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Estimation of serum calcium levels in apheresis platelet donors
P Arpitha1, Ravindra Prasad Thokala1
1Department of Transfusion Medicine, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India.
Insights
Plateletpheresis using acid citrate dextrose is safe, with temporary calcium and pH drops post-procedure. Calcium levels and pH in apheresis donors recover within 30 minutes.
Area of Science:
- Transfusion Medicine
- Hematology
Background:
- Apheresis is a common method for collecting single donor platelets (SDPs).
- Acid citrate dextrose (ACD) is used as an anticoagulant, chelating calcium and potentially altering homeostasis.
- This can lead to hypocalcemia and acute adverse events in donors.
Purpose of the Study:
- To investigate calcium homeostasis in individuals undergoing apheresis for platelet donation.
- To assess the impact of the apheresis procedure on donor calcium levels and pH.
Main Methods:
- A cross-sectional study involving 50 voluntary SDP donors.
- Measurements included total and ionized calcium, pH, and serum albumin at baseline.
- Ionized calcium and pH were measured immediately post-procedure and 30 minutes after completion.
Main Results:
- Ionized calcium levels decreased immediately post-apheresis but returned to baseline within 30 minutes.
- A significant decrease in pH was observed immediately post-procedure.
- Citrate metabolism appears to be largely completed within 30 minutes post-apheresis.
Conclusions:
- Single donor platelet collection via apheresis is generally safe with minor adverse effects.
- The potential toxicity of citrate is not significantly pronounced in donors.
- Calcium homeostasis is restored within 30 minutes following plateletpheresis completion.
Introduction:
Apheresis is practiced widely to collect single donor platelets (SDPs). This procedure utilizes an anticoagulant acid citrate dextrose to prevent clotting of blood in the extracorporeal circuit which chelates divalent ions like calcium. This alters the calcium homeostasis resulting in hypocalcemia causing acute adverse events.
Aim:
The study aimed to know the calcium homeostasis in apheresis platelet donors.
Materials And Methods:
This cross-sectional study was conducted from January 2020 to December 2020 in the department of transfusion medicine. The sample size was 50. Donors who walk in for voluntary SDP donation were selected. Total and ionized calcium, pH, and serum albumin for all the donors at baseline and ionic calcium at the end of the procedure and 30 min after the procedure were measured.
Results:
According to statistical analysis of the ionic calcium level at pre procedure, immediate post procedure and 30 minutes post procedure, there was decrease in the value immediate post procedure and values returned to baseline within 30 minutes. The levels of pH change were analyzed. On comparing the preprocedure and immediate postprocedure values, there was a significant lowering of pH value from the baseline (P = 0.5), indicating acute lowering of pH immediate postprocedure. Hence, most of the citrate metabolism can be achieved within 30 min after completion of the apheresis procedure.
Conclusion:
SDP collection is essentially a safe procedure with minimal adverse effects. Toxicity of citrate is not much pronounced. Recovery of calcium levels is within 30 min of completion of plateletpheresis.
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