title: How to stabilize the level of ionized calcium and citrate during plateletpheresis.
abstract: OBJECTIVE
  Citrate reactions are uncomfortable and potentially dangerous to apheresis donors. Reduction of citrate increases comfort, but may lead to platelet clumping.
  
  
  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.
authors.affiliation: Etablissement de Transfusion Sanguine de l'AP-HP, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Farrokhi
authors.forename: H
authors.initials: H
authors.lastname: Farahmand
authors.forename: A
authors.initials: A
authors.lastname: Bismuth
authors.forename: C
authors.initials: C
authors.lastname: Suarez
authors.forename: B
authors.initials: B
authors.lastname: Ducot
authors.forename: M C
authors.initials: MC
authors.lastname: Gillon
authors.forename: P
authors.initials: P
authors.lastname: Debat
authors.forename: P
authors.initials: P
authors.lastname: Laskowski
authors.forename: F
authors.initials: F
authors.lastname: Pinon
mesh_terms: D001798:Blood Proteins / Q000032:analysis; D002118:Calcium / Q000097:blood*; D019343:Citric Acid / Q000097:blood*; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007958:Leukocyte Count; D008297:Male; D010292:Paresthesia / Q000139:chemically induced; D010710:Phosphates / Q000032:analysis; D010974:Platelet Aggregation; D010976:Platelet Count; D010983:Plateletpheresis / Q000379:methods*; D013997:Time Factors
chemical_list: D001798:Blood Proteins; D010710:Phosphates; D019343:Citric Acid; D002118:Calcium