Postthaw clotting of peripheral blood stem cell products due to insufficient anticoagulant.
The amount of acid citrate dextrose formula A (ACD-A), which is a commonly used anticoagulant in leukopheresis, has to ensure both the safety of the donor and guarantee the integrity of the peripheral blood stem cell (PBSC) product until its transplant. Two recent consecutive cases of postthaw PBSC product clotting initiated a look-back investigation of the ACD-A percentage in leukopheresis products collected in our facility. The data indicated a significant difference between the average amount of ACD-A in prefreezing products collected during 2006 (11.4%) and in products collected during 2007 and 2008 (8.8% and 8.7%, respectively). These findings and the fact that the two clotted products had less than 7% ACD-A indicated that insufficient amount of anticoagulant might contribute to their clotting. This investigation prompted us to modify our collection and thawing procedures to prevent similar events in the future.
Reich-Slotky
Ronit
R
Division of Transfusion Medicine, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA. rslotky@gmail.com
Patel
Nita
N
Dael
Shatrina
S
Semidei-Pomales
Mildred
M
Stephens
Hannah
H
Reich
Michael
M
Schwartz
Joseph
J
D000925:Anticoagulants / Q000494:pharmacology*; D001777:Blood Coagulation; D001800:Blood Specimen Collection; D019343:Citric Acid / Q000494:pharmacology*; D005615:Freezing; D005947:Glucose / Q000031:analogs & derivatives* / Q000494:pharmacology; D006412:Hematopoietic Stem Cells; D006801:Humans
D000925:Anticoagulants; C002113:acid citrate dextrose; D019343:Citric Acid; D005947:Glucose