DONOR SCREENING AS AN ESSENTIAL FACTOR IN THE EFFICIENCY OF DOUBLE PLATELET COLLECTION BY APHERESIS

Abstract

Background/case studies: The need for platelets collected by apheresis in Brazil has been gradually increasing. Blood banks that seek quality and transfusion safety choose to use it whenever available. However, the challenge of attracting donors and the operational cost of this method are still determining factors for its exclusivity in the transfusion of platelet concentrates, especially in a country with a middle per capita income, according to the World Bank. Double platelet collection protocols allow this exclusivity in most of these transfusions. This case study establishes the criteria related to donor screening so that double platelet collection minimizes this challenge. Study design/methods: In March 2024, 36 voluntary and frequent donors with platelet counts > 200,000 cells/μl and body surface > 1.7 m2 were previously selected and invited to participate in the equipment validation process. All participants signed the Consent Form acknowledging the risks and authorizing the disclosure of data. Double platelet collections were scheduled in the validation process of the AmiCORE 2.1 equipment with the addition of Intersol (PAS). The programming established a yield between 6 × 10e11 and 6.5 × 10e11 platelets/unit, with at least 50 mL of storage solution (Intersol 65% plus Plasma 35%) for every 0.5 × 10e10 platelets/unit. The maximum collection time was 1120 minutes. The following concentrate parameters were evaluated: platelet count, leukocyte count, pH and microbiological contamination. The equipment was evaluated for efficiency, A/T index and collection time. The presence of adverse events during the procedure was assessed. Results/findings: : The average efficiency (yield obtained/number of platelets processed) was 68% with a 95% CI(66.3-70.4).The average A/T index, which relates the programmed yield to the yield obtained, was 1.1 with a 95%CI(1-1.04).The mean pH of the platelet concentrates on the 5th day of storage was 6.9 with a 95% CI(6.9-7.1).The collection time did not exceed 110 minutes in 100% of donations.Of the 36 collections completed, 100% reached the minimum platelet yield of 6 × 10e11/unit and 100% of the platelet concentrates had a leukocyte count of less than 5 × 10e6/μL.The average body surface area of the donors was 2.03 m2 (1.7-2.34)There was one case of intense perioral paresthesia which was treated by adjusting the reduction in citrate perfusion, and no drug intervention was required. Conclusions: Based on prior selection of donor with count > 200,000 platelets/μL and body surface area > 1.7 m2, we obtained 100% double platelet concentrates enabling the transfusion of platelet concentrates by apheresis for patients in public and private services, with quality and minimized cost. Importance of research Promoting equality and equity in assistance with apheresis platelet transfusion for both patients in the public Unified Health System and for patients in private services is feasible, even in a country with a middle per capita income, according to the World Bank.Hemotherapy services that are guided by transfusion quality must guarantee access to this methodology, without distinction.