Prospective comparison of high-dose plateletpheresis with the latest apheresis systems on the same donors

Abstract

Background: To improve productivity of automated platelet (PLT) collection, the industry has introduced new instruments or modifications to existing equipment.

Study design and methods: With the same 8 donors for double (DDC) and triple-dose PLT collection (TDC), the Baxter Amicus (AM), the Haemonetics MCS Plus (MCS+), and the Gambro Trima Accel (TA) were evaluated focusing on yield, duration, and citrate donor load. Target endpoints were set at 5.5 x 10(11) to 6.0 x 10(11) PLTs (DDC) and 7.5 x 10(11) to 8.0 x 10(11) PLTs (TDC) in up to 100 and 120 minutes' donation time, respectively.

Results: TA was the most efficient system (74.5 +/- 3.9%) with significant differences from AM (71.1 +/- 3.9%; p = 0.028) and MCS+ (64.0 +/- 7.7%; p = 0.002). TA had advantages over AM for collection rate (10.9 x 10(9) +/- 2.2 x 10(9) vs. 10.1 x 10(9) +/- 1.5 x 10(9) PLTs/min; p = 0.382), whole blood processed (3928 +/- 611 mL vs. 4219 +/- 727 mL; p = 0.382), and time to obtain an established standard dose (TSD 2.5(EU), 30.2 +/- 5.6 vs. 37.7 +/- 5.5 min; TSD 3.5(US), 42.2 +/- 7.8 min vs. 52.7 +/- 7.7 min; p = 0.015), whereas AM was slightly superior in PLT yield (2.81 x 10(11) +/- 0.21 x 10(11) vs. 2.76 x 10(11) +/- 0.31 x 10(11)/unit; p = 0.645). Owing to the lowest draw (42.3 +/- 3.2 mL/min; p < 0.001) and collection rates (6.0 x 10(11) +/- 1.5 x 10(11)/min; p = 0.021), MCS+ was the slowest significantly (p < 0.001) but compensated with fewer citrate reactions owing to lower citrate infusion rates (0.78 +/- 0.11 mL/min/L; p = 0.028).

Conclusion: High-dose plateletpheresis was performed efficiently and safely with all three instruments. AM had advantages in PLT yield, and MCS+, in donor comfort. TA was the fastest in obtaining an established standard dose and, because of this advantage, the machine with the highest practical impact in routine use.