Transfusion · 2025
Safety and efficacy of combined heparin/citrate anticoagulation for cell therapy collections in healthy adult allogeneic donors.
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Zhang Jiahao, Wu Minlin, Racine-Brzostek Sabrina, Shayo Sarah, Yazdanbakhsh Karina, Dormesy Stephanie, Shi Patricia A
Аннотация
BACKGROUND: Reports on the safety and efficacy of combination heparin and citrate anticoagulation with cell therapy collections in adults are limited. There are no reports on the use of this combination in healthy allogeneic adult donors undergoing cell therapy collection. This retrospective analysis is the first study to examine its safety and efficacy in cell therapy collections of healthy adult allogeneic donors.
STUDY DESIGN AND METHODS: The heparin infusion rate and adverse event profile for 90 cell therapy collections using 6 units heparin per mL of citrate anticoagulation were examined. In 12 consecutive large volume collections, activated partial thromboplastin time (aPTT), anti-Xa levels, and target cell collection efficiencies were also analyzed.
RESULTS: Heparin infusion rates approximated the rate recommended for acute venous thrombosis. There were no adverse events related to heparin. There was a good correlation between aPTT and anti-Xa levels, but no patient had supratherapeutic and only 3 had therapeutic anti-Xa levels. An inverse correlation was found between the anti-Xa level and platelet loss. Collection efficiencies of mononuclear cell types were increased compared to citrate-only collections.
CONCLUSION: Heparin/citrate anticoagulation was safe, with lower heparin infusion rates, anti-Xa levels, and less prolonged aPTT than those observed in autologous adult donors. The good correlation between aPTT and anti-Xa levels suggests that aPTT levels can be used to estimate anti-Xa levels. Collection efficiencies of mononuclear cell types on heparin/ACD-A anticoagulation should be further explored.
STUDY DESIGN AND METHODS: The heparin infusion rate and adverse event profile for 90 cell therapy collections using 6 units heparin per mL of citrate anticoagulation were examined. In 12 consecutive large volume collections, activated partial thromboplastin time (aPTT), anti-Xa levels, and target cell collection efficiencies were also analyzed.
RESULTS: Heparin infusion rates approximated the rate recommended for acute venous thrombosis. There were no adverse events related to heparin. There was a good correlation between aPTT and anti-Xa levels, but no patient had supratherapeutic and only 3 had therapeutic anti-Xa levels. An inverse correlation was found between the anti-Xa level and platelet loss. Collection efficiencies of mononuclear cell types were increased compared to citrate-only collections.
CONCLUSION: Heparin/citrate anticoagulation was safe, with lower heparin infusion rates, anti-Xa levels, and less prolonged aPTT than those observed in autologous adult donors. The good correlation between aPTT and anti-Xa levels suggests that aPTT levels can be used to estimate anti-Xa levels. Collection efficiencies of mononuclear cell types on heparin/ACD-A anticoagulation should be further explored.