Over the last few months people have asked me about donating platelets–the portion of blood responsible for forming clots.  Some people, particularly women, have reported issues with donating platelets because of potential harm to recipients. When a good friend of mine was told a few weeks ago she could not donate, she decided to get some answers. Below is her e-mail question and and response from a physician associated with Blood Center of New Jersey.

Q: Last week, I donated whole blood and asked about donating platelets- I’ve never done platelets before. The nurse at the donation center explained something to me about a halt being put on NEW female platelet donors because of some sort of strain that would negatively affect a patient’s health and that unfortunately there are not the adequate funds given to afford testing to see if a new donor had that in their platelets – it’s a little cloudy – I wanted to learn more about what she meant? Does this seem familiar to you at all?

A: The patient condition you refer to is TRALI, Transfusion Related Acute Lung Injury. It is a rare transfusion reaction occurring in 1 in 5,000-10,000 transfusions. One of the causes—though not the only cause—is presence of HLA antibodies in the donor plasma. These are found in up to 25% of women with three or more pregnancies. In an effort to reduce TRALI nationwide, the AABB asked blood centers to implement strategies to reduce risk. Some blood centers have started testing for these antibodies in all female donors and have deferred positive donors from donating apheresis, some do selective testing whereby they ask various questions about pregnancy history and then test women with three or more, others like us and the American Red Cross accept our current female donors as they have donated multiple times without incident and do not test but don’t accept new female donors.

This is an area of blood banking which is under intensive research.  I would expect that this will change in the near future, probably 2nd quarter of next year. We are expecting FDA licensure of a platelet storage solution which will reduce by 2/3 the amount of plasma that the platelets will be stored in.  When that is available, we will again recruit new female donors for platelet apheresis.

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