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Results with new software for plateletpheresis systems
Pergamon
09553886(94)EOO26-F
Transfus. Sci. Vo1.15, No.3, pp.,313J17, 1994 Copyri$t @ 1894 Elaevlcr Science Ltd printed in reat Bntam. All nghts reserved 09X3886/94 $7.00 + 0.00
Short Communication Results with New Software for Plateletpheresis Systems Rainer Moog, MD Norbert Miiller, MD
While 2.8 f 0.7 x 10” thrombocytes were collected in 265 + 16 mL plasma with protocol V. The leucocyte contamination of these procedures was 7.0 f 7.0 x lo6 [protocol IV) and 2.0 + 1.8 X 10’ (protocol V). n
w New software for the cell separators A 201 and CS 3000 Plus have been developed by Baxter. Fresenius recently offered a single needle option for the AS 104 device. The results of separation are described with respect to total platelet yield, efficiency and cell contamination of the platelet concentrate (PC). Two software programs were evaluated in both the A 201 (version 5.12 and 5.13) and AS 104 cell separators (version 4560 with different separation parameters according to protocol IV and V). With software version 5.12, the A 201 collected 2.0 f 0.9 x 10” platelets in 200 mL plasma whereas 2.3 + 0.7 x 10” platelets could be harvested with version 5.13. The separation efficiencies were 32.1 rf: 11.6 and 34.7 + 10.7%, respectively. The leucocyte contamination was 5.6 f 4.6 x 10’ with software version 5.12 and 4.9 + 7.6 x 10s with the 5.13 version. With the CS 3000 Plus cell separator, 2.9 + 0.8 X 10” platelets (efficiency 38.4 + 8.2%) could be harvested in 208 + 2 mL plasma. The white blood cell contamination was extremely low (1.4 f 3.2 x 106). There was a high separation efficacy with the Fresenius single needle procedure of 59.1 + 10.6% (protocol IV) and 58.7 + 7.3% (protocol V), respectively. The total number of platelets sampled in 338 + 21 mL plasma was 3.1 rt 0.8 X 10” in protocol IV.
INTRODUCTION The last few years have seen the introduction of a new generation of cell separators. The A 201 apparatus is a simple retrofit of the Autopheresis-C plasmapheresis system developed for the European market. l3 The Fresenius AS 104 device is a cell separator of the third generation with highly sophisticated safety features.4-6 A single needle option for this blood cell separator has recently been offered. The advantages of this technique are a low anticoagulant/blood ratio and only single vein access. The well established CS 3000 plateletpheresis system, which uses a continuous flow procedure, was changed into the CS 3000 Plus. The aim of this modification was to improve the platelet yield and to reduce the level of leucocyte contamination. Important criteria for assessing a plateletpheresis system are the separation efficiency and purity of the prodUCt.7,s This report compares the parameters of total thrombocyte yield, separation efficacy, white blood cell (WBC)- and red blood cell (RBC)- contamination, time for apheresis and
Institute for Transfusion Medicine, University Clinics Bssm, Hufelandstxa~e55, 4300 Essen, Germany. Received 5193; Accepted 1194. 313
314
Tim~sfus. Sci.
Vol. 15, No. 3
approx. 40 mL/min. A part of the reinfused blood was re-processed during the return cycle. Two programs were studied: one with a cell pump speed of 3.2 mL/min (protocol IV) and one with a cell pump speed of 2.8 mL/min (protocol V.
ACD-consumption seen using new software for three different plateletpheresis systems. MATERIALS AND METHODS Donors All plateletpheresis donors complied with the German guidelines and recommendations for cytapheresis.9J0 All gave written consent prior to apheresis. Predonation platelet counts were greater than 2OO,OOO/~L. Plateletpheresis
Systems
The A 201 apparatus has been described in detail elsewhere.13 A new topbottom port bag was developed as the platelet rich plasma container in order to use the new software. The separation parameters used are shown in Table 1. In comparison with the former software (3.13), the plasma flow was increased to approx. 16 mL/min (software 5.12, protocol I]. Further software (5.13, protocol II) was provided by Baxter (Baxter Deerfield, IL, U.S.A.] to standardize the total platelet yield. The reinfusion rate was 50-150 mL/min. Alteration of the CS 3000 Plus blood cell separator consisted of a new program (protocol III) and a modified TNX granulocyte chamber. A press including an additional blood reservoir for the reinfused blood and a Y-adaptor were necessary for the single needle option in the AS 104 (Fresenius, Bad Homburg, Germany). The chosen interface position was 7 : 1. The blood was reinfused at a rate of
Table 1.
