EFFECT OF DONOR VARIABLES ON YIELD IN SINGLE DONOR PLATELETPHERESIS BY HEMONETICS MCS PLUS ISHAN JOSHI, AMIT SHARMA, RACHNA NARAYAN, SUNITA BUNDAS AND B.S. MEENA

Apheresis is a Greek word that means to separate or remove. Introduction Apheresis is a Greek word that means to separate or remove. In apheresis blood is withdrawn from a donor or patient in anticoagulant solution and separated into components. One or more component is retained and the remaining constituents are returned to the individual. Plateletpheresis procedures (single donor platelets) produce an average of the equivalent of 6-10 units (3-5 x 1011 platelets) of random donor platelet concentrates at one time and have now become the main source of platelets in many countries.

Recently the use of platelet concentrates has grown steadily due to its employment in chemotherapy protocols. This is especially due to lower alloimmunisation and transmission of viruses to patients afforded by reduced donor exposure. With newer technology and more efficient processes, higher yields of platelets may be obtained from one donor. Platelet recovery in a patient is influenced by the transfused dose of platelets which in turn is dependent on the platelet yield. The possibility of obtaining higher platelet yields has important clinical implications: it reduces frequency of platelet transfusions and number of donor exposures with important consequent clinical and economic advantages. This study was planned to investigate the influence of donor demographic and laboratory factors on platelet yield.

MATERIAL AND METHODS This is a retrospective study of records pertaining to the period January 2018 to March 2018. The study included 100 healthy, first time plateletpheresis donors. All the donors were selected according to the guidelines laid down by Drugs and Cosmetics Act.8 Details of plateletpheresis were explained to each donor who gave due consent before the procedure.

Donors were selected based on following criteria: (i) Weight > 60 kg (ii) Age - 18 to 60 years (iii) At least three months from last donation/thirty days from last plateletpheresis (iv) Hemoglobin >12.5 gm/dl (v) Platelet count > 200 x 103/ mm3 (vi) Absence of any illness (vii) No consumption of non-steroidal anti-inflammatory drugs for last three days (viii) Negative test for HIV, Hepatitis B, Hepatitis C, Syphilis and Malaria.

All procedures were completed successfully with peripheral venous access. Cubital vein was used for access. All procedures done were single needle. The procedure was continuous and automated. The blood pump speed was set at of 60-80 ml/min. Blood pressure (BP) and pulse were monitored at frequent intervals during the sessions and donors were closely observed for development of any complications and overall status. Donations were performed by Haemonetics MCS plus apheresis machine (Hemonetics Corporation, Braintree, Massachusetts). All procedures were completed successfully with peripheral venous access. Cubital vein was used for access. All procedures done were single needle. The procedure was continuous and automated. The blood pump speed was set at of 60-80 ml/min. Blood pressure (BP) and pulse were monitored at frequent intervals during the sessions and donors were closely observed for development of any complications and overall status. Donations were performed by Haemonetics MCS plus apheresis machine (Hemonetics Corporation, Braintree, Massachusetts).

RESULTS Age (years) No. of donors 18-20 9 21-30 56 31-40 28 41-50 7 The mean age of the donors (n=100) was 29 years (range18-50years), there were all males. Their age distribution is shown in Table 1 Age (years) No. of donors 18-20 9 21-30 56 31-40 28 41-50 7 Total 100

Platelet count (10 5 /μL) Number of donors 2.1-2.5 33 2.6-3.0 35 Table 2: Pre-donation platelet count distribution among plateletpheresis donors Platelet count (10 5 /μL) Number of donors 2.1-2.5 33 2.6-3.0 35 3.1-3.5 21 >3.5 11

Single needle procedure was done in all plateletpheresis. Haemoglobin level was more than 14 g/dL in 85 donors. The mean BMI was 29.4 ± 0.86 Kg/m2. The mean platelet yield was 3.16 ± 0.62 x 1011; 71 donors gave a platelet yield of more than 3 x 1011 per unit (Table 3).

Platelet count Number (10 5 /μL) donors Number of donors 2.1-2.5 10 Table 3: Platelet yield distribution among plateletpheresis donors Platelet count Number (10 5 /μL) donors Number of donors 2.1-2.5 10 2.6-3.0 19 3.1-3.5 37 >3.5 34

A positive correlation was observed between predonation platelet count and platelet yield (r = 0.284, p<0.01) A negative correlation was observed between age (years) and platelet yield (r = –0.229, p<0.01) But no such correlation was noticed between platelet yield and haemoglobin (0.052), haematocrit (r = – 0.011), or blood group (r = – 0.098) of the donor (Table 4). A positive correlation was also observed between BMI and platelet yield (r = 0.257, p<0.01).

Table 4: Correlation between platelet yield and donor variables All data are expressed as r (p-value) (BMI=body mass index (Kg/m2); Hb=haemoglobin (g/dL); PLT=platelet count (105/μL); Hct= haematocrit; PY=platelet yield) Parameters p-value Age and BMI –0.230 (0.009) Age and Hb –0.112 (0.206) Age and PLT –0.112 (0.203) Age and Hct –0.135 (0.126) Age and PY –0.229 (0.009) BMI and Hb –0.056 (0.528) BMI and PLT 0.352 (0.000) BMI and Hct –0.097 (0.270) BMI and PY 0.257 (0.001) Hb and PLT –0.115 (0.192) Hb and Hct 0.741 (0.000) Hb and PY 0.052 (0.558) PLT and Hct –0.088 (0.319) PY and PLT 0.284 (0.001) PY and Hct –0.011(0.905)

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