Donor safety issues in high-dose platelet collection using the latest apheresis systems

SUMMARY The practice of high-yield or double-dose platelet (DDP) collection through automated apheresis is gradually increasing. Very few studies have examined donor safety issues in DDP collection. The present study highlights the process of DDP donor selection as well as the product quality and donor safety issues on 67 donors. All procedures were performed following the departmental standard operating procedure. We observed a significantly higher mean platelet yield with the Amicus separator than the Fresenius separator (5.4 × 1011vs. 5.1 × 1011, P = 0.03). The Fresenius separator processed a mean blood volume of 3974 mL and collected a mean platelet amount of 444.9 mL, and these were significantly higher when compared with Amicus (P < 0.0001). Mean values of procedure-related parameters, such as acid-citrate-phosphate volume, donation time, needle time, processing time and whole blood processed, and donor-related parameters, like citrate toxicity and vasovagal reactions, were significantly higher during DDP than single-dose platelet collection (P < 0.05). We conclude that obtaining eligible donors for DDP from a shrinking donor population with low normal platelet values is a difficult task. Therefore, each transfusion service should set their own guidelines for DDP collection with the objectives of donor safety and optimal product quality.