Counting Methods Platelets (PLT) were counted electronically (Coulter Counter T 660, Coulter Electronics, Krefeld). Before counting, the PCs were allowed to rest at least 30 min before sampling to achieve disaggregation of the thrombocytes. The samples were thoroughly mixed for at least 10 min prior to counting. Afterwards the PC samples were diluted 1 : 2 for analysis. Contamination values were determined by the Neubauer chamber method.* The separation efficiency was calculated as follows: Total thrombocyte yield x 100 Mean of pre- and post-donation platelet count x processed blood volume Statistics Statistical analysis was determined with the Student’s t-test. When multiple comparisons were performed, P values were corrected with the Bonferroni adjustment. We considered differences significant when P values were < 0.05. The results for each device were expressed as the mean + 1 SD.
Separation Parameters used with Different Plateletpheresis Systems
Protocol No.: Device:
Blood Wholeflow blood rate volume [mL)
(rnL/min)
ACD blood ratio Centrifuge speed (rpm)
I A 201
II A 201
III cs 3000 Plus
IV AS 104
60-100 2777 f516 1 : 12 16003600
60-100 2574 f501 1 : 12 16003600
3500 50 +0 1:9 1600
2455 60 +93 1 : 10 1900
AS:04 25: f0 1 : 10 2000
New!hftwareforPhtdctphardsSy~taur 315
RESULTS It was possible to collect 200 mL PC and approx. 400 mL of plasma from one donor with the A 201 cell separator. The platelet yield in the PCs was very poor and statistically different from the PCs from the CS 3000 Plus and the AS 104 (Table 2). The CS 3000 Plus device resulted in the least leucocyte contamination. A total of 71% of the PCs were below the lower microscopic detection limit. Only once did the leucocyte contamination exceed 10’. The single needle version of the AS 104 produced the best separation efficiency. This result was statistically different from those of the A 201 and the cs 3000 Plus. DISCUSSION The total number of platelets in concentrates from the A 201 cell separator was poor using both protocols. More thrombocytes were harvested with the older software of the A 201 device.‘+l Furthermore, there was no improvement in the purity of the PCs compared with the
results achieved before. The number of contaminating white blood cells was still above the upper limit recommended by the German Section for Hemapheresis. I2 Therefore, the software parameters for this device should be changed to improve the separation results. The only benefits seen with the software studied were the low consumption of anticoagulant and, compared with the former software, a reduction in the donation time by increasing the plasma flow.13 The purity of the PCs was best in the case of the CS 3000 Plus blood cell separator. Similar results were obtained by other authors using this continuous flow procedure. 13,14However, the extraction efficiency was slightly lower than obtained with the CS 3000 in our center.15 The CS 3000 Plus device has one disadvantage: the ACD-flow is not controlled by the computer so that it still needs to be supervised by the operator. The single needle version of the AS 104 gave the best separation efficiency, there were three reasons for this: firstly, a part of the reinfused blood was re-processed during the return cycle in
Table 2. Results of Plateletphereses with Different Blood Cell Separators Protocol No.:
PLT pre-count x lo”/pL PLT post-count x 103/pL PLT PC count x lo”/pL PC weight (g) PLT yield x 10” Separation efficacy % WBC-contamination X lo6 RBC-contamination x lo6 ACD-consumption (mL) Separation time (min) n
I 262 +54 210 +46 1023 f334 200 fl 2.0 f0.7 32.1 k11.6 558.1 k456.9 571.7 k453.4 249 f46 67 +13 21
