Single automated donor plateletpheresis increases the plasma level of proinflammatory cytokine tumor necrosis factor-alpha which does not associate with endothelial release markers von Willebrand factor and fibronectin

The effect of plateletpheresis on endothelium, which has strong effects on blood coagulation, fibrinolysis and platelet function, is not known. Activa tion of leukocytes and subsequent generation of proinflammatory cytokines d uring the extracorporeal circulation may activate the endothelium. To test this hypothesis we measured plasma levels of tumor necrosis factor (TNF)-al pha as a prototype of the proinflammatory cytokines, and von Willebrand fac tor (VWF) and fibronectin as endothelial release/damage markers before and after a single plateletpheresis procedure on an intermittent-flow machine H aemonetics MCS 3p in 17 healthy donors. We found a significant increase in median plasma level of TNF-alpha following plateletpheresis (3.5 vs 26.5 pg /ml, P = 0.02). Such increases in vWF and fibronectin were not observed. Th e increase in plasma TNF-alpha indicates that a single plateletpheresis pro cedure causes leukocyte activation which does not seemingly impair endothel ial cell function. The relation of plateletpheresis-induced proinflammatory cytokine release to some adverse effects observed in both donors and recip ients, and the effect of repeated plateletpheresis on endothelium deserve f urther studies. (C) 2000 Elsevier Science Ltd. All rights reserved.