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Review
. 2024 Jun 1;16(6):e61510.
doi: 10.7759/cureus.61510. eCollection 2024 Jun.

Impact of Plateletpheresis on the Hemoglobin, Hematocrit, and Total Red Blood Cell Count: An Updated Meta-Analysis

Chanchal Ashok  1 , Sunil Mahto  1 , Sushma Kumari  2 , Amit Kumar  3 , Deepankar  4 , Vidyapati  5 , Manoj Prasad  6 , Mayank Mahajan  5 , Partha Kumar Chaudhuri  7
Affiliations
Review

Impact of Plateletpheresis on the Hemoglobin, Hematocrit, and Total Red Blood Cell Count: An Updated Meta-Analysis

Chanchal Ashok et al. Cureus. .

Abstract

Plateletpheresis has become a pivotal part of transfusion medicine. With the increasing demand for plateletpheresis, donor safety is an area of concern because plateletpheresis alters donor hematological parameters. For a better understanding of plateletpheresis, a systemic review is needed to study more evidence-based aspects of plateletpheresis. Electronic databases PubMed, Google Scholar, and Cochrane Library were used to find articles from January 1, 1980, to May 23, 2024. The random effect model was used to meta-analyze the effect of plateletpheresis on hematocrit, hemoglobin, and red blood cell (RBC) count. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. A total of 24 studies were found; the effect of plateletpheresis on hemoglobin, hematocrit, and RBC count was studied in the following respective numbers of donors: 3,374, 3,374, and 690. A decrease of hemoglobin, hematocrit, and RBC count was observed after plateletpheresis having a weighted mean difference (WMD) of 0.50 (95%CI = -0.72 to -0.27), WMD of -1.36 (95%CI = -2.05 to -0.66), and WMD of -0.18 (95%CI = -0.23 to -0.12), respectively. Plateletpheresis shows a decrease in the value of hematological parameters such as hemoglobin, hematocrit, and erythrocyte count due to blood loss in the kits employed in the procedure; cell lysis was also seen because of exposure of erythrocytes to stress or change in osmotic pressure. Thus, strict criteria for donation must be developed for better safety of the donors. Improved automated cell separators for plateletpheresis should be made available in blood banks to ensure good quality hematologic products. Our findings suggest that the duration of the procedure should be decreased.

Keywords: donor safety; hematocrit; hemoglobin; meta-analysis; plateletpheresis; systemic review.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. PRISMA flow diagram representing the selection and inclusion of different studies.
Figure 2
Figure 2. Forest plot for the difference in hemoglobin values between pre-donation and post donation.
Refs. [2,8-29]
Figure 3
Figure 3. Forest plot for the difference in hematocrit values between pre donation and post donation.
Refs. [2,8-29]
Figure 4
Figure 4. Forest plot for the difference in erythrocyte count values between pre donation and post donation.
Refs. [2,13,16,20,24-26,29]
Figure 5
Figure 5. Funnel plot for hemoglobin.
Figure 6
Figure 6. Funnel plot for hematocrit.
Figure 7
Figure 7. Funnel plot for erythrocyte.
Figure 8
Figure 8. Meta-regression analysis graph showing the effect of ethnicity on hemoglobin.
In the horizontal axis, 0 in ethnicity denotes Asian and 1 as Caucasian.
Figure 9
Figure 9. Meta-regression analysis graph showing the effect of the sample size on hemoglobin.
In the horizontal axis, 0 is a sample size less than 75, whereas 1 is more than 75.
Figure 10
Figure 10. Meta-regression analysis graph showing the effect of ethnicity on hematocrit.
In the horizontal axis, 0 in ethnicity denotes Asian and 1 as Caucasian.
Figure 11
Figure 11. Meta-regression analysis graph showing the effect of sample size on hematocrit.
In the horizontal axis, 0 is a sample size less than 75, whereas 1 is more than 75.
Figure 12
Figure 12. Meta-regression analysis graph showing the effect of ethnicity on erythrocyte count.
In the horizontal axis, 0 in ethnicity denotes Asian and 1 as Caucasian.
Figure 13
Figure 13. Meta-regression analysis graph showing the effect of sample size on erythrocyte counts.
In the horizontal axis, 0 is a sample size less than 75, whereas 1 is more than 75.
See this image and copyright information in PMC

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