Background Plateletpheresis is increasingly central to modern transfusion practice, with rising demand for high-yield single-donor apheresis platelets. Optimizing platelet yield while preserving donor safety is critical, particularly as services adopt higher target-yield strategies. This study evaluated donor-level determinants of platelet yield and adverse donor reactions and compared donor safety across different target-yield categories in routine practice. Methodology In this prospective, observational study, 670 plateletpheresis procedures performed at a tertiary cancer center between January and June 2025 were analyzed. Platelet yield (×10¹¹ platelets) and occurrence of any donor adverse reaction (yes/no) were defined as the primary outcome variables. Donor age, body mass index (BMI), hemoglobin concentration, hematocrit, and pre-donation platelet count were evaluated as predictor variables. Associations between donor characteristics and platelet yield were assessed using Pearson correlation and multivariable linear regression. Associations between donor characteristics and adverse reactions were analyzed using multivariable logistic regression. Adverse reaction rates were compared across predefined target-yield categories (3.0, 4.5, and 6.0 × 10¹¹ platelets) using the chi-square test. Results The mean platelet yield was 4.4 ± 1.4 × 10¹¹ platelets. Pre-donation platelet count showed the strongest correlation with yield (r = 0.758, p < 0.001) and emerged as the dominant independent predictor in multivariable analysis (standardized β = 0.657). BMI also independently predicted yield (β = 0.265), while hematocrit demonstrated a modest but statistically significant inverse association. Adverse donor reactions occurred in 10.1% of procedures, predominantly mild. Higher BMI was independently associated with a lower risk of adverse reactions (odds ratio = 0.93 per kg/m²; 95% confidence interval = 0.87-0.99). No significant difference in adverse reaction rates was observed across target-yield categories (p = 0.785). Conclusions Pre-donation platelet count was the strongest determinant of plateletpheresis yield. BMI contributed modestly to higher yields and was associated with a lower likelihood of donor adverse reactions, while hematocrit showed a small inverse association with yield. Donor reactions were infrequent and predominantly mild. Higher target-yield plateletpheresis was not associated with an increased risk of adverse reactions within the applied donor selection framework. These findings suggest that higher-yield plateletpheresis can be implemented in appropriately selected donors without an observed compromise in donor safety.
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