Does plateletpheresis induce a hypercoagulable state? A global assessment of donor's hemostatic system by rotem

Abstract

Since there is still debate on the effects of plateletpheresis on coagulation system, we aimed to perform a global assessment of donor?s hemostatic function undergoing plateletpheresis by rotation thromboelastometry (ROTEM) analysis and to clarify if plateletpheresis procedure induces a hypercoagulable state. Thirty male plateletpheresis donors were included in the study. Four blood samples were drawn at different time intervals: before the beginning of the apheresis procedure; immediately after the completion of the apheresis procedure; 24?h and 7?days after the apheresis procedure. ?Hypercoagulability? was diagnosed readily by having an accelerated clot formation, as evidenced by shortening of CFT and an increase of the clot strength, as evidenced by increasing of MCF. In INTEM assay, CFT value after apheresis was significantly prolonged compared with baseline value while CFT value 7?days after apheresis was significantly shortened compared with values immediately and 24?h after apheresis (p?<?0.001). However, CFT-INTEM still did not show any shortening in any of the measurements when compared to pre-apheresis value. MCF value after apheresis was significantly shortened compared with baseline value while MCF value 7?days after apheresis was significantly prolonged compared with values immediately and 24?h after apheresis (p?<?0.001). However, MCF-INTEM still did not show any increase in any of the measurements when compared to pre-apheresis value. There was no significant difference in CT value between four measurements (p?=?0.064). In EXTEM assay, CFT value after apheresis was significantly prolonged compared with baseline value while CFT value 7?days after apheresis was significantly shortened compared with values immediately and 24?h after apheresis (p?<?0.001). However, CFT-EXTEM still did not show any shortening in any of the measurements when compared to pre-apheresis value. MCF values immediately and 24?h after apheresis were significantly shortened compared with baseline value while MCF value 7?days after apheresis was significantly prolonged compared with values immediately and 24?h after apheresis (p?<?0.001). However, MCF-EXTEM still did not show any increase in any of the measurements when compared to pre-apheresis value. We found no differences in CT value between four measurements (p?=?0.208). Since ROTEM tracings on both INTEM and EXTEM assays did not reveal any significant shortening of CFT and increasing of MCF in any of the measurements after apheresis procedure, we concluded that plateletpheresis does not induce a hypercoagulable state in healthy donors.