Moderate and severe adverse events associated with apheresis donations: incidences and risk factors.
BACKGROUND
The goal of this observational retrospective study was to evaluate various donor and procedural variables as potential risk factors for different types of moderate to severe adverse events (AEs) during apheresis collections.


METHODS
Data on all apheresis collections performed on Trima Accel (TA; CaridianBCT) instruments over a 28-month period were extracted from a donor database (Vista Information System, CaridianBCT) and reviewed along with AE reports from the same period. Donor and procedural variables were compared among uneventful procedures and those that resulted in various types of moderate to severe AEs, including presyncopal or syncopal (PS) episodes, citrate reactions (CR), reactions with both components (PS + CR), and self-reported incidents of significant venipuncture-related vascular injuries (VIs).


RESULTS
A total of 59 moderate to severe AEs occurred among 15,763 procedures (0.37%), including 19 PS, 4 CR, 17 PS + CR, 12 VI, and 7 miscellaneous reactions. Greater blood loss and lower net fluid balance were associated with PS; female sex, older age, and smaller total blood volume (TBV) were associated with CR; and development of VI may be associated with female sex and smaller TBV. Younger age was not a risk factor for AEs.


CONCLUSIONS
Apheresis collections performed by TA instruments are safe with a low incidence of significant AEs. Various types of AEs have different predisposing factors. Apheresis may be a safer option for donors with risk factors for PS reactions associated with whole blood collections, such as younger age, female sex, and small TBV.
Division of Transfusion Medicine, Department of Pathology & Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California 90095, USA. syuan@mednet.ucla.edu
Shan
S
Yuan
Alyssa
A
Ziman
Barbara
B
Smeltzer
Qun
Q
Lu
Dennis
D
Goldfinger
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000209:etiology; D001781:Blood Component Removal / Q000009:adverse effects* / Q000706:statistics & numerical data; D001782:Blood Donors / Q000706:statistics & numerical data*; D002119:Calcium Carbonate / Q000627:therapeutic use; D019343:Citric Acid / Q000009:adverse effects; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006406:Hematoma / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D006996:Hypocalcemia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D015994:Incidence; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010292:Paresthesia / Q000453:epidemiology / Q000209:etiology; D059348:Peripheral Nerve Injuries; D018962:Phlebotomy / Q000009:adverse effects; D011292:Premedication; D012189:Retrospective Studies; D012307:Risk Factors; D013575:Syncope / Q000453:epidemiology / Q000209:etiology; D014680:Veins / Q000293:injuries; D014839:Vomiting / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult
D000925:Anticoagulants; D019343:Citric Acid; D002119:Calcium Carbonate