HAEMATOLOGICAL CHANGES IN POST PLATELETPHERESIS DONORS IN NATIONAL HOSPITAL ABUJA

Abstract

Background: The demand for Apheresis Platelets concentrate transfusions is
increasing daily in our hospitals. This is due to increased cases of malignancy
associated bone marrow suppression and various other causes of thrombocytopaenia
and thrombopathies. Increased use of myeloablative chemotherapy in treatment of
haematological and other malignancies also results in transient severe fall in platelet
count. The demand generally outstrips the supply necessitating the need to search for
additional sources to increase the supply of platelets for transfusion. Is it therefore
possible to reduce the deferral time for plateletpheresis while maintaining donor
safety?
Aims and Objectives: The aim of the study was to determine the haematological
changes that occur post plateletpheresis in donors. To assess the platelets recovery
time after platelets concentrate donation with a view to determining the appropriate
deferral time for repeat plateletpheresis
Methods: Fifty seven healthy plateletpheresis donors were recruited over a period of
seven months and their haematological parameters (Hb, Haematocrit, WBC counts,
platelets counts, RDW and PDW) were analyzed on days 0, 2 and 7 post donation. The
result was compared with 55 healthy whole blood donors for platelets recovery
Results and Analysis: There was a significant transient increase in the Hb (pre:
13.96±1.02, post: 14.72±1.32, Day 2: 13.75±1.04, Day 7: 13.83±1.04. Mean±SD), Hct
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(Pre: 42.18±2.59, Post: 44.07±3.37, Day 2: 41.89±2.82, and Day 7: 42.22±3.38). There
was also significant decrease in the platelets counts (p <0.001), with subsequent good
platelets recovery post donation (Pre: 259.83±44.61, Post: 205.29±36.77, day 2:
216.88±32.71 and day 7: 240.3±41.83). The apheresis donors recovered 64.29% of the
lost platelets after donation, attaining 92.49% of pre-donation count. The WBC count
increased steadily post donation, Pre: 5.53 ± 1.32, Post: 5.74 ± 1.37, (p=0.189)day 2:
5.77 ± 1.53 (p=0.236), and Day 7: 5.85 ± 1.52 (p=0.090). The RDW and PDW did not
change significantly, RDW (Pre: 14.19 ± 1.34, Post: 14.43 ± 1.49 (p=0.001), Day 2:
14.31 ± 1.12 (p=0.253) and Day 7: 14.30 ± 1.22 (p=0.392), PDW; Pre: 11.18 ± 1.3,
Post: 11.38 ± 1.32 (p=0.190), Day 2: 11.57 ± 1.32 (p=0.051) and Day 7: 11.68 ± 1.22
(p=0.009) .
About twenty one percent of circulating platelets was lost after plateletpheresis while
the platelet count reduced by 7.87% (6.53 x 109/L) after whole blood donation. The
platelets recovery was higher after plateletpheresis, 83.47% (day 2) from 78.92% (post
donation) against whole blood donors that depreciated further to 92.13% from 96.83%
(post donation), p-value 0.001, and 92.49% at day 7 against 95.76% of whole blood
pre- donation values, p-value 0.000.
Conclusion: This study has shown statistically significant platelets recovery 7 days
after plateletpheresis making a 7 day deferral for repeat plateletpheresis feasible in our
environment. The study also shows that some donors with high pre-donation platelets
count can donate again after 2 days of donation as recommended by AABB. Strict
monitoring and evaluation of donors should be ensured and thorough pre-donation
examination done, including full blood counts to prevent any adverse events such as
anaemia and thrombocytopenia. Further enlarged study needs to be done to
corroborate this finding.