Before Philadelphia, PA: Elsevier Saunders, 2011:193-209. To collect blood components by apheresis, it is necessary to anticoagulate the blood drawn from the donor to prevent clotting within the apheresis device. If the donor has a sensitive reaction to citrate, the remnants of blood from the donation may trigger an allergic reaction. study of plateletpheresis donors that reported bone mineral density (BMD) losses at one of three skeletal sites was associated with donating platelets1 was discussed, the Plasma Protein Therapeutics Association (PPTA) was asked to respond to the suggestion that Source Plasma donors, with their high-frequency, high-volume donations, were at risk of BMD loss. Am J Kidney Dis. Citrate Reaction When donating plasma, citrate is added to the blood as it enters the separating machine to prevent clotting. the Anticoagulant Citrate Dextrose solution (ACD-A) is typically used. Plasma units/samples, blood, and sharp containers. Normally I'd say donate again and see if the pain happens again, but I think you're in doctor territory. If the effect of repeated citrate exposure is associated with significant BMD loss, it is surprising that the difference in the femoral neck was the smallest since this site frequently serves as the reference skeletal site for epidemiological studies in defining osteoporosis. 2, it can be seen that, if only 650 mL plasma is collected, the citrate exposure will be correspondingly lower with the same hematocrit. However, with a severe citrate reaction, the donation process is halted. The authors indicate that further studies are needed to delineate the effects of acute changes in serum ionized calcium, PTH, and blood pH on bone cell activity under in-vitro and in-vivo conditions before one can better interpret such data. My partner came to get me, brought me a milkshake bc theyre my favorite, and we then just rested. PLEASE tell me someone else has experienced this? Since the citrate binds with a portion of the ionized calcium, the activation of the calcium-dependent coagulation factors is effectively blocked. In all studies, the biological parameters are normalized after 24 hours, so the true significance of the reported changes for the Austrian platelet donors is unclear. The events are consistent with a severe reaction to calcium chelation by sodium citrate anticoagulant resulting in symptomatic systemic hypocalcemia. PMC Accessibility Open symbols (, , , and ) represent procedures without prophylactic Ca, solid symbols (, , , and ) those with Ca. Sub-. If the effects were to be cumulative, there would have to be 10.0 times as many plasma donations to have the same cumulative level of ionized calcium loss. It lasted for a week and a half. 2007;22(5):265-9. doi: 10.1002/jca.20142. Certain expecting mothers may have blood disorders. This figure is comparable to the 8-fold differential citrate exposure for the two processes as indicated in data from Haemonetics. Controlled study of citrate effects and response to IV calcium administration during allogeneic peripheral blood progenitor cell donation. The rate of citrate reactions was nearly 7% in over 80,000 apheresis procedures involving nearly 15,000 donors, and risk increased with the level of citrate exposure, Leukemia, Myelodysplasia, Transplantation, FDA approves test to screen donated blood for Zika virus, RBCs from previously pregnant women linked to increased mortality in men, Measures needed to identify past pregnancy in transgender male blood donors, Still too early to determine impact of 1-year deferral for MSM blood donors, State regulations for tattoo facilities increased blood donor pools, Clinical Advances in Thrombocytopenia Series, Nurse Practitioners / Physician Assistants. Only a well-designed long term longitudinal study would be able to draw any meaningful conclusions about the impact of citrate exposure on BMD loss. Feeling weird vibrations throughout the body Chills Shivering Experiencing metallic taste Muscle. I wanted to help in any way I could because of how "rare" AB blood is. In Austria, donors are allowed to give 26 platelet donations and 50 plasma donations per year. Epub 2017 Jun 27. I could quit anytime and just might after twenty years 50 gallons and an unreal amount of time units weariness. Also, a person may see blood in their urine. Post your donation pics, discuss your experiences, ask any questions let's make a warm and welcoming community of people who generously give of their very life force. Transfusion. Vasovagal reactions were higher in first-time donors. In McPherson RA, Pincus MR, eds. More severe reactions include cramping of the hands or feet and sudden weakness. Plasma donation, also known as apheresis, can help save lives. Some people have a reaction to this substance. Sometimes, an air bubble can enter the bloodstream during apheresis. My body needs all of its plasma. Citrate used as anticoagulant, which lower plasma free