Unsung Heroes

In many ways I consider our apheresis platelet donors to be our unsung heroes, they give a huge amount of time and effort donating platelets. We currently collect around 70% of our platelets by apheresis and make the rest by pooling the platelets from four whole blood donations. Each apheresis donation provides two or three units of platelets and takes around 90 minutes, donors can donate as frequently as two weekly although most do this monthly. These apheresis platelets are preferentially used for babies, children and young adults and for people who have become ‘resistant’ to platelets.
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The concept of becoming resistant to platelets is interesting and can be hard to treat. This means that the transfused platelets are destroyed by the patient’s immune system before they get a chance to work. It can have a number of different causes and often may occur if someone is very ill with a fever and infection. However if patients become resistant to several units of platelets it might be because antibodies have formed, especially if the person has received a lot of platelet transfusions. These patients commonly have had leukaemia treatment or bone marrow transplants or are multiply transfused for disorders where the bone marrow has failed. The antibodies are usually anti-HLA antibodies which form against antigens (proteins) on the surface of white cells and platelets. ‘HLA’ stands for Human Leucocyte Antigen. When antibodies form then the platelets given to a patient need to be compatible with their HLA type so that they don’t receive any HLA antigens that they don’t already have on their own white cells. Only apheresis platelet donations can be used for these patients.
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For platelets only two of the HLA antigens are important, these are called the A and B antigens and these are inherited as a pair – one set from your mother and one from your father. If both sets are the same then this is termed homozygous, if one of each set is the same and one different this is called half homozygote and if both sets contain different antigens then this is called heterozygote.
Donations from both homozygote and half homozygote donors are very useful as they can be given to a wide range of patients. Only around 1:200 people are homozygote and around 1:7 are half homozygote because there are so many different HLA types. Of patients provided with a complete HLA matched platelet donation around 35% of those are met by our 400 homozygote donors and a further 38% from our 2500 half homozygote donors ie nearly three quarters of requests are met by donations from around a quarter of our donors. So if you are one of these donors then your donations are especially useful as they can be matched to so many different patients – often we know when you are donating and we have already decided who needs your donation.
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There are also similar antibodies that can form against another antigen system called HPA or Human Platelet Antigens. These are most commonly a problem during pregnancy when a mother has a rare HPA type and makes antibodies which destroy the baby’s platelets leaving it at significant risk of bleeding. If this occurs in the baby’s head it can cause serious complications or even life long disabilities. This is called Neonatal Allo-Immune Thrombocytopenia or NAIT. Platelets from people who have this rare HPA type may be used for these babies either whilst they are still in the womb or when just born to prevent these complications.
As part of our aim to let donors know how useful you and your donations are to us we will be writing to donors who are either HLA homozygous or half homozygous to let you know this. So if you receive a letter then you will know that your platelets are particularly useful in the situations described above. We will be putting some FAQs on our website about this too. Most donors who have the rare HPA type should already be aware as we have sent you a leaflet in the past.
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If you haven’t received either of these then it certainly doesn’t mean your donations are not useful. They will just be being used in a different way – as mentioned above, your donations will preferentially be being used for babies, children or young adults or may by chance be a match for someone who requires HLA selected platelets or may simply be used for another sick patient. All will be saving or improving someone’s life. So please continue to donate platelets. If anyone reading this is interested in becoming a platelet donor then please speak to the nurse next time you donate blood for more information. And finally thank you to all of you who donate platelets – you are an especially dedicated and valued group of donors – we couldn’t do the work we do without you.http://www.airjordansneakerretro.com

2 CommentsLeave a comment

  • Hi I give blood platelets at Brentwood blood centre every month they are closing the centre I think it is so wrong as I won’t be able to donate platelets eny more because it’s to far to travel ,I think there should be some where local I can donate blood platelets and save lives

    • David, I am sorry it is now too far for you to donate platelets. However we are increasing the amount of platelets we make from whole blood, so I hope you will be able to continue to save lives by donating blood at a location a little closer to where you live. Thank you for all of your support.

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