Apheresis is an effective way to collect, from a single donor, a therapeutic dose of platelets that is sufficient for an adult.

A bag of platelets collected through apheresis, into ACD-A, usually contains at least 2.4 x 1011 platelets.

After leukoreduction through centrifugation (incorporated into the collection process), the number of residual leukocytes in this product is less than 5 x 106. This product can contain a trace amount of residual red blood cells (roughly 3 ± 2 µL).

Also, every platelet donation is subjected to a bacterial culture test.

Action

The main role of platelets is to participate in blood clotting by forming an aggregate that blocks damaged vessel walls in order to treat or prevent bleeding.

Main indications

Transfusion of platelets to a recipient with thrombocytopenia, platelet dysfunction, or hemorrhagic manifestations can control the bleeding or increase the platelet count (prophylactic transfusion).

If required due to an anti-HLA or anti-HPA allo-immunization, a sample can be obtained from an HLA or HPA donor who is compatible with the recipient.

Contraindications

Platelets are usually contraindicated in recipients with thrombotic thrombocytopenic purpura (TTP) or immune thrombocytopenic purpura (ITP), unless the bleeding is endangering the recipient’s life.

Dosage and administration

The number of apheresis platelet bags to be administered depends on each recipient’s condition. One bag administered to a 70-kg adult should increase the platelet count from 30 to 60 x 109/L (from 30,000 to 60,000/µL) when a platelet count is taken 20 to 60 minutes after the transfusion in a patient not known for platelet refractoriness.

Due to the short life span of the platelets transfused, it is sometimes necessary to repeat the dose.

For pediatric needs, it’s possible to connect a device with four satellite bags to the bag using a sterile connection, enabling the hospital to divide up the required volume. A residual amount of 100 ml is required in the parent bag to maintain adequate storage.

The rate of the platelet transfusion must be be adjusted to the recipient’s clinical condition, and the transfusion must not go longer than four hours.

Storage

Bags of apheresis platelets have a seven-day shelf life when stored between 20°C and 24°C.

Bags of platelets must be gently and continually agitated during the storage period.

In the event of a discrepancy between the information on this page and what is in the Circular of information, the latter will take precedence.