Circulatory arrest during PBPC apheresis in an unrelated donor.
BACKGROUND
Nowadays, the collection of PBPCs by apheresis from healthy donors is a routine method. The mobilization with rHu G-CSF and the apheresis procedures are usually well tolerated without severe side effects.


METHODS
We report a severe complication in a 41-year-old unrelated female donor who was allowed to donate PBPCs and was mobilized with 10 microg of G-CSF per kg per day. During PBPC apheresis, she experienced a circulatory arrest after 132 minutes and processing of 7078 mL of blood (twice the donor's blood volume).


RESULTS
Immediate cardiopulmonary resuscitation restored sinus rhythm and regulatory respiration without sequelae. Subsequent cardiologic examinations (heart catheterization, electrophysiologic testing, tilting table test) resulted in the diagnosis of a neurocardiogenic syncope. Other cardiac or circulatory disorders could be excluded. The implantation of a cardiac pacemaker was recommended to the donor. The 4-year-old recipient was successfully transplanted with the partial product collected until the arrest occurred. The patient received a total of 2.54 x 106 CD34+ cells per kg of body weight.


CONCLUSIONS
After exclusion of other cardiac diseases, the diagnosed neurocardiogenic syncope probably induced the circulatory arrest during apheresis rather than the administration of G-CSF.
Cassens
Uwe
U
Institute of Transfusion Medicine/Department of Transplantation Immunology, University Hospital Muenster, Muenster, Germany. cassenu@uni-muenster.de
Baumann
Claudia
C
Hillmann
Hartmut
H
Reinecke
Holger
H
Silling
Gerda
G
Booke
Michael
M
Wawer
Angela
A
Sibrowski
Walter
W
D000328:Adult; D001781:Blood Component Removal / Q000009:adverse effects*; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects; D006323:Heart Arrest / Q000209:etiology*; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000166:cytology*; D006801:Humans
D016179:Granulocyte Colony-Stimulating Factor