With a spike in the number of dengue cases across the country, the demand for platelets and its donors has gone up. A common feature of dengue cases is a decline in the body’s platelet count, which then must be countered through transfusion of platelets collected through donation.
Platelets are the body’s cells which are responsible for arresting blood. In a procedure known as plateletpheresis, a device called apheresis machine is used to collect platelets from donors by separating them from other components such as fluids and red blood cells which are then given back to the donor.
What are platelets?
Dr Kirti Sabnis, Infectious Diseases Specialist, Fortis Hospital Mulund & Kalyan says that platelets are cells in our blood that carry an important function that is blood clotting.
“When we experience a cut, after some time, you may notice that the blood stops oozing. This process is very important, otherwise we lose a lot of blood volume – this work is done by platelets,” says Dr Sabnis.
Why do platelets decline during viral infections?
In case of a viral infection like dengue, a decline in platelets occurs because the virus affects the body’s cells responsible for producing platelets. As a result, they produce symptoms such as bleeding gums, bleeding from the nose, bleeding while coughing and vomiting etc.
However, the major use for platelets happens in case of cancer patients undergoing chemotherapy, those with certain blood disorders and undergoing major surgeries and organ transplant procedures, says Dr C Shivaram, consultant and head, transfusion medicine, Manipal Hospitals, Bangalore.
Dr Shivaram says that in cases of dengue, platelet transfusion must be carried out only if there is evidence of bleeding.
“If there is any bleeding, for instance, gastrointestinal bleeding, the person may be passing blood in stools, or mucosal bleeding, the person bleeds from the mouth – only then the platelet transfusion is recommended,” says Dr Shivaram, adding “If you were to give platelets to a dengue patient, it doesn’t mean it stays in their body for a long time. They get destroyed very quickly. All clinicians and those managing blood banks know this fact. Hence, platelet usage in dengue cases has come down significantly.”
According to Dr Shivaram, physicians today desist from platelet transfusions in dengue cases unless the platelet count is extremely low around 10,000/microlitre of blood. He recommends drinking plenty of fluids during viral fevers and implementing mosquito control measures to protect yourself against dengue.
Who can donate platelets?
Dr Shivaram says that to donate platelets, one must have a haemoglobin level equal to or greater than 12.5 g/dl (men or women) in addition to a minimum platelet count of 1.5 lakhs/microlitre of blood.
According to the American Red Cross, the ideal blood types for platelet donation include A positive, A negative, B positive, O positive, AB positive and AB negative.
According to the UK National Health Service (NHS), you cannot donate platelets if you have most types of cancer, or are HIV positive, HTLV (human T-lymphotropic virus) positive, are a Hepatitis B or C carrier, have had or are being treated for syphilis, have ever injected or being injected with non-prescribed drugs such as body-building drugs, injectable tanning agents etc.
Platelet donor eligibility criteria
The criteria for platelet donation is similar to that of blood donation such as the donor’s age must be between 18-65 years, not suffering from any infection, in good health, no consumption of alcohol previous night, avoiding smoking half an hour before and after donation, and not to donate in empty stomach. Besides, the willing donor must have blood pressure less than 140/90 mm Hg with or without medication with no change in medication dose in the last one month.
How platelet donation or plateletpheresis works
Bhoopendran V (61), an entrepreneur and frequent platelet donor from Bangalore, says that when one goes in for platelet donation, they will have to undergo a Complete Blood Count (CBC) test in addition to getting their blood pressure checked out.
“If the tests show that you are medically fit and if you qualify to be a whole blood donor, then you will be connected to the machine that draws your blood,” says Bhoopendran.
“This process will take about one hour and we might keep the patient at the facility for another 15 minutes and we give them a post-donation certificate and post-donation advice,” says Dr Shivaram, adding that the donated blood components are later in the day also tested for transmissible infections such as HIV, hepatitis B & C, Syphilis and malaria.
Dr Shivaram adds that in some cases, people prefer to do some rapid testing to make sure the donor tests negative for HIV, hepatitis and HCV and then only connect him/her to the apheresis machine.
How to prepare for a platelet donation?
Vinod Nirikhi (37) an IT professional and frequent platelet donor from Bangalore recommends getting a good night’s sleep the day before going in for a platelet donation.
“Post donation, since I am used to it, I’m able to go about my daily routine as usual. The only thing I keep in mind is to not lift any weights. However, some people, especially people who have not donated platelets before, may feel dizzy since fluids are administered back to the donor during the process. I would recommend keeping yourself hydrated by drinking plenty of fluids,” Nirikhi tells Happiest Health.
Alphonse Kurian, chairman of the blood donation committee of Lion’s Club, Sanjaynagar, Bangalore, says that since platelet donation is an entirely voluntary exercise, providing small incentives like free parking can help motivate more people to donate.
Kurian encourages all eligible donors to walk into the nearest blood bank to check if there is a shortage of platelets and donate.
Bhoopendran says it makes him feel good to know that the platelets that he donates ends up being helpful for a lot of people who are suffering from serious illnesses such as leukemia, dengue and people who have undergone significant trauma.
Dengue, a vector borne infection causes decline in platelet levels. If the platelet declines to extreme low levels, like 10,000/microlitre of blood, platelet transfusion is suggested. During platelet donations, platelets are separated from other components which are then given back into the donor. One must have a haemoglobin level equal to or greater than 12.5 g/dl and a minimum platelet count of 1.5 lakhs/microlitre of blood to donate platelets.