II 291 f40 229 *34 1133 f367 200 f0 2.3 f0.7 34.7 k10.7 492,8 k758.9 748.6 f1155.4 232 +47 63 +12 12
III
Iv
v
278 +46 193 +42 1396 +359 208 +2 2.9 kO.8 38.4 f8.2 1.4 f3.3 13.3 f27.8 364 f41 75 +2 31
274 +57 202 f40 926 +251 338 +21 3.1 kO.8 59.1 k10.6 7.0 f7.0 26.9 k39.1 355 +24 85 +9 26
242 +42 175 f24 1053 +270 265 +16 2.8 kO.7 58.7 f7.3 20.2 k18.0 50.6 hl3.4 334 +12 75 +5 23
316
Transfus. Sri
Vol. 15,No. 3
order that thrombocytes could be harvested. Secondly, the blood volume processed
was
lower
using
the
AS 104
device and thirdly, there was a large volume of PC using protocol IV. This volume was decreased to 265 + 16 mL according to the German recomrnendations for cytapheresis in protocol V.9,10 The data of Valbonesi et al. on the single needle procedure with the AS 104 were comparable to our findings.16 White blood cell contamination could be lowered further to the level obtained with the dual arm technique used in our center.” The single needle option may give mild side effects due to the anticoagulant (acral and perioral paraesthesia) as reported by the donors during the reinfusion cycle with the AS 104. Overall, these data show that any one of the software studied results in both advantages and disadvantages. All the software could be improved to give better separation results or lead to more donor safety.
Acknowledgements The authors wish to thank MIS Karin Weber for counting the contaminating cells and the sta# of the Hemapheresis Unit for their excellent assistance.
REFERENCES 1.
Schoendorfer DW, Williamson LH, Sheckler VL, Fitzgerald BP: Platelet collection with the Autopheresis-CR apheresis system. Vox Sang 1990; 58:100-105. W, Moog R: Thrombozy2. Luboldt tapherese mit dem neuen Zellseparator A 201 (Baxter), in Kretschmer V, Stangel W, Weiphaar D (eds): Beitriige zur Znfisionstherapie, vol. 28. Basel, Karger, 1991, pp. 195-200. 3. Moog R, Luboldt W, Kriitzfeldt A, Paar D, Holtmann M, Mengelkamp AK: Thrombozytapherese mit dem Zellseparator A 201 (Baxter)-erste Daten zur Znfusionstherapie Biokompatiblitat. 1991; 18:244-247. 4. Neumann HJ, Brause W, Mathieu B: Verbessertes Sicherheitskonzept fur einen neuen Zellseparator AS 104 (Fresenius), in Kretschmer V, Stangel W (eds): Beitrdge zur Znfusionstherapie, vol. 18. Basel, Karger, 1987, pp. 238-240.
5. Kretschmer
V, See A, Sohngen D, Bachem M, Kadar JG, Borberg H, Pelzer H, Ziifel P: First results with the new Fresenius cell separator AS 104. Plasma
Ther Transjirs Technol1987; 8:298-301. 6. Valbonesi M, Frisoni R, Fella M, Capra
C, Malfanti L, Ferrari M, Zia S, Florio G, Nickel H: Plateletpheresis with the new Fresenius AS 104 blood cell separator. I
Clin Apheresis 1991; 6:84-87. 7. Borberg H, Kretschmer V, Godehardt E,
Sojka G: Evaluierung eines neuen, vollautomatischen Blutzellseparators mit kontinuierlichem BlutdurcMup, in Kretschmer V, Stangel W, Weighaar D (eds): Beitrage zur Znfusionstherapie, vol. 28. Basel, Karger, 1991, pp. 177-187. 8. Kretschmer V: Comparison of different plateletpheresis systems. Znfusionsther-
apie 1991; 18:188-195. 9. Kretschmer V, Borberg H, Giannitsis D,
Kamanabroo D, Mempel W, Miiller V, Miiller N, Neumeyer H: Durchfi&rung apparativer Hamapheresen zur Gewinnung von Blutbestandteilkonserven. Empfehlungen der Hamapheresekommission der Deutschen Gesellschaft fur Transfusionsmedizin und Irnmunhamatologie. Znfusionstherapie 1987; 14 (suppl. 14):57-64. 10. Richtlinien zur Blutgruppenbestimmung und Bluttransfusion. Bundesarztekammer. Bundesgesundheitsamt. Koln, Deutscher Iirzte-Verlag, 199 1. 11 Schooneman F, Briquel ME, Streiff F, Schoendorfer DW, Reppucci A: Preliminary results of a new plateletpheresis prototype based on Autopheresis C. Apheresis 1990; 337:15-18.
