Literature DB >> 30692809

Need for plateletpheresis procedure with voluntary regular apheresis donors: An experience.

Ripal J Shah1, Vishvas Amin1.   

Abstract

Entities:  

Year:  2018        PMID: 30692809      PMCID: PMC6327769          DOI: 10.4103/ajts.AJTS_127_16

Source DB:  PubMed          Journal:  Asian J Transfus Sci        ISSN: 0973-6247


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Sir, Millions of lives are saved each year through blood transfusions. With the improvement of medical science and increasing of life expectancy, the demand for blood products has increased. With better understanding of the thrombostatic potential of platelets and availability of technologies that can collect and separate platelets from whole blood, the need and indications of platelets have increased manifold in the last 15–20 years. The single donor platelet (SDP) is more effective and safer than random donor platelet products.[1] The National and State Blood Transfusion Councils, with support from various nongovernment organizations, carry out extensive work for donor motivation and retention.[2] However, these kinds of motivational activities in the community are mostly directed toward whole-blood donation. In this era of component therapy, apheresis plays a vital role in the planning of transfusion therapy for patients. Apheresis has allowed the supply of a therapeutically beneficial component to grow with medical needs.[3] The risk of viral transmission is at least two-fold higher for whole-blood-derived platelet concentrates than SDP which is a major advantage other than dosage effect.[4] Being the largest blood transfusion center in Western India, platelets are required on a regular basis to the patients admitted in various hospitals in and around the city. Ahmedabad city is developing as a medical hub; and usually, these patients come either from other parts of the country or overseas countries and have no donor pool available with them. Whole-blood donors donate blood to help others (on true altruistic nature).[5] In India, compensation to apheresis donors is not allowed by the Food and Drug Administration. Therefore, many centers ask relatives to donate apheresis. Mainly SDPs are done on demand, and group-specific donors are called and selected. Donor recruitment for plateletpheresis to meet the huge demand from the clinicians was not an easy task. Being one of the largest centers in Western India, with more than 95 centurion donors (those who have donated blood for more than 100 times), our large number of regular altruistic blood donor base added advantage to create apheresis donor directory. However, constant counseling of regular voluntary blood donors and relatives/friends of patients who are benefited by SDP and motivation of the staff helped us achieve the goal. The main hindrances faced during the initial phase of donor recruitment are as follows: The donors were totally ignorant about the procedure of apheresis Donors were apprehensive about getting infections as remaining blood components being transfused back Donors were initially reluctant to volunteer as it is time-consuming. Against 30 min in whole-blood donation, time taken was about 90–100 min[6] Donors were also apprehensive regarding lowering of their own platelet count postdonation and feared to develop bleeding. To overcome obstacles and to make them aware, a short documentary was prepared about procedures of apheresis donations in details starting from donor screening, apheresis procedure up to the donor leaving blood bank safely. In the initial phase, all staff members of blood bank from all positions volunteered themselves to register. This created a positive effect. On counseling, donors also volunteered and registered for apheresis donation. The above observations led us to think that most blood donors are not aware of SDP donation and plateletpheresis procedure. Hence, motivational activities should be directed toward platelet donation. Plateletpheresis is a need-based procedure. However, voluntary blood donors can be targeted and motivated to donate SDP whenever required. The advantages of platelet donation over whole-blood donation should be stressed upon. The regular voluntary blood donors should be made aware that there is no or minimal blood loss in this procedure and they are fit to redonate in day's time. It should also be highlighted that this procedure yields a higher quality product, reduces multiple donor exposure, and causes fewer donor reactions due to return of fluid.[7] The principles of donor recruitment may be short term, that is, to recruit SDP donors to meet the immediate need.[2] This is usually done in most of the centers practicing plateletpheresis. However, without any long-term planning to recruit donors of tomorrow, a culture of voluntary blood donation in the community cannot be developed. Thus, short- and long-term programs should go hand in hand.[2] Such kind of long-term strategies, if incorporated in routine donor motivational programs, will help enlighten the people regarding the procedure of plateletpheresis and also help the transfusion service acquire SDPs from regular voluntary donors when required. As voluntary donors are managed by blood center efficiently, all procedures are done on the same group of donors.

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Conflicts of interest

There are no conflicts of interest.
  2 in total

1.  Voluntary whole-blood donors, and compensated platelet donors and plasma donors: motivation to donate, altruism and aggression.

Authors:  Michael Trimmel; Helene Lattacher; Monika Janda
Journal:  Transfus Apher Sci       Date:  2005-10       Impact factor: 1.764

Review 2.  The collection of platelets by apheresis procedures.

Authors:  T L Simon
Journal:  Transfus Med Rev       Date:  1994-04
  2 in total

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