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Alteration in biochemical parameters during plateletpheresis in healthy donors: A compendious analysis
Kanika Garg1, Paramjit Kaur1, Ravneet Kaur Bedi1
1Department of Transfusion Medicine, Government Medical College and Hospital, Sector 32-B, 160030 Chandigarh, India.
Insights
Plateletpheresis significantly reduces calcium and magnesium levels in donors, potentially causing hypocalcemic reactions. Monitoring these biochemical changes is crucial for donor safety and managing adverse events.
Area of Science:
- Biochemistry
- Hematology
- Transfusion Medicine
Background:
- Plateletpheresis utilizes citrate anticoagulant, which can lead to transient hypocalcemia and hypomagnesemia.
- These electrolyte disturbances may cause discomfort and adverse reactions in healthy donors.
Purpose of the Study:
- To assess the impact of citrate infusion during plateletpheresis on various biochemical parameters in healthy donors.
- To correlate observed biochemical changes with the incidence and severity of adverse donor reactions.
Main Methods:
- Sixty healthy plateletpheresis donors were enrolled.
- Blood samples were collected at baseline, 30 minutes into the procedure, and 30 minutes post-procedure.
- Measurements included total calcium, ionized calcium, serum magnesium, parathyroid hormone, total protein, and serum albumin.
Main Results:
- Significant decreases in total calcium, ionized calcium, serum magnesium, total protein, and serum albumin were observed.
- Parathyroid hormone levels significantly increased from baseline to procedure completion.
- Hypocalcemic reactions were the most common adverse events, particularly with Amicus double yield apheresis, and were managed with calcium supplementation.
Conclusions:
- Plateletpheresis causes substantial reductions in serum calcium and magnesium levels.
- The significant increase in parathyroid hormone warrants further investigation.
- Declines in total protein and albumin may be a consideration for donors undergoing concurrent plasmapheresis.
Objectives:
During plateletpheresis, citrate induces hypocalcemia and hypomagnesemia, which are usually transient and self-limiting, but they can lead to significant donor discomfort. The aim of study was to determine the effect of citrate infusion on a multitude of biochemical parameters during plateletpheresis in healthy donors and to correlate changes with adverse donor reactions.
Methods:
The study was conducted on 60 healthy plateletpheresis donors. Blood samples were drawn on three occasions, a baseline pre-donation sample, 30min at start of procedure and 30min post procedure. Heparinized samples were taken to measure ionized calcium and plain samples to measure serum calcium, serum magnesium, parathyroid hormone, total protein and serum albumin.
Results:
There was statistically significant decline in mean total calcium (9.27±0.66mg/dl to 8.72±0.87mg/dl) and ionized calcium (3.8±0.51mg/dl to 2.9±0.67mg/dl) from baseline until 30min after the start of procedure respectively. A significant fall in serum magnesium, total protein and serum albumin was observed. The mean parathyroid hormone showed significant increase from baseline levels till at the completion of procedure (19.94±12.1pg/ml to 92.08±36.78pg/ml). If the yield was set constant, there was negative correlation between ACD used and pre-donation platelet count. Majority of adverse donor reactions were hypocalcemic reactions, which were more with Amicus double yield plateletpheresis and were managed with calcium supplementation.
Conclusion:
Plateletpheresis induces marked reduction in serum calcium and magnesium levels. Moreover, increase in parathyroid hormone levels was significant. In addition, decline in total protein and serum albumin may be a concern in donors also participating in plasmapheresis.
