title: National audit of citrate toxicity in plateletpheresis donors.
abstract: 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.
  
  
  RESULTS
  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.
authors.affiliation: Manchester Blood Centre, Plymouth Grove, Manchester M13 9LL, UK. yvette.makar@nbs.nhs.uk
authors.forename: Yvette F
authors.initials: YF
authors.lastname: Makar
authors.forename: M O
authors.initials: MO
authors.lastname: Butler
authors.forename: G M
authors.initials: GM
authors.lastname: Cockersole
authors.forename: G
authors.initials: G
authors.lastname: Gabra
authors.forename: J M
authors.initials: JM
authors.lastname: Serevitch
mesh_terms: D001771:Blood Banks / Q000592:standards*; D001782:Blood Donors; D019343:Citric Acid / Q000506:poisoning*; D006801:Humans; D015994:Incidence; D008485:Medical Audit; D010983:Plateletpheresis / Q000009:adverse effects*; D006113:United Kingdom
chemical_list: D019343:Citric Acid