1.
Course of hemoglobin and hematocrit during and after preparatory plasmaphereses without and with infusion of NaCl 0.9% 500 ml
Evers J, Ehren N, Engelen T, Hansen M, Luethje K, Taborski U
Transfusion Medicine & Hemotherapy. 2014;41((2):):114-6.
Abstract
BACKGROUND The aim of this study was to evaluate the course of hemoglobin (HGB) concentration and hematocrit (HCT) in donor blood during and after preparatory plasmaphereses (PP) without NaCl and with an infusion of 500 ml 0.9% NaCl during PP. METHODS After informed consent 32 plasma donors were studied in a crossover design. They underwent PP once without NaCl infusion and once, on a different day, with infusion of 500 ml 0.9% NaCl. HGB concentration and HCT values in donor blood were analyzed using a Sysmex KX-21N analyzer. The values of HGB concentration and HCT before PP were set to 100%. Changes in HGB concentration and HCT were calculated in percent directly after PP, and after 24 and 72 h. RESULTS During PP, there was a notable change in HGB concentration (11.2 + 4.0%) and HCT (11.6 + 3.9%) in donor blood. The difference between the 2 samples without and with NaCl was highly significant (p < 0.001). After 24 and 72 h, all differences were reduced. CONCLUSION We observed significant changes in HGB concentration and HCT in donor blood during PP. We recommend a concomitant infusion of 500 ml 0.9% NaCl during PP to all donors.
2.
A prospective trial assessing the safety and efficacy of collecting up to 840 mL of plasma in conjunction with saline infusion during plasmapheresis
Buzza M, Marks DC, Capper H, Cassin E, Badcock CA, Reid S, Kwok M, Yang H, Lee J, Corrigan C, et al
Transfusion. 2012;52((8):):1806-13.
Abstract
BACKGROUND The demand for plasma for manufacturing intravenous immunoglobulin and other plasma derivatives is increasing. A prospective study was conducted to determine whether up to 840 mL of plasma could be safely and effectively collected in conjunction with saline infusion during plasmapheresis. STUDY DESIGN AND METHODS Ninety-one plasma donors were enrolled in a modified 3 x 3 crossover study to assess the equivalence of three plasma collection methods: 750 mL of plasma with no saline (control, Method 1), 840 mL of plasma with a 250-mL saline infusion during and at the end of the donation (Method 2), and 800 mL of plasma with a 500-mL saline infusion at the end of the donation (Method 3). The primary efficacy endpoint was the total protein concentration of the collected plasma. Secondary efficacy endpoints were immunoglobulin (Ig)G and Factor (F)VIII plasma concentration and donors' acceptance of the new procedures. Safety was determined from the adverse event (AE) rate. RESULTS The total protein, IgG, and FVIII concentrations in plasma collected under Methods 2 and 3 were significantly lower than those in plasma collected under Method 1 (p < 0.0001). These variables were also significantly lower in plasma collected under Method 2 compared to Method 3. During the study, 75 AEs were recorded, 73 of which were mild to moderate. Significantly more donors (31%) preferred Method 2 compared to Method 3 (p = 0.006). CONCLUSIONS Saline infusion during plasmapheresis led to hemodilution of plasma proteins. However, the benefits to donor safety and satisfaction are compelling reasons to implement saline infusion during plasmapheresis. 2012 American Association of Blood Banks