1. EXTENT OF CHANGES IN PRE AND POSTDONATION DONOR VARIABLES IN SINGLE AND DOUBLE DOSE PLATELETPHERESIS AND ITS IMPLICATIONS ON DONOR SAFETY
Dr. R. Sreedevi M.D(IH & BT)
Assistant Professor, Department of Transfusion Medicine
Govt. Stanley Medical College Hospital
Chennai

2. AGENDA Discussion Introduction Aim & Objective Materials and Methods
Literature
Results
Methodology
Introduction
Aim & Objective
Materials and Methods
Results
Discussion
Conclusion
Suggestions

3. Introduction
Major advantages of Single Donor Platelets over random donor platelets
Ability to reduce transfusion frequency and alloimmunization
Infectious complications
Transfusion reaction rate.
Ease of leukoreduction.
Platelet transfusion management of the alloimmunized or refractory patient.

4. BACKGROUND
Proper selection of donors with good pre-donation platelet count - essential for optimal platelet yield in single donor plateletpheresis.
Double dose platelet-pheresis(DDP) procedures - commonly done nowadays to reduce the immunogenicity and cost of the product.
Benefits of optimizing the yield of plateletpheresis
Cost effective – Higher yield
Reduction in transfusion frequency
& alloimmunization – useful for patients

5. Aim and Objectives
To observe the effects of single and double dose plateletpheresis on normal haematological values of healthy donors.
To assess the donor safety - an important area of concern in plateletpheresis

6. Methodology Type of Study Prospective Cross-sectional Study
Place of Study
Department of Transfusion Medicine, Govt Stanley Medical College Hospital, Chennai
Duration of Study
Jan 2018 to Oct 2018
No. of plateletpheresis procedures done 45
29 – Single dose
16 – Double dose
Equipment Used
COBE Spectra continuous flow cell separator
Parameters Assessed
Pre and post donation Haematological Parameters – Hb, HCT, Platelet Count, WBC count & RBC count
All procedures were performed following the departmental standard operating procedure

7. RESULTS
Average platelet yield achieved in single dose plateletpheresis was
X 1011 platelets per unit.
Mean pre-and post-donation platelet counts were 273,000/μL and
209,000/μL respectively,
Mean Hb decreased slightly from g/dL to g/dL,
Mean red cell count dropped slightly
Mean WBC counts dropped from 6543/μL to 6120/μL.
Mean Hct decreased slightly from 44.7% to 44.2%,

8. Pre and post‑donation hematological parameter change (mean)
Donor parameters
Pre-Donation
Post-Donation
Platelet count (×109 /L)
272.81±55.02
209.12±43.38
WBC count (×109 /L)
6.540 ±1.6
6.120 ±1.64
Hb (g/dL)
14.76±1.09
14.11±1.07
Hct (%)
44.71±2.87
44.20±2.97
RBC count (×109 /L)
5.44±0.67
5.40 ±0.75
There was a significant decrease in post-donation platelet count (p<0.001).
Post donation haemoglobin concentration (p=0.002) and WBC count (p=0.037) significantly decreased in the donors.
No significant change in RBC count and haematocrit.

9. RESULTS contd.. Double yield was collected in 16 procedures.
Donors with preplatelet count >300,000/μl were subjected to double yield collection.
Average yield achieved was x platelets.
Mean post donation TPC was 167,000/μl
There was a significant decrease in post-donation platelet count (p<0.001) and also HB and HCT values and WBC count
No significant decrease in RBC count.
Though the mean post platelet count decreased significantly the post-donation platelet count did not decrease below 100 x 109 /L.
Not associated with clinical manifestations in the donor.
Significant association between donor weight > 75 kgs and DDP

10. Correlation between platelet count and product yield
Donor platelet count (×109 /L)
Product yield (×1011/unit)
(n=14)
4.25
(n=15)
4.55
(n=11)
6.19
>351 (n=5)
6.35
We observed significant relation of pre-donation donor platelet count and platelet yield (p < 0.001)

11. Comparison with other studies worldwide
Study by Simon et al.- same results observed except Hb level increased Post-Donation
Significant reductions in donor haematological values after plateletpheresis without clinical manifestations have also been reported by - Lewis et al., Beyan et al., Das et al., Sahoo et al., Suresh et al.
Makroo et al., Chaudhary et al., - Same results observed regarding Double Dose Plateletpheresis: A Savior to Shrinking Donor Pool and Platelet Inventory Management
William J et al. – weight >75 kg, female donors and preplatelet count > /μl – contribute to favourable yields in DDP

12. Conclusion
Plateletpheresis procedure is relatively safe with no adverse effect and clinical manifestation in the donor – if proper Pre-Donation selection criteria applied
DDP does not lead to major adverse effects
Post DDP hematological parameters are also within the acceptable range.
DDP further reduces alloimmunization, transfusion frequency and cost of the product.

13. Suggestions
It has been recommended in many studies that apheresis donors with low normal pre-procedure platelet counts (150 – 200 x 109/L) and Hb concentration (12.5 – 13 g/dL) should be examined for post-donation drops in these haematological parameters.
36% of the healthy donors in some regions of our country had a pre- donation platelet count of <200 x 109/L
There is difference in platelet count in region wise – especially northern & eastern Indian population having low platelet count compared to southern parts of our country.

14. Suggestions Contd..
So guidelines for high dose platelet collection should be individualized according to each transfusion medicine department’s policy and need for donor safety and good product quality.
Post donation hematological parameters should be monitored in all those donors who are undergoing regular and high dose platelet- pheresis for donor safety and to maintain optimal donor pool.

15. THANK YOU