Abstract
Alterations of the complement system occurring during continuous-flow filtration leukapheresis (CFFL) and intermittent-flow centrifugation leukapheresis (IFCL) were assessed in 16 donors. Five blood samples were obtained at timed intervals during each cytaphere-sis, three directly from each donor and two from the efferent lines returning blood from the leukapheresis machines to the donors. Components measured were C1, C2, C4, C3, C3-C9 and CH50 of the classical, and factor B, properdin and properdin convertase of the alternative pathways. Changes in concentrations of components were compared to baseline values present in donor blood obtained prior to cytapheresis. During the first 10 minutes of CFFL, C2, C4, C3-9 and CH50 were decreased (p < 0.05) in machine efferent fluids, but returned towards normal as the procedure continued. Changes in donor venous blood, decreased factor B, properdin and C3-C9, were demonstrated only at the end of cytapheresis. During IFCL, significant (p < 0.05) decreases of C1, C2, C3-C9 and factor B occurred in donor blood after 60 minutes of cytapheresis, however, all deficiencies except B corrected spontaneously as cytapheresis continued. In contrast, concentrations of C2, C4, C3-C9, CH50 and factor B remained decreased in machine efferent fluids throughout the procedure. The data support those of previous studies that have demonstrated complement activation at the filter site during CFFL. Changes in donor venous blood are a new finding that may indicate in vivo activation of the alternative pathway. Profound changes of the complement system occur during IFCL also, but complement activation seems a less likely explanation. Instead, complement proteins may be lost by adsorption onto the surfaces of the IFCL software.
Published Version
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