12. Erganzungen zu den Empfehlungen der stanindigen Haraapherese-Kommission zur apparativen Zytapherese bei BlutZnfusionstherapie spendern. 1990; 17:284.
13. Kretschmer V, Pinnschmidt U, Keller P: First results of plateletpheresis with CS3000 plus. Znfusionstherapie, 1991: 18 (suppl. 2):55-56. 14. Schoonernan F, Briquel ME, Streiff F: Platelet concentrate evaluation with the new procedure of CS 3000 (CS 3000 plus). Znfusionstherapie 1991; 18 (suppl. 2]:55. 15. Moog R, Holtmann G, Holtmann M, Luboldt W: Vergleich dreier Zellseparatoren, in Kretschmer V, Stangel W, Sachs V (eds): Beitriige zur ZnfusionsF3mZG2 vol. 26. Basel, Karger, 1990. pp. 16. Valbonesi M, Frisoni R, Capra C, Mal-
New softwue for PlateleQll~
fanti L, Zia S, Lercari G, Florio G, Ferrari M, Fella M: Single-Needle procedure with the Fresenius AS 104. Infusionstherapie, 19913 18 (~uppl.2):53.
sy8tema
317
17. Moog R: Die Bedeutung der Trexmgrenzenposition bei der Thrombozytapherese AS 104. dem Zellseparator IZjtsionstherapie, 1992; 19X51-63.
09553886(94)EOO26-F
Transfus. Sci. Vo1.15, No.3, pp.,313J17, 1994 Copyri$t @ 1894 Elaevlcr Science Ltd printed in reat Bntam. All nghts reserved 09X3886/94 $7.00 + 0.00
Short Communication Results with New Software for Plateletpheresis Systems Rainer Moog, MD Norbert Miiller, MD
While 2.8 f 0.7 x 10” thrombocytes were collected in 265 + 16 mL plasma with protocol V. The leucocyte contamination of these procedures was 7.0 f 7.0 x lo6 [protocol IV) and 2.0 + 1.8 X 10’ (protocol V). n
w New software for the cell separators A 201 and CS 3000 Plus have been developed by Baxter. Fresenius recently offered a single needle option for the AS 104 device. The results of separation are described with respect to total platelet yield, efficiency and cell contamination of the platelet concentrate (PC). Two software programs were evaluated in both the A 201 (version 5.12 and 5.13) and AS 104 cell separators (version 4560 with different separation parameters according to protocol IV and V). With software version 5.12, the A 201 collected 2.0 f 0.9 x 10” platelets in 200 mL plasma whereas 2.3 + 0.7 x 10” platelets could be harvested with version 5.13. The separation efficiencies were 32.1 rf: 11.6 and 34.7 + 10.7%, respectively. The leucocyte contamination was 5.6 f 4.6 x 10’ with software version 5.12 and 4.9 + 7.6 x 10s with the 5.13 version. With the CS 3000 Plus cell separator, 2.9 + 0.8 X 10” platelets (efficiency 38.4 + 8.2%) could be harvested in 208 + 2 mL plasma. The white blood cell contamination was extremely low (1.4 f 3.2 x 106). There was a high separation efficacy with the Fresenius single needle procedure of 59.1 + 10.6% (protocol IV) and 58.7 + 7.3% (protocol V), respectively. The total number of platelets sampled in 338 + 21 mL plasma was 3.1 rt 0.8 X 10” in protocol IV.
