Apheresis versus whole‐blood‐derived platelets: pros and cons

Platelet concentrates for prophylactic or therapeutic treatment of patients can be isolated from whole blood using the platelet-rich plasma-method or the buffy coat-method on one hand, or can be collected by apheresis with return of unwanted blood cells to the donor on the other hand. A number of variables among the methods, including the anticoagulant, centrifugation and processing after collection, and pre- or post storage pooling, affect storage characteristics of platelets. Data suggest, however, that most differences balance out, both based on in vitro studies, and on recovery and survival studies. A marginal difference in corrected count increment in favor of apheresis platelets was observed, but the practical consequence is likely to be small. The need for pooling of whole-blood-derived platelet concentrates increases donor exposure, and thereby potentially increases the risks associated with transfusion of whole-blood-derived platelet concentrates. Indeed, risk of viral and variant Creutzfeldt-Jakob disease transmission is at least two-fold higher for whole-blood-derived platelet concentrates, but allo immunization rates, acute reaction rates, and transfusion related acute lung injury rates are not different. Apheresis donation procedures have fewer adverse events. The various benefits and disadvantages of the methods have to be balanced when choosing a preferred way of platelet collection.

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