Feasibility and safety of multicomponent apheresis donation

Abstract

Background and Objectives Modern apheresis devices offer the possibility to collect blood components that are well standardized, as compared with those available with manual whole blood donations. Recent technologic advances in multicomponent donation have made possible the development of systems that can collect different blood components from the same donor during one apheresis session. Red blood cells (RBCs) can be concurrently collected with plasma or platelets (PLTs).Materials and Methods A PLT yield of ≥2 × 1011 per unit according to European guidelines can be targeted by the algorithm of the blood cell separators after entering donor specific parameters such as body weight, height and blood counts. Furthermore, two units of RBCs can also be collected during one apheresis session provided that the donor fulfils the eligibility criteria for that procedure.Results The haemoglobin content of apheresed RBCs after addition of additive solution is higher than the minimal European requirement of whole blood derived RBCs of 40 g per unit due to standardization. Automated blood cell separators permit predictable collection of blood components with consistent yields and volumes. Repeat apheresis donors accept multicomponent donation and consent to concurrent component collection in >90% of the procedures. The results of a national survey showed that approximately 75% were willing to give an additional RBC unit four times per year. This allows blood centres to increase the number of units colleted at low extra costs. Collecting an additional RBC unit in plateletpheresis causes extra costs of approximately 20€ for disposables and work load compensating the production costs with respect to the selling price. The incidence of acute adverse events in multicomponent apheresis was reported with less than 1%. Small, female donors with lower pre‐donation haematocrit were at higher risk for adverse events, especially when RBCs were collected. Double unit RBC collection showed to be safe if special eligibility criteria were respected.Conclusion Previous definitions of blood component yield and volume as well as the flexibility to collect those multicomponents allow the blood centre to collect those components that maximize donors’ contribution and to meet the demands of its area hospitals for blood components. Blood transfusion services are progressively increasing their reliance on apheresis technology to optimize the number of blood components collected per donor visit and to reduce the number of donors a patient is exposed to. The use of these systems has shown at the same time that multicomponent donations have been well tolerated by the donors and are cost‐effective.