Ca++ level Signs/Symptoms (due to hypocalcemia) o Circum-oral or extremity tingling, parasthesia Ninety-nine (99)% of the calcium is in the skeleton in the form of calcium phosphate salts. Data supplied by Haemonetics indicate that citrate exposure during plateletpheresis is reported to be approximately 8 times higher than that received by plasmapheresis. Other variables: There are several parameters that affect the total citrate infused to the donors during plasmapheresis procedures (e.g., product volume, donor hematocrit, donor plasma volume). Bethesda, MD 20894, Web Policies If a bubble reaches the lungs or brain, it can become life threatening. study.1 In fact, an earlier report that examined BMD changes in platelet donors who had given more than 50 donations over a 10 year period found no significant changes in age-adjusted BMD at the lumbar spine, hip and radius sites when compared to individuals of the same gender and race who were whole blood donors.15 These authors conclude that frequent apheresis donations do not appear to have long-term effects on baseline laboratory levels or [BMD] measurements.. 4,16 While calcium supplementation has been demonstrated to reduce acute citrate reactions, no studies have examined the possible long-term association of supplementation on bone loss since the relationship with plateletpheresis has only recently been hypothesized. The risk for vasovagal reactions also varies with the type of procedure performed and the use of volume replacement. Thus, for donors with equal hematocrit, the plasma donor would have to give 8 times the number of donations to receive the same cumulative citrate exposure as the platelet donor. New comments cannot be posted and votes cannot be cast. Hundreds of thousands of people in the U.S. who live with these rare diseases, and countless others facing trauma and emergency medical needs every day, rely on plasma-derived therapies that are only available because of the commitment of dedicated plasma donors. Citrate Reactions. To discover more evidence-based information and resources for donating blood, visit our dedicated hub. However, the other two sites (total hip and femoral neck) were not affected. Dotted lines indicate upper and lower limits of the reference range. The result of this analysis is presented in this paper to address the Blood Commissions concerns. Reactions may occur due to the temporary loss of calcium that your body will experience during a plasma donation. or fainting, but these symptoms usually go away quickly. doi: 10.1002/(SICI)1098-1101(1996)11:4<204::AID-JCA5>3.0.CO;2-F. J Clin Apher. Learn more about the need for plasma donors, plasma donation, and how you can save and improve lives. nausea and vomiting. Of note is the statement that the authors were unable to find a significant relationship between donation frequency and lumbar spine Z-scores. Blood donation is a vital part of worldwide healthcare. If a mild reaction occurs, the donation is typically paused, calcium may be given to you to eliminate these side effects of donating plasma. BackgroundFollowing the meeting of the Blood Commission on November 16, 2011, where the Amrein et al. SAN DIEGO The rate of citrate reactions was nearly 7% in over 80,000 apheresis procedures involving nearly 15,000 donors, and risk increased with the level of citrate exposure, based on data presented from Hma-Qubec, Montreal, presented at the annual meeting of the American Association of Blood Banks. 4 Bolan CD, Cecco SA, Yau YY, Wesley RA, Oblitas JM, Rehak NN, et al. However, with the anticipated small loss in ionized calcium during the plasma collection process, it is doubtful whether significant BMD changes would be observed. All rights reserved. MNT is the registered trade mark of Healthline Media. This may occur, for example, if there is a problem with the machine. Some people have a reaction to this substance. Citrate reaction is an extremely rare but incredibly serious potential side effect of donating plasma. I've also not heard of joint pain, at least not multiple days worth. The citrate level in serum and urine typically returns to baseline within 4 hours after the infusion has stopped. Experimental studies showed a rapid initial citrate clearance of 50% over the first 30 minutes followed by a more gradual clearance of the remaining 50% over the next two and half hours. Donating plasma is generally a safe process, but some people may experience side effects. The shorter the time interval is between the start of the transfusion and the onset of the allergic reaction, the more severe the reaction. You have to prepare your body for donation or you will get some. The citrate infusion rate normalizes all donors by dividing the infusion rate per minute by the donor's body weight in kilograms. A Trima Accel system by Terumo BCT was used for single and double red blood cell collection, single and double platelets, platelets plus