Comparison of Double RBC Collection
by Blood Cell Separators
Pimpun Kitpoka MD*, Sarawan Chanthet MSc*,
Viroje Chongkolwatana MD**, Ampaiwan Chuansumrit MD***, Mongkol Kunakorn MD*
Affiliation :
* Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
** Department of Transfusion Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
*** Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Background : The problem of red blood cell (RBC) shortage occurs because of the expanding demand for blood utilization
and the difficulties in donor recruitment and retention. Resources can be maximized by using current technology to collect
two units of RBC from the same donor during a single collection session.
Objective : To evaluate the performance, collection efficiency (CE), production cost, and donor satisfactions of two
commercially available blood cell separators (BCS) for double dose red cell (DDRC) collection. Donor safety, clinical
effectiveness, and patient safety were studied.
Material and Method: Thirty-one repeated male donors from the blood bank, Department of Pathology, Faculty of Medicine,
Ramathibodi Hospital, Mahidol University were recruited for DDRC collection by two BCSs, the Alyx™, Fresenius Kabi,
NC, USA, and the MCS®+, Haemonetics Corporation, Scotland. The donation intervals were at least 16 weeks. The target
RBC volume was 360 mL (180 mL x 2 units). Pre- and post-donation hematologic parameters were monitored and quality
tests for DDRC were performed. Donor reactions (DR) were observed and donor satisfaction questionnaires were collected
after donations. Eighty-six units of RBC were transfused to 33 patients. Transfusion reactions (TR) were observed, and
hematocrit (Hct) increments were determined pre-transfusion and 24 hours post-transfusion.
Results : The Alyx™ was faster for collecting and filtrating RBC (p<0.001) and had better CE (p<0.001). All DDRC from
both BCSs met all the quality standards, required by both the American Association of Blood Banks (AABB) and the Food
and Drugs Administration (FDA), which were hemoglobin (Hb) >42.5 g, Hct 50 to 70% and the residual white blood cells
(WBC) <5x106. The Alyx™ processed less whole blood (WB) volume but provided DDRC with higher RBC yield, Hb content,
and RBC volume than that of MCS®+ (p<0.001). However, the MCS®+ had one advantage over the Alyx™ whereby the
DDRC collected by the MCS®+ were washed to reduce the risk of plasma associated TR. No serious DR from either BCS
was observed. All donors had Hb >10 g/dL and Hct >30% after collection, as required by AABB. Serum ferritin reduction
and iron depletion found in DDRC donors were not different from WB donors. All donors were satisfied with the DDRC
collection process and would like to donate again. There was no evidence of acute or delayed TR in the patients. Hct
increased significantly in 69.70% of the patients.
Conclusion : DDRC collection can be performed safely and efficiently from both BCS. The quality of DDRC from both BCSs
met the AABB and FDA standards. Donor safety, transfusion safety, and effectiveness were observed. Even though the
production cost of DDRC was slightly higher than that of whole blood derived filtered RBC, DDRC was better in terms of
quality, risk reduction for infectious agents, and RBC alloimmunization. Production of DDRC can also be helpful supplying
special RBC such as group O, Rh D negative, and phenotyped RBC.
Keywords : Double dose RBC collection, Two units RBC, Apheresis
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