Effect of plateletpheresis on total platelet count and mean platelet volume: A meta-analysis
Gil-Betancur A, Mantilla-Gutierrez CY, Cardona-Arias JA
J Evid Based Med. 2020
OBJECTIVE Currently, there are discrepancies in the reports on the extent of the reduction in platelet count after platelet donation by apheresis, and its impact on mean platelet volume (MPV). This study was conducted to meta-analyze the effect of plateletpheresis on platelet count and on mean platelet volume, based on studies published between 1980 and 2018. METHODS Medline-Pubmed, Scielo, ScienceDirect, and Scopus databases were searched from inception to December 31 2019. The PRISMA guidelines, reproducibility, and evaluation of the methodological quality were guaranteed. Heterogeneity was evaluated with DerSimonian-Laird's, publication bias with a Begg's test. Sensitivity analysis and cumulative meta-analysis were also conducted, as well as a forest plot. RESULTS Twenty-five studies with 3769 donors were systematized to analyze platelet count, and seven studies with 1176 donors to observe MPV. Most studies were published in India and the United States. There was a postprocedure reduction in both variables. The reduction in platelet count was 14.3 x 10(3) /muL (95% CI 11.4 to 17.1 x 10(3) muL). The reduction in MPV was 1.43 fL (95% CI 0.3 to 2.5 fL). The analysis of subgroups showed that, in the case of platelet count, the reduction is not statistically significant two weeks after donation. CONCLUSION Platelet donation by apheresis reduces platelet count and MPV in donors, which is detrimental to the purposes of the procedure; although the decrease is not clinically significant for the donor or the recipient. This demonstrates the need for subsequent studies to evaluate variables, such as donation frequency and donation intervals, should be considered to evaluate if the reported decrease is easily compensated, without adverse consequences for donors, or if modifications in donor selection criteria are required.
[Effect of plateletpheresis on the white blood cell count: meta-analysis 1980-2018]
Gil-Betacur A, Mantilla-Gutierrez CY, Cardona-Arias JA
Revista espanola de salud publica. 2019;93
BACKGROUND In the scientific literature, the impacts of plateletpheresis on leukogram parameters are not clear, with a high divergence in the studies that have evaluated changes in leukocytes. The objective of this paper was to meta-analyze the effect of plateletpheresis on the leukocyte count, based on studies published between 1980-2018. METHODS Systematic review with meta-analysis of random effects for the difference of means. The phases of the PRISMA guide were applied with 132 search strategies in Pubmed, Scielo, Science direct and Scopus. Reproducibility and evaluation of methodological quality were guaranteed. Heterogeneity was evaluated with Galbraith and Dersimonian and Laird's, publication bias with Funnel Plot and Begg; sensitivity analysis, accumulated meta-analysis and Forest Plot were carried out. RESULTS Nineteen studies were included with 2,358 donors, mostly from India, United States, Turkey, Germany and Austria. A mean difference of -0,80 x109L (IC95%= -1,96; 0,36x109L) between the predonation value and the value immediately after donation was founded; no publication bias was found and the conclusion presented good sensitivity since it does not vary with the elimination of studies in successive phases. CONCLUSIONS The donation of platelets by apheresis does not affect the leukocyte count in the donors, in the last century there were reports of reductions in this parameter, explained by the blood loss in the cases used for the procedure and by effects produced in the blood cells by the biomaterials; however, at present the high safety of plateletpheresis for the white blood cell count is evidenced.
Effect of plateletpheresis on hematocrit, hemoglobin and erythrocyte count: Meta-analysis 1980-2018
Gil-Betacur A, Mantilla-Gutierrez CY, Cardona-Arias JA
Scientific reports. 2019;9(1):19770
The effects of platelet donation by apheresis on different parameters of the erythrogram are still unclear. The objective was to meta-analyze the effect of plateletpheresis on hematocrit, hemoglobin, and erythrocyte count, with a systematic review with random effects meta-analysis of the mean difference. The PRISMA guidelines were considered, as well as 133 search strategies on four different databases. Reproducibility was guaranteed and methodological quality was evaluated. Heterogeneity was evaluated with Galbraith and DerSimonian-Laird's, publication bias with a funnel plot and a Begg's test, sensitivity analysis and a cumulative meta-analysis were also conducted. Eighteen (18) articles were included, 17 evaluated the effects on hematocrit in 2,564 donors; 13 on hemoglobin in 1,640 donors; and 4 on red blood cell count in 243 donors. A decrease of 2.26% (CI95% = 2.11-2.41) was observed in hematocrit, of 0.80 g/dL (CI95% = 0.75-0.86) in hemoglobin and -0.21 x 10(12)/L (CI95% = -0.13; -0.29) in red blood cell count. Plateletpheresis has a negative effect on the erythrogram parameters, explained by blood loss in the kits used for the procedure and cell lysis. Such evidence is relevant to secure the efficiency and safety of the procedure, improve selection processes or determine the number of donations that can be performed without affecting donors' health.
Iron deficiency prevalence in blood donors: a systematic review, 2001-2011 . Spanish
Mantilla-Gutierrez CY, Cardona-Arias JA
Revista Espanola de Salud Publica. 2012;86((4):):357-69.
Background: Blood donation is associated with decreased iron stores in blood donors which may affect the development of physiological functions and overall health. Previous studies reported a wide variation in the prevalence of iron deficiency in this population (1% to 62%). So, we want to establish the prevalence of iron deficiency in blood donors from a systematic review of the literature. Methods: Exhaustive and reproducible search of literature in 7 databases, based in a protocol for searching in 4 languages between 2001 to 2011 with inclusion and exclusion criteria and information extraction. The analysis was based on the calculation of frequencies and specific prevalence by sex and number of previous donations, with their respective confidence intervals in Excel and Epidat (3.0). Results: A total of 16.979 donors, 5.096 regular, with 59% men. The prevalence of iron deficiency found was 13% (IC 95%: 12,4 to 13,4) with a range between 1% and 62%. Prevalence statistically higher was observed in women (19,56%) and repetitive donors (20,36%). Conclusion: We obtained iron deficiency prevalence in blood donors over higher risk groups like children, being higher in female and repetitive donors. That suggests the need to encouraged blood banks in the application of protocols designed to preserve healthy donors and this will result in an adequate blood supply.