The Study of the Levels of Ionized Calcium in Plateletpheresis Donors
Keywords:
Ionized calcium, PlateletpheresisAbstract
Background: The collection of platelets by apheresis requires the administration of anticoagulant which contained citrate to prevent the clotting of extravascular blood in the separation circuitry. The citrate is infused back to the donors during the retum cycle. Citrate chelates the free bicactive blood calcium so the levels of ionized calcium in the donors are decreased. Objective: To study the levels of ionized calcium in plateletpheresis donors, adverse effects dunning donation and evaluate the qualty platet concentrates: Materials: One hundred and forty healthy donors underwent plateletpheresis were studied. The donors were divided into 2 groups. Group 1, 70 donons, did not receive any medication before plateletpheresis. Group 2, 70 donors, 2 tablets of calcium carbonate (caltrate-600), which is equivalent to calcium 1,200 mg were given immediately before plateletpheresis. Methods: Plateletpheresis was carried out with intermittent flow centrifugal blood cell separator Haemonetics MCS3p) using platelet A3p protocol and MCS3p platelet disposable L/N 894. Acid citrate dextrose formula-A (ACD-A) was used as anticoagulant. A ratio of ACD-A to whole blood was 1:10. The levels of ionized calcium of donors were measured by the ion-selective electode NOVA Nucleus analzerl. The complete blood counts in donors, the platet and leukocyte counts in platelet concentrates were performed with an automated cell counter (Cell-dym 400). Results: The levels of predonation ionized calcium in donors group 1 and group 2 were 4.44+-0.56 mg/dL and 4.30+-0.54 mg/dL, respectively. The averages of citrate infusion rates were 1.10+-0.17 mg/kg/min and 1.07+-0 11 mg/kg/min. The predonation ion ionized calcium and the averages of citrate infusion rate in groups were not signicanty different (p = 0.61 and 0.16, respectively. The postdonation ionized calcium decreased with the averages of 23.67% in group 1 and 11.86% in group 2. The levels of postdonation ionized calcium in donors group 2 (3.79+-0.43 mg/dL) were significanty higher than those in group 1 (3:39+-0.59 mg/dL). Perioral paresthesia was 8/70 (11.42%) in group 1 and 7/70 (10%) in group 2. Moderate discomfort accompanied by nausea was experienced by one case in group 1. Although the numbers of donors with symptoms in both groups were not significantly diferent (p = 0:99) but the donors who had expenced in group 1 and donated again in group 2 felt better dung donation. The platet vields were 4.92+-1.13 x1011 (3.09-7.71 x 1011 with leukocyte contamination of 8.54+-6.62 x 107 for group 1 and 4.83+-1.09 x 1011 (3.01-7.98 x 1011) with white cell contamination of 7.64+-6.10 x 107 for group 2. Conclusion: The oral calcium supolementation immediately before plateletoberesis reduces the diminution of ionized calcium (bypocalcemia) and the disconforting symptoms in donots. The platelet concentrates in this study meet the AABB standard which contains at least 3.0 x 1011 platelets in 75% of units tested.
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