Dr Shivanand Gundalli, Consultant Transfusion Medicine, Asian Heart Institute, Mumbai

Blood component donations by apheresis have become more common in modern blood transfusion practices. Apheresis is becoming a routine procedure in most of the blood centers in developing countries. Technical advances in automated cell separators have improved the productivity and quality of the collection of apheresis platelets. There are a variety of plateletpheresis instruments available on the market, and some studies focusing on the comparison of different cell separators have been conducted. In recent years, it has been possible to collect double-dose platelets using new generation instruments. The double-dose plateletpheresis (DDP) is considered to be an advantageous way of preparing platelet concentrates, owing to the low incidence of immunological and infectious complications for the patients.

Some devices are dedicated to the collection of leukoreduced plateletpheresis the CE and CR were sufficient with the hemonetics and few devices are dedicated for platelet (PLT) yields, collection efficiency (CE), and collection rates (CR) are also good. During the last decades, there have been significant improvements in the productivity and quality of plateletpheresis.

The use of apheresis equipment to collect blood components has rapidly increased in the past years. A variety of apheresis instruments are now available on the market for double-dose plateletpheresis.

Few devices are having e single-needle system that usually draws off more blood than the centrifuge can handle. The parameters of these devices are usually whole-blood flow, interface set point and anticoagulant/whole-blood ratio. Leukoreduction techniques may be performed by leukoreduction filter.

The parameters of the other devices include whole blood flow, and anticoagulant/whole blood ratio, and single-needle system is used.

Platelet (PLT) transfusions play an important role in patients with thrombocytopenia or severely impaired platelet function. Platelet concentrates are prepared from whole-blood donations or by plateletpheresis. In recent years, different instruments have been developed to perform plateletpheresis

Details of plateletpheresis should be explained to each donor who gave informed consent before the procedure. Criteria for eligibility for a single unit ( 3 10 11) were as follows: Age 18–60 years; preapheresis peripheral blood PLT Count 150 109 /L; hemoglobin (Hb) level 13.5 g/dl; donor body weight 50 kg; negative tests for HIV, hepatitis B surface antigen, hepatitis C, and syphilis; absence of any illness; in good health; at least 3 months since last whole donation; At least 3 days since last plateletpheresis; adequate venous accesses; and no consumption of non-steroidal anti-inflammatory drugs and acetyl salicylic acid in the last 7 days. Complications are mild and consist of hypotension, hypocalcemia, and flushing. All reactions respond rapidly to decreased flow rates and/or calcium supplementation. Usually there will not be any high-rate adverse events that would cause early termination of the plateletpheresis

The PLT yield and CE have been widely referred to as an important factor for both blood banks and donors. The newer hemonetics should provide satisfactory PLT yields and collection efficiency, for WBC reduction.

Lung injury after heart operations has been reported to involve various factors, such as complement, platelets, endothelial cells, and inflammatory substances released from cells. Leukocytes are activated by complement and other factors during cardiopulmonary bypass, and leukocyte sequestration occurs primarily in the lung. Leukocytes have been reported to play a major role in postperfusion lung syndrome, respiratory dysfunction after heart operations with cardiopulmonary bypass. The removalofleukocytesandplateletsduring heart operations with cardiopulmonarybypassisexpected to
prevent postoperative deteriorationofrespiration function.

The blood cell separators are particularly recommended for severely ill patients or patients in whom the duration of cardiopulmonary bypass is expected to
be long.


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