Adverse Events Associated with Plateletpheresis: A Tertiary Care Hospital Experience in Southern India EC10-EC12
Dr. Bonagiri Shanthi,
Flat No. 406/405, Gayatri Apts, Naveen Nagar Colony, Road No. 1, Banjara Hills, Hyderabad-500040, Telangana, India.
Introduction: Platelet transfusions play a major role in preventing major haemorrhage and improve survival in severe thrombocytopenic patients. Generally, apheresis procedures are well tolerated. Systemic reactions are mainly vasovagal reactions and citrate toxicity is also one of the common reaction.
Aim: To identify the profile of platelet donors associated with adverse events resulting from plateletpheresis donation.
Materials and Methods: This retrospective study was carried out for a period of three years. A total of 615 Single Donor Platelet (SDP) apheresis procedures were performed during study period. Both continuous and intermittent flow centrifugation cell separators (Fresenius Kabi and Trima Accel) were used for performing the procedures. Predonation donor platelet count and other procedure variables were analysed in relation to the adverse events noted using the Pearson correlation.
Results: Age range of SDP varied from 19 years to 48 years. Platelet counts of the donors ranged from 1.6 to 4.5 lac/dL. Amongst the selected 615 donors, 15 (2.43%) had citrate related toxicity reactions, 2 (0.32%) had a vasovagal reactions, 8 (1.3%) had mild haematomas. Increase in the amount of Acid Citrate Dextrose (ACD) volume used (r=0.99, p-value <0.005), was associated with increased duration of the procedure and low donor platelet count. Among the donors who suffered adverse events, 22 (88%) were first-time platelet donors and 3 (12%) were repeat donors.
Conclusion: The overall rate of acute adverse events, among healthy SDP in our study was very low. However, in the study citrate toxicity increased in donors with platelet count <2.5 lac/dL. Precautions and close monitoring in such cases helps in decreasing the severity of citrate toxicity.