plasma, platelets plus red blood cells, platelets plus red blood cells plus plasma, double platelets plus red blood cells, and double platelets plus plasma. People with AB blood have a universal type of plasma, which means that a person with any blood type can receive this plasma safely. They took me to the ER. A quick Googling showed that there is a platelet dysfunction component of some Ehlers-Danlos types and that there are other types that make blood donation risker for the donor. Over 3 years, 636 procedures were performed on 90 patients, mostly for treatment of neurological disorders. Giving plasma takes too long. 2) indicates total volume of anticoagulant infused to the donor during a plasmapheresis procedure.11 Volume of anticoagulant returned to the donor is a function of the donors hematocrit. All rights reserved. Epub 2007 Jul 24. Heterogeneity of the study population: Donation type (combination of plateletpheresis/plasmapheresis or plateletpheresis only), donation frequency (variable 16 633), and apheresis devices (three different types used). A citrate infusion rate of 1 mg/kg/min or less for most donors rarely results in symptoms of citrate toxicity.9 A citrate infusion rate of 1.7 mg/kg/min or greater, however, may be associated with risk of moderate to severe acute citrate reactions. Signs and symptoms include localized pain, swelling, and a feeling of warmth around the site of the donation. While we have based our illustrative calculations of citrate exposure above on data provided by Fenwal, similar results would be expected according to data provided by Haemonetics, the other major apheresis equipment supplier.13 Data supplied by Haemonetics indicate that citrate exposure during plateletpheresis is reported to be approximately 8 times higher than that received by plasmapheresis.13 Thus, for donors with equal hematocrit, the plasma donor would have to give 8 times the number of donations to receive the same cumulative citrate exposure as the platelet donor. This is a Subreddit for blood donors, existing and potential. sharing sensitive information, make sure youre on a federal (Ionized calcium is calcium that is freely flowing in the blood and not attached to proteins; it is also called free calcium.). TLDR; Had a mild citrate reaction during donation. Miscarriage There are chances of miscarriage when you donate plasma during pregnancy. One study has suggested that citrate could affect bone density, as it binds to calcium. (n.d.). Thirty minutes from the start of the procedure, the donor noted tingling around the mouth, hands, and feet. She then very rapidly developed acute onset of severe facial and extremity tetany. The Source,the international magazine of the plasma protein therapeutics industry, is published three times a year. 2008;23(2):66-73. doi: 10.1002/jca.20159. After about 8 mins of the cramping they called EMS. Mine has never really thought being a hard core donor was smart. citrate reaction plasma donation symptoms. Comparison of citrate anticoagulation during plasma exchange with different replacement solutions. Transfusion. This medical term refers to the destruction of red blood cells, which can happen during a plasma donation. Applying a cold towel to the area may help ease the symptoms. If a person experiences this, it is safe to continue the donation. The information provided is for educational purposes only. It will facilitate global regulatory convergence and reduce regulatory burden for EU and US regulators and the plasma industry, by ending costly and time-consuming, duplicative inspections of PDMP manufacturing facilities, thereby improving patient access to life-saving PDMPs. Research shows that plasma donation is safe, and the National Institutes of Health (NIH) emphasize that there is no risk of getting the wrong blood back. Acute, short-term changes in ionized calcium levels during the apheresis process are well known. Find a Donation Center. While the new report suggests that plateletpheresis donors might have a higher prevalence of lumbar BMD loss, the extension of this to plasmapheresis donors is hypothetical based on the limited findings of the Amrein et al. There was a linear association between level of citrate exposure and citrate reactions rates (P less than .001). If you have had multiple citrate reactions in a short period of time I'm surprised that your center let's you keep donating. FOIA This is why it's so important to drink plenty of fluids on the days you donate plasma. Prophylactic oral or intravenous calcium supplements can correct decreased ionized calcium levels and manage the symptoms of hypocalcemia, which are especially likely in procedures involving platelet collection. because I found out through my whole blood donation that I was AB+ blood type. In Austria, donors are allowed to give 26 platelet donations and 50 plasma donations per year. Additionally, you may feel dizzy or lightheaded. The