Post blood donation seroma formation?

The Medical Director of a blood bank in Pennsylvania wonders if anyone ever had a blood donor return following an apheresis collection with clear fluid coming from the venipuncture site? The inquiring colleague reports that one of their long standing donors began oozing a clear fluid almost 2 hours following an automated apheresis product collection. The "drainage" persisted for 72 hours post donation. The site was never red, painful or swollen. There was never any red cells or hint of red discoloration. The donor soaked several 4x4s in a day, and in the last 48-72 hours soaked a pad of 4x4s and an ace bandage he had applied. The inquiring physician examined the donor when the discharge had stopped. The site had a thick serum crust, leading the physician to believe the fluid was proteinaceous. The donor acknowledged that this situation had happened once before, but only lasted an hour or so. The inquiring physician wonders if the donor developed a seroma, possibly the result of multiple previous donations. Has anyone else seen such a complication, and if so, what was the cause?

The following comments have been received.

ADDENDA Jan. 12, 2010

1. A physician with years of experience in studying (and publishing data about) blood donor reactions comments as follows: "I read the case. I have never seen one. I have no idea on what the etiology is".

ADDENDA June 9, 2010

2. The Donor Room Services Director at a Community Blood Center in Kansas reports having observed this kind of problem (but only rarely) in a plasma donor with keloid scaring at the phlebotomy site who was donating twice weekly for consecutive years. The draining of the fluid took anywhere from a few hours to a couple of days post-donation. The donor was instructed to use a pressure bandage and observe for a change to purulent drainage, redness, warmth to touch, etc... It did not develop into further complications.
   
   
3. A physician familiar with the Red Cross national donor complication program writes that no similar cases were reported over a couple of years in the Red Cross national donor complication program. That's alot of apheresis procedures with nothing comparable! Here's a mechanism to consider, though. Previous infiltration in the return arm (was this the return arm?) could have left a tissue cleft that would reopen and fill with serum like a giant blister sack with a little bit of subsequent infiltration or trauma. It would be important to confirm that this wasn't just leakage of a large volume infiltration that, for some reason, didn't cause pain or swelling. That sounds unlikely and the description doesn't fit that mechanism.

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