Brief Report
Citrate anticoagulation: Are blood donors donating bone?
Walter Bialkowski,
Roberta Bruhn,
Gustaf Edgren,
Paula Papanek,
Corresponding Author
Walter Bialkowski
Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin
Correspondence to: Walter Bialkowski, Clinical and Translational Rehabilitation Health, Marquette University, P.O. Box 1881, Milwaukee, WI 53201-1881, USA. E-mail: [email protected].Search for more papers by this authorRoberta Bruhn
Epidemiology Core, Blood Systems Research Institute, San Francisco, California
Search for more papers by this authorGustaf Edgren
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
Department of Medicine, Division of Hematology, Karolinska University Hospital, Stockholm, Sweden
Search for more papers by this authorPaula Papanek
Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin
Search for more papers by this authorWalter Bialkowski,
Roberta Bruhn,
Gustaf Edgren,
Paula Papanek,
Corresponding Author
Walter Bialkowski
Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin
Correspondence to: Walter Bialkowski, Clinical and Translational Rehabilitation Health, Marquette University, P.O. Box 1881, Milwaukee, WI 53201-1881, USA. E-mail: [email protected].Search for more papers by this authorRoberta Bruhn
Epidemiology Core, Blood Systems Research Institute, San Francisco, California
Search for more papers by this authorGustaf Edgren
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
Department of Medicine, Division of Hematology, Karolinska University Hospital, Stockholm, Sweden
Search for more papers by this authorPaula Papanek
Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin
Search for more papers by this authorConflicts of interest: none.
Abstract
An estimated 2.4 million volunteer apheresis blood donation procedures were performed in the United States in 2010, and increases in the proportion of transfused blood products derived from apheresis blood collections have been consistently reported. Anticoagulation is required during apheresis and is achieved with citrate. Donor exposure to citrate causes an acute physiological response to maintain serum mineral homeostasis. Some data are available on the sequelae of this acute response in the days and weeks following exposure, raising questions about bone mineral density in regular apheresis donors. New research is emerging that addresses the potential long-term health outcomes of repeated citrate exposure. This article reviews the acute physiological response to citrate anticoagulation in volunteer blood donors, presents contrasting perspectives on the potential effects of citrate exposure on bone density, and identifies key knowledge gaps in our understanding of long-term health outcomes in apheresis donors. J. Clin. Apheresis 31:459–463, 2016. © 2015 Wiley Periodicals, Inc.
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