2016 Volume 62 Issue 5 Pages 592-600
To prevent adverse events following platelet transfusion, it is usually recommended that platelet concentrate products (PCs) be washed with a cooling centrifuge. However, the majority of hospitals do not have access to suitable equipment. On the other hand, almost all hospitals have hollow fiber membrane equipment on hand for hemodialysis and plasma exchange. Given this situation, we decided to develop a new method for preparing washed platelet concentrate (WPC) using a membrane plasma separator. We compared the quality with WPC prepared by the centrifuge method (CM) and our newly developed membrane method (MM). The new MM consists of 4 processes; 1) a separator (EC-4A10, Kawasumi Laboratories, INC.) is first rinsed. 2) Platelets are primed outside of the hollow fibers. 3) The platelets are then washed with 1,200 ml of BRS-A (Bicarbonate Ringer's solution with ACD-A) and 4) recovered with 240 ml of BRS-A. The platelet recovery rates were 95.8% in MM and 90.4% in CM (p<0.05). The removal rates of plasma proteins were significantly superior in CM compared to those in MM. Specifically, albumin, IgG, IgA, IgM and total protein removal rates in CM were 97.2%, 96.2%, 96.2%, 97.2%, 95.7%, while those in MM were 93.2%, 92.1%, 78.0%, 7.3%, 85.8% (p<0.05). On the other hand, the CD62P-selectin levels were significantly lower in MM than in CM when measured at 1, 12, 24 hours after the respective procedures. In conclusion, MM was superior in having a higher platelet recovery rate and less platelet activation than CM. However, plasma proteins were more poorly removed in MM. We assume that this result was due to the relation between protein molecular weight and membrane pore size. However, currently it is not clearly known how important of a role these proteins take in adverse transfusion reactions, and further examination is needed.
