CLINICAL EXPERIENCE WITH TRANSFUSION OF LEUKOCYTE-POOR PLATELET CONCENTRATES PREPARED BY FILTRATION WITH PROSTACYCLIN
Repeated transfusions with platelets from randomly selected donors lead to HLA alloimmunization in about 50% of thepatients. This is caused by lymphocytes that contaminate the platelet concentrates. Attempts to remove the leukocytes from the platelet concentrates by additional centrifugation steps lead to substantial loss of platelets.We report here a new procedure for removal of almost all leukocytes with excellent platelet recoveries. Single donor concentrates are treated with 50 ng/ml prostacyclin in order to inactivate the platelets transiently. The concentrates are then passed through a cellulose acetate filter to remove the leukocytes. In 30 fresh concentrates this treatment reduced the contamination by leukocytes to less than 0.1 million per concentrate with a platelet recovery of 89± 1% (mean ±SEM). In concentrates stored for 3 days the contamination was reduced to about 5 million per concentrate. Thirty filtered platelet concentrates, obained from single donors by platelet apheresis using a Haemonetics U 50, were transfused to ten thrombocytopenic patients within 1 hour after filtration and were well tolerated. No signs of hypotension or other side effects were observed. The transfusions led to corrected count increments of (22.0±1.1) x 10 per ml blood after one hour and normal survival thereafter. In four out of five patients these concentrates reduced the bleeding time.We conclude that transient inactivation of platelets by prostacyclin enables optimal removal of leukocytes and may help to reduce alloimmunization during frequent transfusions with platelet concentrates.Supported by the Praeventionfund (grant 28953), The Hague.