Preparation and utilization of leukocyte poor apheresis platelets

Abstract

Efficiency of collection of apheresis platelets was found to be equivalent (approximately 50%) with the COBE 2997, the Fenwal CS3000, Haemonetics V50 or COBE Spectra ™ cell separators. A minor fraction (1.5–3.5%) of 6466 consecutive transfusions of apheresis platelets were complicated by febrile transfusion reactions (FTRs). There was a 12.1% incidence of second FTRs following an initial reaction. Centrifugation, filtration, or the provision of platelets harvested on the COBE Spectra ™ reduced the incidence of subsequent FTRs to ⩽3.1% in patients with two prior FTRs. Leukocyte content in apheresis platelets ranged from 5 × 10 5 in COBE Spectra ™ apheresis platelets to 10 9 in platelets from the Fenwal CS3000 or COBE 2997. Filtered platelets from the Haemonetics V50 were as leukopoor as COBE Spectra ™ apheresis platelets, but centrifugation or filtration of other apheresis platelets did not achieve equivalent leukodepletion. These results suggest that (1) FTRs are rare after transfusion of apheresis platelets; and (2) provision of either platelets from the COBE Spectra ™ or other apheresis platelets which have been centrifuged or filtered can avoid FTRs in the majority of patients with a history of repeated prior reactions.