INTRODUCTION The last few years have seen the introduction of a new generation of cell separators. The A 201 apparatus is a simple retrofit of the Autopheresis-C plasmapheresis system developed for the European market. l3 The Fresenius AS 104 device is a cell separator of the third generation with highly sophisticated safety features.4-6 A single needle option for this blood cell separator has recently been offered. The advantages of this technique are a low anticoagulant/blood ratio and only single vein access. The well established CS 3000 plateletpheresis system, which uses a continuous flow procedure, was changed into the CS 3000 Plus. The aim of this modification was to improve the platelet yield and to reduce the level of leucocyte contamination. Important criteria for assessing a plateletpheresis system are the separation efficiency and purity of the prodUCt.7,s This report compares the parameters of total thrombocyte yield, separation efficacy, white blood cell (WBC)- and red blood cell (RBC)- contamination, time for apheresis and
Institute for Transfusion Medicine, University Clinics Bssm, Hufelandstxa~e55, 4300 Essen, Germany. Received 5193; Accepted 1194. 313
314
Tim~sfus. Sci.
Vol. 15, No. 3
approx. 40 mL/min. A part of the reinfused blood was re-processed during the return cycle. Two programs were studied: one with a cell pump speed of 3.2 mL/min (protocol IV) and one with a cell pump speed of 2.8 mL/min (protocol V.
ACD-consumption seen using new software for three different plateletpheresis systems. MATERIALS AND METHODS Donors All plateletpheresis donors complied with the German guidelines and recommendations for cytapheresis.9J0 All gave written consent prior to apheresis. Predonation platelet counts were greater than 2OO,OOO/~L. Plateletpheresis
Systems
The A 201 apparatus has been described in detail elsewhere.13 A new topbottom port bag was developed as the platelet rich plasma container in order to use the new software. The separation parameters used are shown in Table 1. In comparison with the former software (3.13), the plasma flow was increased to approx. 16 mL/min (software 5.12, protocol I]. Further software (5.13, protocol II) was provided by Baxter (Baxter Deerfield, IL, U.S.A.] to standardize the total platelet yield. The reinfusion rate was 50-150 mL/min. Alteration of the CS 3000 Plus blood cell separator consisted of a new program (protocol III) and a modified TNX granulocyte chamber. A press including an additional blood reservoir for the reinfused blood and a Y-adaptor were necessary for the single needle option in the AS 104 (Fresenius, Bad Homburg, Germany). The chosen interface position was 7 : 1. The blood was reinfused at a rate of
Table 1.
Counting Methods Platelets (PLT) were counted electronically (Coulter Counter T 660, Coulter Electronics, Krefeld). Before counting, the PCs were allowed to rest at least 30 min before sampling to achieve disaggregation of the thrombocytes. The samples were thoroughly mixed for at least 10 min prior to counting. Afterwards the PC samples were diluted 1 : 2 for analysis. Contamination values were determined by the Neubauer chamber method.* The separation efficiency was calculated as follows: Total thrombocyte yield x 100 Mean of pre- and post-donation platelet count x processed blood volume Statistics Statistical analysis was determined with the Student’s t-test. When multiple comparisons were performed, P values were corrected with the Bonferroni adjustment. We considered differences significant when P values were < 0.05. The results for each device were expressed as the mean + 1 SD.
