Genetic variations of CD36 and low platelet CD36 expression - a risk factor for lipemic plasma donation in Taiwanese apheresis donors

Background New CD36 mutations are constantly being identified, although no study has specifically targeted a Taiwanese population. CD36 deficiency can result in dyslipid state and slow clearance of chylomicron. This could be linked to more frequent lipemic donations. Study Design and Methods We used flow cytometric methods to study the CD36 deficiency in 640 regular volunteer platelet apheresis donors from Taipei blood centre. The coding exons of CD36 gene were sequenced in CD36‐deficient individuals, and the allele frequencies of CD36 variants were determined in the larger population by mutation‐specific PCR and oligonucleotide hybridization. Visual inspection of lipemic plasma was routinely performed on samples taken before commencement of apheresis. Individuals found to have lipemic plasma are deferred until next donation. We investigated the link between positive lipemic deferral record and low platelet CD36 expression status. Results We found four donors (0·6%) with type I CD36 deficiency (both platelets and monocytes CD36null) and six (1·0%) with type II CD36 deficiency (PLT: CD36null, monocyte: CD36low). Six CD36 genetic variants were identified, two of them were novel, all but one are found exclusively in CD36null and CD36low expressors. Subjects with CD36 genetic variants also displayed deficient or reduced CD36 on monocytes. Donors with null or low PLT CD36 expression were more likely to have a lipemic deferral record than control subjects with normal PLT CD36 expression (X2 = 27·36, odds ratio = 2·6, 95% conference interval: 1·8–3·8, P < 0·0001). Conclusion Through this study, we established a donor registry to supply CD36‐negative platelets for patients in need.