Evaluation of Cobe Trima for the collection of blood components with particular reference to the in vitro characteristics of the red cell and platelet concentrates and the clinical responses to transfusion

This study evaluated Cobe Trima for donor and operational acceptability, th e quality and storage stability of the blood components collected, and the clinical responses to transfusion. The study was carried out in 2 phases; p hase 1 assessed the efficiency of red cells and platelet collection, and th e characteristics of the components collected before and after storage. Pha se 2 was an evaluation of operational issues and the in vitro characteristi cs of the red cells and platelet concentrates at the time of transfusion in respect to their cellular content, and leucocyte (interleukin IL-6 and IL- 8) and platelet-derived (Rantes) cytokine levels. Cytokine levels were also measured in the donors before and after the collection procedure and in pa tients both before and after transfusion. The clinical responses to a small number of transfusions were assessed. The Cobe Trima was found to be strai ghtforward to use by the operators, although additional operator training w as required to manage occasional uncertainty with alarm messages. It was ac ceptable to the donors except for the occurrence of citrate reactions in 3/ 6 donors in phase 1; this problem persisted in phase 2 (6/15 donors), and n eeds to be addressed in the future. All blood components met UK product spe cifications apart from 2 platelet concentrates; 2 red cell concentrates, an d one unit of FFP; the red cell and platelet concentrates had good storage characteristics. The 2 procedures, which resulted in low platelet yields, w ere due to occlusion of the plasma line; the method for installation of the harness has been subsequently modified to prevent this. 2 red cell concent rates showed haemolysis; the reason for this was not established. The Facto r VIII level was satisfactory in plasma and the cellular content was low. T he responses to 12 platelet transfusions were expected as in a group of hae matology patients, and no immediate adverse effects were reported with any of the transfusions. Leucocyte-associated (IL-8 and IL-6) and platelet-asso ciated (Rantes) cytokine levels were not elevated in donor samples taken be fore or after the collection procedure, or in the red cell and platelet con centrates at the time of issue. Pre- and post-transfusion IL-8 levels were raised in one patient with non-immune platelet refractoriness, and normal i n 2 patients with excellent or almost satisfactory responses to platelet tr ansfusions raising the question as whether IL-8 could be used as a laborato ry marker for nonimmune platelet refractoriness due to infection. (C) 2000 Elsevier Science Ltd. All rights reserved.