Separation Parameters used with Different Plateletpheresis Systems
Protocol No.: Device:
Blood Wholeflow blood rate volume [mL)
(rnL/min)
ACD blood ratio Centrifuge speed (rpm)
I A 201
II A 201
III cs 3000 Plus
IV AS 104
60-100 2777 f516 1 : 12 16003600
60-100 2574 f501 1 : 12 16003600
3500 50 +0 1:9 1600
2455 60 +93 1 : 10 1900
AS:04 25: f0 1 : 10 2000
New!hftwareforPhtdctphardsSy~taur 315
RESULTS It was possible to collect 200 mL PC and approx. 400 mL of plasma from one donor with the A 201 cell separator. The platelet yield in the PCs was very poor and statistically different from the PCs from the CS 3000 Plus and the AS 104 (Table 2). The CS 3000 Plus device resulted in the least leucocyte contamination. A total of 71% of the PCs were below the lower microscopic detection limit. Only once did the leucocyte contamination exceed 10’. The single needle version of the AS 104 produced the best separation efficiency. This result was statistically different from those of the A 201 and the cs 3000 Plus. DISCUSSION The total number of platelets in concentrates from the A 201 cell separator was poor using both protocols. More thrombocytes were harvested with the older software of the A 201 device.‘+l Furthermore, there was no improvement in the purity of the PCs compared with the
results achieved before. The number of contaminating white blood cells was still above the upper limit recommended by the German Section for Hemapheresis. I2 Therefore, the software parameters for this device should be changed to improve the separation results. The only benefits seen with the software studied were the low consumption of anticoagulant and, compared with the former software, a reduction in the donation time by increasing the plasma flow.13 The purity of the PCs was best in the case of the CS 3000 Plus blood cell separator. Similar results were obtained by other authors using this continuous flow procedure. 13,14However, the extraction efficiency was slightly lower than obtained with the CS 3000 in our center.15 The CS 3000 Plus device has one disadvantage: the ACD-flow is not controlled by the computer so that it still needs to be supervised by the operator. The single needle version of the AS 104 gave the best separation efficiency, there were three reasons for this: firstly, a part of the reinfused blood was re-processed during the return cycle in
Table 2. Results of Plateletphereses with Different Blood Cell Separators Protocol No.:
PLT pre-count x lo”/pL PLT post-count x 103/pL PLT PC count x lo”/pL PC weight (g) PLT yield x 10” Separation efficacy % WBC-contamination X lo6 RBC-contamination x lo6 ACD-consumption (mL) Separation time (min) n
I 262 +54 210 +46 1023 f334 200 fl 2.0 f0.7 32.1 k11.6 558.1 k456.9 571.7 k453.4 249 f46 67 +13 21
II 291 f40 229 *34 1133 f367 200 f0 2.3 f0.7 34.7 k10.7 492,8 k758.9 748.6 f1155.4 232 +47 63 +12 12
III
Iv
v
278 +46 193 +42 1396 +359 208 +2 2.9 kO.8 38.4 f8.2 1.4 f3.3 13.3 f27.8 364 f41 75 +2 31
274 +57 202 f40 926 +251 338 +21 3.1 kO.8 59.1 k10.6 7.0 f7.0 26.9 k39.1 355 +24 85 +9 26
242 +42 175 f24 1053 +270 265 +16 2.8 kO.7 58.7 f7.3 20.2 k18.0 50.6 hl3.4 334 +12 75 +5 23
316
Transfus. Sri
Vol. 15,No. 3
order that thrombocytes could be harvested. Secondly, the blood volume processed
was
lower
using
the
AS 104
device and thirdly, there was a large volume of PC using protocol IV. This volume was decreased to 265 + 16 mL according to the German recomrnendations for cytapheresis in protocol V.9,10 The data of Valbonesi et al. on the single needle procedure with the AS 104 were comparable to our findings.16 White blood cell contamination could be lowered further to the level obtained with the dual arm technique used in our center.” The single needle option may give mild side effects due to the anticoagulant (acral and perioral paraesthesia) as reported by the donors during the reinfusion cycle with the AS 104. Overall, these data show that any one of the software studied results in both advantages and disadvantages. All the software could be improved to give better separation results or lead to more donor safety.
Acknowledgements The authors wish to thank MIS Karin Weber for counting the contaminating cells and the sta# of the Hemapheresis Unit for their excellent assistance.
REFERENCES 1.
