National audit of citrate toxicity in plateletpheresis donors
Article first published online: 18 JUN 2002
Volume 12, Issue 3, pages 187–191, June 2002
How to Cite
Makar, Y. F., Butler, M. O., Cockersole, G. M., Gabra, G. and Serevitch, J. M. (2002), National audit of citrate toxicity in plateletpheresis donors. Transfusion Medicine, 12: 187–191. doi: 10.1046/j.1365-3148.2002.00372.x
- Issue published online: 18 JUN 2002
- Article first published online: 18 JUN 2002
- Received 18 July 2001; accepted for publication 4 February 2002
- cell separator;
- citrate toxicity;
Summary 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:
- 1The type of manufacturer's cell separator used (Cobe Spectra, Haemonetics, Baxter Amicus and Trima).
- 2The type of procedure: single needle, dual needle, single, double or triple dose.
- 3The 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.