Transfus. 2009; 7: 188-192.
Pérez M, Roura J, Caveda O, Arévalo C, Basulto M. Plasmaféresis en el síndrome de Guillain Barre. Archivo Médico de Camagüey. 2004; 8: 5-9.
Gutiérrez J, Muñoz E, Arango C, Vásquez E, Montoya J, Villa J. Pancreatitis aguda inducida por hipertrigliceridemia y tratamiento con plasmaféresis. Iatreia. 2012; 25: 391-397.
León A, Huertas J, Hurtado J. Glomerulonefritis aguda con énfasis en compromiso rápidamente progresivo. Colomb Med 2011; 42: 536-548.
Lora C, Navarro J. Síndrome Miasténico de Eaton-lambert. Rev Colomb Anest. 2001; 29: 1-3.
Daza J, Roncallo A. Neuromielitis óptica: Estado de arte. Salud Uninorte. Barranquilla Col 2007; 23: 204-219.
Conte A, Cadoudal N, Siguret V. Síndrome de anticuerpos antifosfolípidos. Acta Bioquím Clín Latinoam. 2008; 42: 271-278.v
Martínez A, Cano ME, Palacios A, Mateo P. Manejo anestésico del Síndrome de Hellp. Rev Colomb Anest. 2003; 31: 1-3.
Euler H, Schoroeder J. plasmaféresis para lupus con nefritis. New England J Med. 1992; 327: 1028-1030
Dau P. Recambio plasmático en polimisitis y dermatomiositis. New England J Med. 1992; 327: 1030.
Mellwig K, Pulawski E, Horstkotte. Lipidapheresis: oxidative stress, rheology, and vasodilatation. Clin Res Cardiol. Suppl 2012; 7: 45-49.
Mariani R, Peluchi S, Perseghin P, Corengia C, Piperno A. Erythrocytapheresis plus erythropoietin: an alternative therapy for selected patients with hemochromatosis and severe organ damage. Hematology journal. 2005; 90: 717-718.
Gutierrez C, Serra J, Hering E, Vaisman S. Policitemia neonatal y eritroferesis. Rev Chil Pediatr. 1988; 59: 16-20.
Medina M. Aféresis terapéutica, recambio plasmático terapéutico, citaféresis. Rev Med Inst Mex Seguro Soc. 2005; 43 (supl 1): 47-52.
Black V, Lubchenco L, Luckey D, Koops B, Guinnes G, Powell D, et al. Development and neurological sequelae of neonatal hyperviscosity syndrome. Pediatrics. 1982; 69: 426-431.