Schoendorfer DW, Williamson LH, Sheckler VL, Fitzgerald BP: Platelet collection with the Autopheresis-CR apheresis system. Vox Sang 1990; 58:100-105. W, Moog R: Thrombozy2. Luboldt tapherese mit dem neuen Zellseparator A 201 (Baxter), in Kretschmer V, Stangel W, Weiphaar D (eds): Beitriige zur Znfisionstherapie, vol. 28. Basel, Karger, 1991, pp. 195-200. 3. Moog R, Luboldt W, Kriitzfeldt A, Paar D, Holtmann M, Mengelkamp AK: Thrombozytapherese mit dem Zellseparator A 201 (Baxter)-erste Daten zur Znfusionstherapie Biokompatiblitat. 1991; 18:244-247. 4. Neumann HJ, Brause W, Mathieu B: Verbessertes Sicherheitskonzept fur einen neuen Zellseparator AS 104 (Fresenius), in Kretschmer V, Stangel W (eds): Beitrdge zur Znfusionstherapie, vol. 18. Basel, Karger, 1987, pp. 238-240.
5. Kretschmer
V, See A, Sohngen D, Bachem M, Kadar JG, Borberg H, Pelzer H, Ziifel P: First results with the new Fresenius cell separator AS 104. Plasma
Ther Transjirs Technol1987; 8:298-301. 6. Valbonesi M, Frisoni R, Fella M, Capra
C, Malfanti L, Ferrari M, Zia S, Florio G, Nickel H: Plateletpheresis with the new Fresenius AS 104 blood cell separator. I
Clin Apheresis 1991; 6:84-87. 7. Borberg H, Kretschmer V, Godehardt E,
Sojka G: Evaluierung eines neuen, vollautomatischen Blutzellseparators mit kontinuierlichem BlutdurcMup, in Kretschmer V, Stangel W, Weighaar D (eds): Beitrage zur Znfusionstherapie, vol. 28. Basel, Karger, 1991, pp. 177-187. 8. Kretschmer V: Comparison of different plateletpheresis systems. Znfusionsther-
apie 1991; 18:188-195. 9. Kretschmer V, Borberg H, Giannitsis D,
Kamanabroo D, Mempel W, Miiller V, Miiller N, Neumeyer H: Durchfi&rung apparativer Hamapheresen zur Gewinnung von Blutbestandteilkonserven. Empfehlungen der Hamapheresekommission der Deutschen Gesellschaft fur Transfusionsmedizin und Irnmunhamatologie. Znfusionstherapie 1987; 14 (suppl. 14):57-64. 10. Richtlinien zur Blutgruppenbestimmung und Bluttransfusion. Bundesarztekammer. Bundesgesundheitsamt. Koln, Deutscher Iirzte-Verlag, 199 1. 11 Schooneman F, Briquel ME, Streiff F, Schoendorfer DW, Reppucci A: Preliminary results of a new plateletpheresis prototype based on Autopheresis C. Apheresis 1990; 337:15-18.
12. Erganzungen zu den Empfehlungen der stanindigen Haraapherese-Kommission zur apparativen Zytapherese bei BlutZnfusionstherapie spendern. 1990; 17:284.
13. Kretschmer V, Pinnschmidt U, Keller P: First results of plateletpheresis with CS3000 plus. Znfusionstherapie, 1991: 18 (suppl. 2):55-56. 14. Schoonernan F, Briquel ME, Streiff F: Platelet concentrate evaluation with the new procedure of CS 3000 (CS 3000 plus). Znfusionstherapie 1991; 18 (suppl. 2]:55. 15. Moog R, Holtmann G, Holtmann M, Luboldt W: Vergleich dreier Zellseparatoren, in Kretschmer V, Stangel W, Sachs V (eds): Beitriige zur ZnfusionsF3mZG2 vol. 26. Basel, Karger, 1990. pp. 16. Valbonesi M, Frisoni R, Capra C, Mal-
New softwue for PlateleQll~
fanti L, Zia S, Lercari G, Florio G, Ferrari M, Fella M: Single-Needle procedure with the Fresenius AS 104. Infusionstherapie, 19913 18 (~uppl.2):53.
sy8tema
317
17. Moog R: Die Bedeutung der Trexmgrenzenposition bei der Thrombozytapherese AS 104. dem Zellseparator IZjtsionstherapie, 1992; 19X51-63.