Related Experiment Videos
How to stabilize the level of ionized calcium and citrate during plateletpheresis
P Farrokhi1, H Farahmand, A Bismuth
1Etablissement de Transfusion Sanguine de l'AP-HP, Paris, France.
Insights
This study introduces a stepwise citrate reduction protocol for apheresis donors, improving comfort by reducing citrate infusion without causing platelet clumping. This method enhances donor safety and collection efficiency.
Area of Science:
- Apheresis Technology
- Donor Safety
- Biochemistry
Background:
- Citrate reactions pose risks to apheresis donors.
- Reducing citrate improves donor comfort but can cause platelet clumping.
Purpose of the Study:
- To describe a protocol for stepwise reduction of citrate infusion during plateletpheresis.
- To evaluate the safety and efficacy of this protocol in reducing citrate load without compromising platelet quality.
Main Methods:
- A stepwise reduction protocol for ACD-A (anticoagulant citrate dextrose solution, type A) volume was implemented.
- The protocol was tested on 80 healthy donors using Cobe 2997 and Fenwal-CS 3000 cell separators.
Main Results:
- Ionized calcium decreased by approximately 18% in the first hour.
- Mild neuromuscular hyperexcitability was observed in only 22-28% of donors.
- Significant reduction in phosphate ions was noted (p < 0.0001).
Conclusions:
- The stepdown citrate reduction protocol effectively lowers citrate load.
- This method avoids the complication of platelet clumps during apheresis.
Background And Objectives:
Citrate reactions are uncomfortable and potentially dangerous to apheresis donors. Reduction of citrate increases comfort, but may lead to platelet clumping.
Materials And Methods:
We describe a protocol for stepwise reduction of the volume of ACD-A injected during plateletpheresis. This protocol has been carried out in 45 healthy donors with the Cobe 2997 (Cobe) cell separator, and in 35 with the Fenwal-CS 3000 (CS).
Results:
Using this protocol, during the first hour of platelet collection, ionised calcium decreased on average by 18% for CS and by 18.4% for Cobe. During the second hour, Ca2+ and citrate ion concentration did not change with either Cobe or CS (about 65% of citrate ion load is eliminated). We observed mild signs of neuromuscular hyperexcitability in only 22% and 28% of donors with Cobe and CS, respectively. We also found a significant reduction of phosphate ions (p < 0.0001) at the end of the procedures.
Conclusions:
With this stepdown citrate reduction protocol, we obtained a significant reduction of injected citrate without the complication of platelet clumps.