✯✯✯ Essay On Plateletpheresis

Saturday, June 19, 2021 10:20:02 AM

Essay On Plateletpheresis

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Additional references. Sign up for our Email Newsletters. Click here for information on linking to our website or using our content or images. Home About Us Advertise Amazon. Telephone: ; Email: CommentsPathout gmail. This website is intended for pathologists and laboratory personnel but not for patients. We welcome suggestions or questions about using the website. However, we cannot answer medical or research questions or give advice. Since each blood bag usually mL or mL contains a relatively small number of platelets, it can take as many as a dozen blood bags usually from 5 to 10 bags, depending on the size of the blood bags and each donor's platelet count to accumulate a single unit of platelets enough for one patient.

This greatly increases the risks of the transfusion. Each unit of platelets separated from donated whole blood is called a "platelet concentrate". Modern automatic thrombapheresis allows blood donors to give a portion of their platelets, while keeping their red blood cells and at least a portion of blood plasma. Therefore, no more than three units of platelets are generally harvested in any one sitting from a donor. Most donors will donate a "single" or "double" unit, however the occurrence of "triples" has been increasing as more suitable donors are recruited.

Because platelets have a shelf life of just 5 days, more platelet donors are always needed. Some centers are experimenting with 7 day platelets, but this requires additional testing and the lack of any preservative solutions means that the product is far more effective when fresh. Even though red blood cells can also be collected in the process, many blood donation organizations do not do so because it takes much longer for the human body to replenish their loss. In addition, some though not all centers defer further platelet donations until the red blood cells can be replenished.

In most cases, blood plasma is returned to the donor as well. However, in locations that have plasma processing facilities, a part of the donor's plasma can also be collected in a separate blood bag see plasmapheresis. For example, in Australia around 5. Due to their higher relative density , white blood cells are collected as an unwanted component with the platelets. Since it takes up to 3 liters of whole blood the amount of a dozen blood bags to generate a dose of platelets, white blood cells from one or several donors will also be collected along with the platelets. A 70 kg lb man has only about 6 liters of blood. If all of the incidentally collected white blood cells are transfused with the platelets, substantial rejection problems can occur.

Therefore, it is standard practice to filter out white blood cells before transfusion by the process of leukoreduction. Early platelet transfusions used a filter to remove white blood cells at the time of transfusion. It takes a trained person about 10 minutes to assemble the equipment, and this is not the safest or most efficient means of filtration because living white blood cells can release cytokines during storage and dead white blood cells can break up into smaller fragments that can still stimulate a dangerous response from the immune system. In addition, simple filtration can lead to increased risks of infection and loss of valuable platelets.

Newer, more advanced thrombapheresis machines can filter white blood cells during separation. This can seriously damage the patient's health. There are two types of manual platelet apheresis. Platelets are the clotting cells of the blood, and when donated, frequently go to cancer patients, because due to chemotherapy many cancer patients are unable to generate enough platelets of their own. The basic principles of automatic platelet apheresis are the same as in the manual procedure, but the whole procedure is performed by a computer-controlled machine. Since the donor's blood is processed in a sterile single-use centrifuge, the unwanted components can be returned to the donor safely. This allows the apheresis machine to repeat the draw-centrifuge-return cycle to obtain more platelets.

The bulk of the machine and the length of the donation process means most platelet donations are done in blood centers instead of mobile blood drives. Each country has its own rules to protect the safety of both donor and recipient. Since the machine used to perform the procedure uses suction to draw blood out of a donor's body, some people who can give whole blood may have veins too small for platelet donation.

Blood centers evaluate each donor's veins prior to donation. Most newer apheresis machines can separate a maximum donation of platelets in about 60 to minutes depending on the donor's health condition. After a short physical examination , the donor is taken into the donation room and sits in a chair next to the machine. The technician cleans one or both arms with iodine, or other disinfectant, and inserts the catheter into a vein in the arm. With some procedures both arms are used, one to draw blood and the other to return it. The process takes about one to two hours while blood is pulled into the machine, mixed with an anticoagulant such as sodium citrate , spun around, and returned to the donor.

The donor's blood undergoes repeated cycles of draw and return. Side effects of the donation of platelets generally fall into three categories: blood pressure changes, problems with vein access, and effects of the anticoagulant on the donor's calcium level. Blood pressure changes can sometimes cause nausea, fatigue, and dizziness. Venous access problems can cause bruising, referred to as a hematoma.

While donating, a supply of calcium antacid tablets is usually kept close by to replenish the calcium lost. Because the anticoagulant works by binding to the calcium in the blood, a donor's levels of calcium — and especially of active calcium ions — drop during the donation process. The lips may begin to tingle or there may be a metallic taste; since calcium enables the function of the nervous system, nerve-ending-dense areas such as the lips are susceptible, at least during the donation process.

Unusually low calcium can cause more serious problems such as fainting, nerve irritation [ citation needed ] and short-duration tetany. Such an acute hypocalcaemia is usually due to low calcium levels prior to donation, aggravated by the anticoagulant. Hypocalcaemia can be curtailed by modestly increasing dietary calcium intake in the days prior to donation. Serious problems are extremely rare, but apheresis donors are typically not allowed to sleep during the long donation process so that they can be monitored.

Firstly, the donor must not take aspirin or other anti- platelet medications such as clopidogrel Plavix for anywhere from 36 to 72 hours prior to donation. Guidelines vary by blood center. The reason is that aspirin can prevent platelets from adhering to clot bleeding. Some blood centers also prohibit the taking of any NSAID non-steroidal anti-inflammatory drug for 36 hours prior.

Secondly, one is generally allowed to donate platelets anywhere from every 3—28 days. This is a stark contrast to whole-blood donation, which has an eight-week or longer waiting period between donations. Along those lines, since platelet donation does temporarily remove whole blood from the body, it may be necessary to wait eight weeks after a whole blood donation to donate platelets, although two weeks is more common. In the US, a donor is only allowed to donate 24 times each year and may not lose more red blood cells or plasma in a year than they would from the maximum allowable number of whole blood donations.

The donation should not be done more than 2 times a week and should also be limited to 24 times in one year. Thirdly, additional tests may be required before becoming a donor for the first time. These tests may establish a platelet count. Newer automated platelet pheresis machines do that as the donation begins, and adjust accordingly the quantity of platelets to be drawn. Tests may also determine the donor's compatibility with particular recipients through an HLA Human Leukocyte Antigen test.

These tests usually involve nothing more involved than the drawing of several tubes of blood. Adverse conditions that can happen during a plateletpheresis donation are hypocalcemia , hematoma formation, and vasovagal reactions.

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