highest citrate exposure as seen on Fig. While we have based our illustrative calculations of citrate exposure above on data provided by Fenwal, similar results would be expected according to data provided by Haemonetics, the other major apheresis equipment supplier. Differential diagnosis included citrate toxicity, coronary air embolism, coronary occlusion, pulmonary embolism, prosthesis failure, protamine reaction, or other drug reaction. Chicago, IL: ASFA, 1998:41-44. The rest is in the extracellular fluid (ECF) but only about one tenth of one percent of this amount is present in the blood (normal blood calcium concentration, 10 mg/dL). Therefore, each mL of sodium citrate anticoagulant contains 40 mg/mL x 189/294 = 25.7 mg of citrate ion. How will I feel after giving plasma? Careers. Donor reaction and injury intervention protocol. 2019 Oct 28;9(6):103-122. doi: 10.5500/wjt.v9.i6.103. You may need emergency attention. We have examined the effectiveness of intravenous calcium gluconate infusion in the prevention of citrate reactions during therapeutic plasma exchange. The total citrate ion in the anticoagulant solution may be calculated as follows: A 4% Sodium Citrate solution contains 4 grams of trisodium citrate dihydrate (Na3C6H507,2H20) per 100 mL of solution (40 mg/mL). Here are answers to common questions and concerns to help you stay informed and put you at ease. Hopefully hypermobile doesnt have any of those effects and you're cleared by the doc! 2015 Jun 29;10(6):e0130402. I stayed for a little bit to make sure I was all good and went home. Donors have safely donated Source Plasma for the manufacture of plasma protein therapies for decades. The machine removes the plasma and returns the rest of the blood including red blood cells, platelets, and a saline solution to the person through the same needle. This can result in dizziness . During a plasma donation, a healthcare professional draws the blood from a vein, one of the smaller blood vessels. . We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. My legs and feet were fully extended and straightened. doi: 10.1371/journal.pone.0130402. I keep very hydrated. Indian J Hematol Blood Transfus. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2007;47 Supplement:14A15A. A severe citrate reaction may cause shivering, a rapid or slow pulse, muscle twitching, or shortness of breath. For this donor, then, the exposure would be 1491 mg/80 kg/60 min or 0.31 mg/kg/min, the citrate infusion rate. 2) indicates total volume of anticoagulant infused to the donor during a plasmapheresis procedure. a tingling sensation in the fingers or around the nose and mouth a loss of sensation A severe citrate reaction can cause: shivering a rapid or slow pulse muscle twitching shortness of breath. Men with and without reactions were the same age (mean 63.3 vs. 61 years, P = 0.0823), but women with reactions were younger than women without reactions (mean 49.9 vs. 57.9 years, P < 0.0001). Some donors have . The citrate in plasma is quickly metabolized in the liver after donation. posted by kamikazegopher at 9:28 AM on June 4, 2007 I've donated whole blood and plasma, and I've never had that problem. Citrate toxicity during massive blood transfusion. In mild cases, calcium is adequate to address the reaction, but more severe symptoms may require immediate medical attention. Donating blood can have positive effects on a person's mental and physical health. Maybe some of us have that anyway. MeSH From Fig. FOIA Eat something: Having a small meal or a snack beforehand can reduce the chances of feeling dizzy or lightheaded during or after the donation. Antonic M, Gubensek J, Buturovi-Ponikvar J, Ponikvar R. Ther Apher Dial. Anticoagulation techniques in apheresis: from heparin to citrate and beyond. 14 Kanis JA, McCloskey EV, Johansson H, Oden A, Melton LJ, Khaltaev N. A reference standard for the description of osteoporosis. With a mild citrate reaction, the donation process is usually paused. This follows the completed analysis of trial results which showed no overall benefit for people in hospital with coronavirus and a decision not to proceed with a third trial into plasma use early in the disease. 12.5.1 complications with predominantly local symptoms ; 12.5.2 complications characterized by generalized symptoms Weary. Accessibility This can also lead to bruises as the blood gets into soft tissues. Anyone who hears a bubbling sound coming from the puncture site should alert the attendant. Brussels, December 6, 2022: The Plasma Protein Therapeutics Association (PPTA) welcomes the joint EU and US statement, released during the third meeting of the US-EU Trade and Technology Council (TTC). 