Name of the Procedure:

Platelets, Pheresis, Leukocytes Reduced, Each Unit

Common name(s): Platelet pheresis, Apheresis platelets
Technical/medical term: Platelet apheresis with leukocyte reduction

Summary

Platelet apheresis with leukocyte reduction is a medical procedure where platelets are collected from a donor's blood, and leukocytes (white blood cells) are reduced or removed. These platelets are then used for transfusions in patients who need them, such as those undergoing chemotherapy or who have certain blood disorders.

Purpose

Platelet apheresis with leukocyte reduction is primarily performed to collect platelets for transfusion into patients who have a low platelet count (thrombocytopenia), are undergoing extensive cancer treatments, or have disorders that impair platelet production. The goal is to increase the patient's platelet count to prevent bleeding and improve clotting ability, while the leukocyte reduction minimizes immune reactions and other complications.

Indications

• Low platelet count (thrombocytopenia)
• Patients undergoing chemotherapy
• Bone marrow transplant recipients
• Surgical patients with significant blood loss
• Patients with clotting disorders (e.g., aplastic anemia, leukemia)

Preparation

• Donor selection based on medical history and blood tests
• Fasting may be required for several hours before the procedure
• Hydration is important; donors should drink plenty of fluids
• Donors may be advised to avoid aspirin or other blood-thinning medications for a week prior

Procedure Description

1. Donor Selection and Preparation: The donor is seated comfortably and a needle is inserted into a vein, typically in the arm.
2. Blood Collection: Blood is drawn from the donor and passed through an apheresis machine that separates platelets from other blood components.
3. Leukocyte Reduction: The machine reduces the leukocyte content to minimize potential adverse reactions when transfused.
4. Return of Blood: The remaining blood components (red cells, plasma, white cells) are returned to the donor through another needle in the opposite arm.
5. Storage: The collected platelets are stored in special bags and kept ready for transfusion to the recipient.

Tools used include the apheresis machine, sterile needles, and tubing systems. No anesthesia or sedation is required as the procedure is non-invasive.

Duration

The procedure typically takes about 1.5 to 3 hours, depending on the donor's blood flow rate and required platelet volume.

Setting

Platelet apheresis is usually performed in blood banks, specialized clinics, or hospital transfusion centers.

Personnel

• Apheresis nurse or technician
• Blood bank physician (in supervisory or consultative role)
• Phlebotomist (for blood draw support)

Risks and Complications

Common risks:

• Bruising or discomfort at needle insertion site
• Mild dizziness or light-headedness Rare risks:
• Allergic reactions to anticoagulant used in the process
• Citrate reaction (temporary tingling, muscle cramps due to calcium binding)
• Infection at needle insertion sites

Proper procedural protocols and monitoring help manage these risks effectively.

Benefits

• Reduces risk of bleeding in patients with low platelet counts
• Provides a critical component for patients undergoing intensive treatments (e.g., chemotherapy, bone marrow transplants)
• Leukocyte reduction minimizes transfusion reactions

Benefits are generally realized immediately after transfusion.

Recovery

After the procedure:

• Donors are monitored for a short period to ensure no immediate adverse reactions.
• Adequate hydration and rest are recommended.
• Donors can resume normal activities within a few hours.

Alternatives

• Whole blood platelet transfusion: Simpler but with higher leukocyte content and less efficacious platelet yield.
• Synthetic platelet substitutes: In development but not widely available.

Each alternative has different efficacy, availability, and risk profiles compared to platelet apheresis.

Patient Experience

During the procedure, donors may feel slight discomfort at the needle site and mild tingling. Post-procedure, they might experience slight fatigue but can typically return to routine activities soon after. Measures such as hydration and calorie intake are recommended to maintain comfort.