To the Editor:
We read with interest the article by Chaudhary et al.
[1] evaluating the need for quality systems and standard operating procedures (SOP) in automated plateletpheresis for a developing country like India. We would like to suggest certain modifications in the flowchart proposed by the authors with the aim to obtain a high-quality component with maximum platelet yield and simultaneously ensuring donor safety.
According to AABB standards [2], 90% of SDP must contain platelets 3 3 10 11 /unit while the Council of Europe [3] recommends 2 3 10 11 /unit. The authors suggest that the European guidelines may be more suitable for India as only 41.2% of their SDP obtained on Baxter CS 3000plus met AABB standards whereas 96% met European guidelines. We do not agree with the authors that the minimum quality requirements of apheresis platelets be reduced. Out of 350 procedures performed at our centre on Baxter CS 3000plus, we found a yield from 3.04-8.8 3 10 11 /unit (3 3 10 11 /unit) in 318 units (90.85%) with the donor pre-procedure platelet count varying between 1.8-4.7 3 10 9 /L. Our observation from northern India is similar to another study from western India [4]. Moreover, in 9.15% of procedures where the yield was <3 3 10 11 /unit, the donor platelet count was 1.5-1.8 3 10 9 /L and in 100% the yield was >2.5 3 10 11 /unit. The authors have not correlated a low platelet yield with the pre-apheresis donor platelet count as the platelet yield is dependent upon the pre-procedure platelet count of the donor, blood volume processed, and efficiency of platelet removal by the cell separator [4]. A statistically higher blood volume was processed using Baxter CS 3000plus as compared to Haemonetics MCS 3p. The reasons for this difference on platelet yield were not discussed by the authors. We found a residual WBC level of <5 3 10 5 /unit in 128 units (85.3%) out of 150 units tested using Neubauer's haemocytometer.
For an efficient quality management system, the authors have suggested an SOP, an operational flow chart for plateletpheresis and recommend it to be easily followed by other centers in India. We do agree with the authors that as compared to repeat regular plateletpheresis donors in developed countries, due to economic con-