[Ravveendrra]

It all started with an excellent thread here : Team BHP Blood donor list. Thanks RTech for that excellent initiative. That thread was immensely useful when a TBHPian needed platelets a week ago.

Blood transfusion has come a long way from the initial days when the only transfusion possible was of whole blood. Over time transfusion medicine developed and only required components were being transfused and whole blood transfusions were reserved for major surgeries, accident and trauma cases etc.

Just a few years ago, whole blood used to be collected from the donor and then seperated into its major components i.e. Plasma, Red Blood Cells (RBC) and Platelets. These components were issued to patients according to their requirements. This process was wasteful as often some components would go waste. Not so now, I was told that systems are in place to collect only platelets.

I was intrigued by the whole process of collecting only platelets and was introduced to Apheresis.

Aphereisis is pronounced a-fur-e-sis. This basically means that only required components are removed from the donor's blood and the balance is returned to the donor. It is an 'on-line' system i.e. the blood is collected from a vein, processed to gather the required component and the balance is returned to the body of the donor, all at the same time.

I have been keen on blood donation ever since a doctor cousin complained bitterly that surgical procedures are being held up and several lives are being lost because adequate blood and blood products are not available. That was twenty years ago and I dutifully did the rounds of the major hospitals in town offering blood. Unfortunately, I was refused. The blood banks in these hospitals flat refused to take blood from me saying "You have a rare blood group, we have a requirement of blood of that group infrequently. If we take and store your blood, it will most probably have to be thrown away after a while once its shelf life is over." The blood banks however were glad to add my name and contact details into their list of donors (computers were rare those days and 'database' was not a term in general currency) so, I went into their registers - mostly the dog-eared variety. I did receive some calls over the years but, it was like once in 5 years. Sudev posted a link to Indian Blood Donors (thanks again Sudev). I registered with Indianblooddonors.com early last week and was pleasantly surprised to receive a call on Thursday asking if I was willing to donate platelets. I agreed and had my first experience of apheresis.

The procedure is quite simple actually. The donor reports at the bank, a sample is drawn from a vein in one arm and sent to the lab to check for suitability, typing, compatibility etc. One can expect the report within an hour.

Once the path-lab gives the go ahead, a vein (preferably in the other arm) is tapped and a needle inserted. An inflatable tourniquet is placed on the upper arm above the needle. A tube from the needle goes into a 'splitter' and three tubes are connected to it. The tubes are led into a machine about the size of a decent sized mini-bar in a hotel room.

The machine has three bags attached to it. One is a bag containing an anti-coagulating agent. One is a bag for plasma and one is a bag for platelets. The tourniquet is inflated and blood from the donor flows into the machine. It helps if the donor spueezes a rubber ball in the hand. A centrifuge in the machine spins and seperates the different components. Plasma (along with RBC, I think) is returned to the donor and platelets are collected in a bag. The tourniquet is deflated and the plasma (+RBC?) is returned to the donor via the same needle. There are several cycles lasting about 15-20 minutes each during which the blood is alternatively drawn and returned back.

The procedure is quite painless except for a little prickling sensation (too mild to be called irritation) in the arm when the blood is pumped back in. The whole process took exactly one hour in my case. I understand that the time taken depends on the blood flow in the donor's body and the platelet count. The maximum time taken being about 90 minutes.

I understand that there is another system/machine in which two needles are inserted, one for drawing the blood out and the other for returning the plasma etc. I wonder which is the newer/better one.

Why Apheresis?

1. For patient:

a. Less 'foreign' substance is introduced into the body hence less chances of rejection, reaction etc.

b. Only required component is transfused enhancing efficacy & efficiency.

c. One unit of platelets contains as many platelets (required component) as 5 units of whole blood!

d. In case of voluntary donations, the platelets are absolutely fresh and from a single donor hence more effective.

2. For donor:

a. One can donate only when necessary.

b. The time between donations comes down drastically. In the case of whole blood donation the minimum time between donations is about 60 days. In the case of platelets the donor may donate after about 5 days.

c. Donor's blood is used most effectively. Blood is a precious component in the body, with Apheresis only that part of it as is required is drawn which means the donor's body suffers least dislocation.

