A case of leucodepletion failure in Cobe spectra plateletpheresis: further studies on the identification of the potential cause.
A 54-year-old double dose donor failed leucodepletion by Cobe LRS for five sequential donations, without triggering the "machine failure alarm". All collections were uneventful but final products appeared lipaemic. The last two donations were studied: (i) by collecting the first half of each donation into one bag and the other half into a second bag. In both cases, the product in bag one was leucodepleted and that in bag two "failed" leucodepletion. (ii) By examining the filterability of the final products using an LRF6 filter. Leucodepletion was satisfactory but showed a slightly higher level of leucocytes as compared to control or lipaemic donations, possibly due to the presence of an interfering substance in the platelet product. (iii) By examining the cellular content of the LRS cone and comparing it with those obtained from lipaemic donations from other donors. Only the test cone contained a large mass of waxy white material. It is postulated that this material was gradually filling the cone and increasingly interfering with its leucodepleting function as the donation progressed. (iv) To monitor pre/post whole blood as well as the products for the presence of abnormal leucocyte subsets. The only difference was the presence of some extra abnormal dot plot. The intensity of these extra events which was reduced both upon donation and filtration. We conclude that, in this case, failure of leucodepletion was clearly donor rather than machine or process related. The implementation of this investigative study may help in the characterisation of the potential cause of leucodepletion failures.
Seghatchian
J
J
National Blood Service-North London, Colindale Avenue, Colindale, London NW9 5BG, UK. jerhard.seghatchian@nbs.nhs.uk
Beard
M J
MJ
Krailadsiri
P
P
D001782:Blood Donors; D048429:Cell Size; D019544:Equipment Failure Analysis / Q000592:standards; D005374:Filtration; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D007937:Leukapheresis; D007958:Leukocyte Count; D008055:Lipids / Q000009:adverse effects; D008875:Middle Aged; D010976:Platelet Count; D010983:Plateletpheresis / Q000295:instrumentation* / Q000379:methods / Q000592:standards*
D008055:Lipids