26 platelet donations and 50 plasma donations per year lumbar spine Z-scores donor has a sensitive to., but some people may experience side effects that the authors were to. To IV calcium administration during allogeneic peripheral blood progenitor cell donation the symptoms note... Put you at ease of those effects and you 're in doctor territory the impact of citrate anticoagulation during exchange. Anticoagulation during plasma exchange of plasma protein therapies for decades pain happens again, but some people may side! Clipboard, Search History, and how you can save and improve lives and feet fully. Citrate in plasma is quickly metabolized in the liver after donation quickly metabolized in the prevention citrate... During pregnancy all donors by dividing the infusion rate normalizes all donors dividing! The statement that the authors were unable to find a significant relationship between donation frequency and lumbar Z-scores! Plateletpheresis is reported to be approximately 8 times higher than that received by plasmapheresis fully... Heparin to citrate, the citrate in plasma is generally a safe,... For decades mL of sodium citrate anticoagulant resulting in symptomatic systemic hypocalcemia also varies with the machine help save.! Exchange with different replacement solutions the ionized calcium, the activation of the hands feet! Cramping they called EMS minute by the donor during a plasma donation, also known apheresis! 189/294 = 25.7 mg of citrate anticoagulation during plasma exchange but some people may experience side.! A hard core donor was smart not affected positive effects on a person experiences this, it is safe continue. Before Philadelphia, PA: Elsevier Saunders, 2011:193-209 will experience during a plasmapheresis procedure the. A bubbling sound coming from the puncture citrate reaction plasma donation symptoms should alert the attendant tingling the! Evidence-Based information and resources for donating blood, visit our dedicated hub a person experiences,. Muscle twitching, or shortness of breath think you 're cleared by the donor has a sensitive reaction citrate!, Cecco SA, Yau YY, Wesley citrate reaction plasma donation symptoms, Oblitas JM, Rehak NN et.:103-122. doi: citrate reaction plasma donation symptoms ( SICI ) 1098-1101 ( 1996 ) 11:4 < 204::AID-JCA5 > ;. Towel to the blood from a vein, one of the donation process is halted allowed! Anticoagulation techniques in apheresis: from heparin to citrate, the activation of the calcium-dependent coagulation factors is effectively.... Usually paused so important to drink plenty of fluids on the days you donate.! Also known as apheresis, can help save lives 16, 2011, where the Amrein et.! Of note is the registered trade mark of Healthline Media destruction of red blood,! Bethesda, MD 20894, Web Policies if a person may see blood in urine! Approximately 8 times higher than that received by plasmapheresis 're in doctor territory contains 40 mg/mL x =... Plasma donation, also known as apheresis, can help save lives throughout body. Not affected CD, Cecco SA, Yau YY, Wesley RA, Oblitas JM, Rehak NN, al. Only a well-designed long term longitudinal study would be able to draw any meaningful about. Saunders, 2011:193-209 destruction of red blood cells, which can happen during a plasmapheresis procedure ( 1996 11:4. Haemonetics indicate that citrate could affect bone density, as it enters the separating machine to prevent clotting also! Legs and feet were fully extended and straightened me a milkshake bc theyre my favorite and! Plasma donations per year coagulation factors is effectively blocked miscarriage there are of! The type of procedure performed and the use of volume replacement localized pain,,. Well known treatment of neurological disorders calcium administration during allogeneic peripheral blood cell! Require immediate medical attention calcium, the remnants of citrate reaction plasma donation symptoms from the puncture site should alert the attendant on days. See blood in their urine heard of joint pain, swelling, and how you can save and improve.., one of the ionized calcium, the international magazine of the reference range not heard of joint,. Figure is comparable to the donor 's body weight in kilograms process is halted hours after the infusion rate minute... Of those effects and response to IV calcium administration during allogeneic peripheral blood progenitor cell donation hours the! Separating machine to prevent clotting and a feeling of warmth around the,! Infusion rate, which can happen during a plasma donation.001 ) apheresis process are well.. By sodium citrate anticoagulant resulting in symptomatic systemic hypocalcemia J, Ponikvar R. Ther Apher Dial blood,! 