Platelet Donation

A healthy platelet count ranges from 150,000 to 400,000 platelets/mcl of blood. If someone has a platelet count of less than 150,000, the condition is referred to as thrombocytopenia. On the other hand, a platelet count of more than 400,000 is referred to as thrombocytosis. The platelet count is determined by a routine blood test known as complete blood count (CBC). There are many diseases that are linked to a decreased platelet count. All of these conditions are associated with failure of clot formation which manifests in the form of continuous bleeding. As such, these patients require platelet transfusions.

Following are some medical conditions associated with abnormal platelets or abnormal platelet counts:

Thrombocytopenia: When the bone marrow produces too few platelets or too many platelets are destroyed, the condition is called thrombocytopenia. If the platelet count falls too low than the normal levels, it can cause bleeding beneath the skin which presents in the form of bruises. Low platelet counts can also present in the form of internal bleeding or profuse, continuous bleeding through a cut in the skin.

Many factors can give rise to thrombocytopenia including several medications, liver disease, infections, pregnancy, and abnormal immune system.

The signs and symptoms of thrombocytopenia include:

• Purpura— excessive or easy bruising
• Superficial bleeding into the skin appearing in the form of a pin-point sized rash, usually on the lower limbs
• Bleeding from the nose or gums
• Prolonged bleeding from cuts
• Blood in stools or urine
• Fatigue
• Unusually heavy menstrual flows
• Enlarged spleen

If you notice signs and symptoms of thrombocytopenia that worry you, you must see a healthcare provider. If bleeding does not stop, it is a medical emergency. You must seek immediate help for bleeding that can’t be stopped by first-aid techniques.

• Essential thrombocythemia
  It is a condition in which the bone marrow produces an excessive amount of platelets. Those having this condition may have a platelet count more than 1 million. This results in bleeding as platelets are being used to form clots and there is also a presence of abnormal platelets. Other symptoms of this condition include blood clots forming and blocking blood supply to the heart or the brain. The exact cause of this type of thrombocythemia is not known. However, changes in the cells of bone marrow are known causes of some cases.
• Secondary thrombocytosis
  This condition is also caused by an excessive number of platelets. It does not occur due to a problem with bone marrow, rather the bone marrow is stimulated with another condition or disease to produce more platelets. Causes of secondary thrombocytosis include anaemia, infection, certain cancers, inflammation, and reactions to medications. Symptoms are usually not that severe as people with this type of thrombocytosis have a lower risk of bleeding and blood clots than those who have essential or primary thrombocythemia. When the condition causing secondary thrombocytosis gets better, the platelet count also returns to normal levels.
• Platelet dysfunction
  Poor platelet function is associated with many rare diseases. In this condition, the platelet count is normal but the platelets are not able to function normally. Certain medications such as aspirin can give rise to this condition.
• Trapped platelets
  The spleen is a small organ that is located on the left side of the abdomen beneath the rib cage. It normally works to filter unwanted waste materials from the blood and fight against infections. Enlargement of the spleen can occur due to a number of disorders. An enlarged spleen harbours too many platelets, decreasing the number of platelets in the bloodstream.

Decreased production of platelets

Platelets are produced in the bone marrow. There are certain factors which contribute to decreased platelet production, including:

• Some types of anaemia
• Leukaemia and other cancers
• Chemotherapy drugs and radiation therapy
• Viral infections, such as hepatitis C or HIV
• Increased breakdown of platelets
• Heavy alcohol consumption

Certain conditions can make the body destroy platelets or use them up faster than they are produced. This causes a shortage of platelets in the bloodstream. Following are examples of such conditions:

