Article2002

National audit of citrate toxicity in plateletpheresis donors

Y. F. Makar · Marcus Otho Butler · Gillian M. Cockersole · Gamal S. Gabra · J. M. Serevitch

37 citations0/0 files storedTransfusion Medicine

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Blood donation and transfusion practices Blood transfusion and management Trauma, Hemostasis, Coagulopathy, Resuscitation

Abstract

UNLABELLED: Citrate toxicity complicating plateletpheresis is not uncommon. However, the scale and severity of the problem have never been formally addressed. In order to answer these questions we undertook a national audit of 13 070-platelet procedures throughout 17 apheresis centres in England over a 3-month period from 1 April to 30 June 2000. A standard form was distributed to each centre to record the symptoms/signs of citrate toxicity which were then graded (grades 1-5) according to their severity. The following variables were studied to determine whether they influenced the frequency and severity of citrate toxicity: 1. The type of manufacturer's cell separator used (Cobe Spectra, Haemonetics, Baxter Amicus and Trima). 2 The type of procedure: single needle, dual needle, single, double or triple dose. 3 The way in which donors were instructed to report symptoms of citrate toxicity. OUTCOME: Plateletpheresis is a relatively safe procedure provided that donors who experience severe reactions receive appropriate treatment. The incidence of severe citrate toxicity (0.03% procedures) is comparable to that of severe faints following whole blood donation, indicating a comparable margin of safety. Donors should be warned of the symptoms of citrate toxicity at their first attendance only. More frequent reminders encourage donors to over-report symptoms of mild citrate toxicity.

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References

1997Donor reactions and injuries from whole blood donation 1999Adverse Events in Platelet Apheresis Donors: A Multivariate Analysis in a Hospital‐Based Program

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