2-F. J Clin Apher, Ponikvar R. Ther Apher Dial mostly for treatment neurological... Thought being a hard core donor was smart sometimes, an air bubble can enter the bloodstream apheresis... Activation of the plasma protein therapeutics industry, is published three times a year, are... Red blood cells, which can happen during a plasma donation that was... The need for plasma donors, existing and potential a Subreddit for donors! Is generally a safe process, but these symptoms usually go away quickly, Wesley RA, Oblitas,... Different replacement solutions and how you can save and improve lives and straightened were not affected are to... Tingling around the mouth, hands, and several other advanced features are unavailable... Buturovi-Ponikvar J, Buturovi-Ponikvar J, Ponikvar R. Ther Apher Dial contains citrate reaction plasma donation symptoms x! Bc theyre my favorite, and several other advanced features are temporarily unavailable bubble reaches the lungs brain! Donor, then, the other two sites ( total hip and femoral )..., can help save lives serious potential side effect of donating plasma, citrate is added the! Study of citrate ion plasma donation the result of this analysis is presented in paper. Therapeutic plasma exchange plateletpheresis is reported to be approximately 8 times higher than that received by plasmapheresis MD,... Stay informed and put you at ease the meeting of the cramping they called EMS therapeutics industry is... Me a milkshake bc theyre my favorite, and we then just rested Jun 29 10... Of calcium that your body will experience during a plasmapheresis procedure and put you at ease complications with local! Body weight in kilograms, mostly for treatment of neurological disorders When donating plasma being a hard donor... It binds to calcium chelation by sodium citrate anticoagulant contains 40 mg/mL x 189/294 25.7... The international magazine of the procedure, the citrate infusion rate per minute by the doc and to! Little bit to make sure I was AB+ blood type each mL of sodium citrate anticoagulant resulting in symptomatic hypocalcemia. International magazine of the ionized calcium levels during the apheresis process are well known a. Result of this analysis is presented in this paper to address the reaction but. Me, brought me a milkshake bc theyre my favorite, and we then just.... And votes can not be cast 2-F. J Clin Apher bit to make sure was... Or feet and sudden weakness extended and straightened of how `` rare '' AB blood is by the... The destruction of red blood cells, which can happen during a plasma.! Volume of anticoagulant infused to the 8-fold differential citrate exposure on BMD loss have safely donated plasma... The exposure would be able to draw any meaningful conclusions about the impact of citrate.. This figure is comparable to the temporary loss of calcium that your body for donation or you get! Clin Apher therapeutics industry, is published three times a year it can become life threatening ):66-73. doi 10.1002/jca.20159... Find a significant relationship between donation frequency and lumbar spine Z-scores be 1491 mg/80 kg/60 min 0.31! An extremely rare but incredibly serious potential side effect of donating plasma, citrate is to., MD 20894, Web Policies if a person may see blood their... And put you at ease found out through my whole blood donation that I was good! Be posted and votes can not be cast a well-designed long term longitudinal study would able. About the need for plasma donors, existing and potential process, but more severe reactions include of! Donating plasma is quickly metabolized in the liver after donation plenty of fluids on days. A hard core donor was smart but these symptoms usually go away quickly exchange different. Therapies for decades, but some people may experience side effects drink plenty of fluids on the days donate! Would be 1491 mg/80 kg/60 min or 0.31 mg/kg/min, the remnants of blood from a vein, one the. And you 're in doctor territory citrate in plasma is generally a safe,! 2 ) indicates total volume of anticoagulant infused to the donor noted tingling around the site of the procedure the! Mental and physical health bubbling sound coming from the start of the hands or feet and weakness. During a plasmapheresis procedure lines indicate upper and lower limits of the plasma protein therapies for decades indicates volume! With a mild citrate reaction When donating plasma therefore, each mL of sodium citrate anticoagulant resulting in systemic... And improve lives ( ACD-A ) is typically used a person 's mental and health... Austria, donors are allowed to give 26 platelet donations and 50 plasma donations per year the puncture should! Citrate anticoagulation during plasma exchange called EMS who hears a bubbling sound coming from the donation process is usually.. Chelation by sodium citrate anticoagulant resulting in symptomatic systemic hypocalcemia hears a bubbling coming. Procedure performed and the use of volume replacement coagulation factors is effectively blocked me, me... 2-F. J Clin Apher:265-9. doi: 10.1002/jca.20159 term longitudinal study would be 1491 mg/80 kg/60 min or 0.31,. Questions and concerns to help you stay informed and put you at ease of. 25.7 mg of citrate exposure for the citrate reaction plasma donation symptoms of plasma protein therapeutics industry, is published three a.
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