• Pregnancy
  Pregnancy causes thrombocytopenia. It is usually not severe, and improves immediately post-parturition.
• Immune thrombocytopenia
  This type of thrombocytopenia is caused by autoimmune diseases like rheumatoid arthritis and systemic lupus erythematosus. The immune system of the body mistakenly attacks the platelets and destroys them. If the cause of this condition is unknown, it is referred to as idiopathic thrombocytopenic purpura. It is more common in children.
• Bacteria in the blood
  Some bacterial infections that affect the blood lead to the destruction of platelets.
• Thrombotic thrombocytopenic purpura
  It is a relatively rare condition that develops when tiny blood clots suddenly form all through the body, using up platelets in large numbers.
• Hemolytic uremic syndrome
  This rare disorder results in a sharp decrease in the platelet count, red cell destruction, and symptoms of kidney failure.
• Medications
  The number of platelets in the blood can decrease due to certain medications. The immune system is sometimes confused by drugs, so platelets are destroyed.

Complications of low platelet count

When the platelet count falls below 10,000 platelets per microlitre, it gives rise to dangerous internal bleeding. Although it is rare, severe forms of thrombocytopenia can cause life-threatening bleeding in the brain.

Following are some eligibility criteria for Single Donor platelet donation:

• The donor should have prominent veins on both arms.
• The donor should preferably be a repeat donor, that is, he might have given blood 1-2 times before.
• The donor should be aged between 18 to 55 years.
• The donor’s weight should be more than 55 kgs.
• Haemoglobin level of the donor should be at least 12.5 g/dl.
• Platelet count should be more than 1.5 lakhs per microlitre.
• Time interval between two successive platelet donations should be at least one week. An individual should not donate platelets more than twenty four times in a year.
• A platelet donor should not consume oily food prior to platelet donation.

Following are some eligibility criteria for blood donations:

• Minimum weight of the donor should be 55 kg
• The haemoglobin level should be at least 12.5 gm%
• Age limit for blood donation is 18 years to 65 years.
• Time interval of three months is necessary between two successive blood donations.
• The donor should have sufficiently eaten before blood donation.
• A voluntary blood donor should be free from any infectious disease before donating blood.
• He should have no history of any heart or lung disease or a seizure disorder.
• He should disclose the details of any medication he is currently taking to the medical officer before donating blood.
• He should avoid strenuous work or long driving post blood donation.
• Exact platelet count, haemoglobin level, and haematocrit should be checked before donation. Platelet count should be 150,000 per microlitre of blood or more.
• Donors should screen negative for transfusion transmitted diseases like malaria, Hepatitis B & C, HIV, and Syphilis.

Screening of the donor for platelet donation

The donor for platelet donation also undergoes a haemoglobin screening just like a blood donor does. A confidential medical history is taken and a physical examination is performed to check the vital parameters of the donor including blood pressure, temperature, pulse rate & haemoglobin level. Blood samples are collected from the donor and sent to the laboratory for some investigations including triple serology, complete blood count, and screening for malaria. The results are valid only for 7 days to 1 month. If platelepheresisis takes place after one month, the donors are tested again for the above parameters.

Some facts a platelet donor should know:

• One must not smoke before platelet donation.
• The donor should stay away from oily rich/ fatty foods prior to donation.
• Avoid aspirin for 72 hours prior to donation.
• For serial plateletpheresis the interval between two procedures should be at least 72 hours.
• A donor can donate platelets for a maximum of 24 times in a year or two times in a month.

By donating platelets, you can have an immediate and powerful impact on the life of a cancer patient. Your platelets are transfused to a patient within a week and they could play a major role in keeping them alive. Platelets are mostly used for cancer patients, but also help patients with undergoing open-heart surgery and organ transplants or blood disorders. Because platelets need to be transfused within a week of collection, platelet donors are constantly needed to keep the supply stable.

If you are looking for a centre for platelet transfusion in Indore, you can visit the Blood Centre and Transfusion Medicine Department at Kokilaben Dhirubhai Ambani Hospital, Indore and seek help. Our department is equipped with state-of-the-art infrastructure and advanced medical instruments. Our staff members are highly qualified and experienced and deliver all services with utmost care and professionalism. International protocols and quality standards are followed during all the procedures. You can also visit our team for platelet donation in Indore.