title: Risk factors for acute, moderate to severe donor reactions associated with multicomponent apheresis collections.
abstract: BACKGROUND
  Legitimate concerns exist over the safety of donors during multicomponent apheresis collections (MACs), when large volumes of red blood cells (RBCs) and plasma are removed. This study evaluates the predictive value of various donor- and procedure-related variables for moderate to severe donor acute adverse events (AAEs).
  
  
  METHODS
  Data on all apheresis donation procedures performed at a large university hospital-based donor center over a 2-year period were obtained by a review of adverse event forms and procedure logs (Trima Accel 5.1, Gambro BCT). Various donor- and procedure-related variables were compared between procedures that resulted in moderate to severe AAEs and those that did not.
  
  
  RESULTS
  Moderate to severe AAEs occurred in 53 (0.47%) of 11,333 apheresis donation procedures. The majority of events (96.2%) had predominantly features of vasovagal reactions (VVRs). Females were at significantly higher risk (odds ratio [OR] = 2.8, p < 0.0003) compared to males. Donors who experienced AAEs had significantly lower predonation total blood volume (TBV) and hematocrit (Hct) and higher total RBC loss and net fluid loss at the end of the procedures. Total plasma loss alone was not significantly different between the two groups. Total blood loss was significantly higher among donors who experienced AAEs as a percentage of the donor's TBV.
  
  
  CONCLUSIONS
  Apheresis collections are well tolerated even when multiple components are collected, with a very low overall incidence of moderate to severe AAEs (0.47%). Small, female donors with lower predonation Hct are at higher risk, especially when RBCs are collected.
authors.affiliation: Department of Pathology and Laboratory Medicine and Biomathematics, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA. syuan@mednet.ucla.edu
authors.forename: Shan
authors.initials: S
authors.lastname: Yuan
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Gornbein
authors.forename: Barbara
authors.initials: B
authors.lastname: Smeltzer
authors.forename: Alyssa F
authors.initials: AF
authors.lastname: Ziman
authors.forename: Qun
authors.initials: Q
authors.lastname: Lu
authors.forename: Dennis
authors.initials: D
authors.lastname: Goldfinger
mesh_terms: D000328:Adult; D001781:Blood Component Removal / Q000009:adverse effects*; D001782:Blood Donors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors