The Play of Citrate Infusion with Calcium in Plateletpheresis Donors
- PDF / 462,700 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 98 Downloads / 157 Views
ORIGINAL ARTICLE
The Play of Citrate Infusion with Calcium in Plateletpheresis Donors Trupti Lokhande1 • Sherin Thomas2 • Guresh Kumar3 • Meenu Bajpai1
Received: 3 January 2020 / Accepted: 17 August 2020 Ó Indian Society of Hematology and Blood Transfusion 2020
Abstract Citrate is the anticoagulant of choice for plateletpheresis. Citrate toxicity is common during plateletpheresis as citrate chelates calcium and causes hypocalcemia in donors. We have conducted this study to analyze the effects of routine citrate infusion during plateletpheresis on laboratory and clinical parameters. We also compared the dose of citrate delivered to donors during plateletpheresis using two different cell separators as Haemonetics MCS ? and Trima Accel. The study was conducted on 50 plateletpheresis donors who were eligible for donation. Donor demographics and baseline parameters were recorded. Pre, mid and post-procedure blood samples were collected for hematological and biochemical analysis. We found a significant decrease in baseline iCa (1.23 ± 0.07 mmol/L) from start to mid-procedure (1.19 ± 0.006 mmol/L) which recovered at 30 min post procedure (1.2 ± 0.01 mmol/L). The incidence of citrate toxicity was 10%. In donors with citrate toxicity, the postprocedure recovery of iCa was not seen and there was a & Meenu Bajpai [email protected] Trupti Lokhande [email protected] Sherin Thomas [email protected] Guresh Kumar [email protected] 1
Department of Transfusion Medicine, Institute of Liver and Biliary Sciences, New Delhi 110 070, India
2
Department of Biochemistry, Institute of Liver and Biliary Sciences, New Delhi 110 070, India
3
Department of Research, Institute of Liver and Biliary Sciences, New Delhi 110 070, India
further decrease in iCa levels. We also found a significant fall in Hb and platelet count post plateletpheresis. We observed that lower PLT counts (\ 200 9 103/lL) necessitated higher blood volume processing and therefore a higher anticoagulant (citrate) dose. The Trima Accel cell separator reached platelet target yield faster but with a higher citrate dose as compared to Hemonetics MCS ? . Ionized calcium decreases significantly during plateletpheresis but recovers soon after the completion of the procedure. Serious adverse events were not observed during plateletpheresis. The mild citrate toxicity which occurred was easily managed by slowing the procedure and administering oral calcium to donors. Trima Accel and Hemonetics MCS ? both collected platelets efficiently, with minimal donor discomfort. Keywords Plateletpheresis iCa ACD-A Citrate Hypocalcemia
Introduction Anticoagulation plays a primary role in maintaining blood in the fluid state in the extracorporeal apheresis circuit. Citrate was the first anticoagulant used for blood collection in 1914 and it has been the anticoagulant of choice since then [1]. The inhibition of the coagulation cascade by the anticoagulant citrate results from its ability to chelate calcium ions. Citrate toxicity is a common adverse effect of p
Data Loading...