Drawbacks:

1. Time required is generally more than in case of whole blood donation.

2. Cost. The Apheresis machine uses 'single use' components to prevent infection etc. This means that one donation costs between Rs.9,000/- and Rs.14,000/-. Typically this is borne by the donee patient. Not everyone can afford this, especially if frequent transfusions are required.

3. ? Possible reactions etc. esp. from the rubber tubing and anti-coagulants used.


My Doubts:

Are only platelets taken from my blood? Is all of the plasma and RBC returned to my body? This arises from the fact that the returning tube had only a clear liquid in it and the technician removed a centrifuge chamer (disposable) with red in it for disposal. I wonder if the return of RBC is not feasible for some reason.

Bottomline:

Q. Would I do it again?
A. Definitely!

Q. Would I suggest it to others?
A. Forget suggesting it, I would cajole, beg & plead to have more donations.

How to do it?

a. Please get your details on line. Register in the TBHP Blood Donors thread & poll.

b. Register on indianblooddonors.com. If you want you can read about Mr. Khusru Poacha, the founder and sustainer of that site, before you do. I have had the honour of speaking to him this evening when he called me in response to a query I posted on the web-site. I am totally bowled over by this soft spoken gentleman who sounds so humble, sincere and earnest.

c. If your blood belongs to a rare group. Please register yourself with as many blood banks and databases as you can. You may be the only one who can save one patient and conversely one day your life just might depend on getting that rare blood.

I am no expert in medicine, blood transfusions or bio-technology. I have just tried to put down my observations and thoughts on the subject as a lay-man. I am sure this post has several inaccuracies and mistakes. I request and rely on the doctors and other more knowledgeable folk in this forum to correct this thread.

Cheers,

[v1p3r]

Good thread, great intent behind it!

[quickdraw]

I remember that I've donated blood a couple of times. Its a great feeling to help someone out in need and I would not hesitate again if ever called upon. But the machine etc that you were talking about is quite intriguing I am actually going to wiki it a little bit. Gone are the days when it was as simple as O'-' for me

[phamilyman]

Great thread. The only other drawback of apheresis is that you're unable to move for 1.5-2 hours (in my case). Because both hands have a needle, you're unable to either eat, or even move to pee!

[muralisk]

I have been donating for the past 18 years and have never come across blood transfusion. But, I am game for it and I am registered on at least 4 forums and pretty much in all major hospitals in Bangalore. I belong to rare category.

[GTO]

Originally Posted by Ravveendrra

Are only platelets taken from my blood? Is all of the plasma and RBC returned to my body? This arises from the fact that the returning tube had only a clear liquid in it and the technician removed a centrifuge chamer (disposable) with red in it for disposal. I wonder if the return of RBC is not feasible for some reason.

Bottomline:

Q. Would I do it again?
A. Definitely!

Q. Would I suggest it to others?
A. Forget suggesting it, I would cajole, beg & plead to have more donations.

Great thread. Not going to get into the technicalities, but from a layman's perspective:

1. You contribute toward saving a life. Priceless.

2. Zero pain. Someone in the circle was detected with cancer and was in dire need of platelets. I volunteered. The entire procedure was a walk in the park. Medical technology has indeed come a long way.

3. Zero effort. All I did was lie in bed for 120 minutes reading a book.

4. Any side effects? None. Procedure was in the evening and I went out for dinner the same night. Back to work the next day.

Again, this is an opportunity to give so much to someone else, and at such little cost to us (nothing but a couple of hours of time).

[kkr2k2]

Awesome ravs.

Originally Posted by Ravveendrra

.......

Bottomline:

Q. Would I do it again?
A. Definitely!

Q. Would I suggest it to others?
A. Forget suggesting it, I would cajole, beg & plead to have more donations.
......

Sometimes we need to do that also.


I gave platelets to a relative of ours not knowing back then about the importance till a fellow bhpian required platelets. This time I was explained in detail and luckily arun(absynthguzzler) recovered quickly before I could give mine.

Originally Posted by GTO

.....
Again, this is an opportunity to give so much to someone else, and at such little cost to us (nothing but a couple of hours of time).

Thats very true, now I kind feel proud that those two hours is worth some one's life!!!

[sourav9385]

Hey Guys!

Bumping up an old thread. My dad was diagnosed with Stage 3 Bone Cancer(Multiple Myeloma) about 4 months ago. He underwent 3 months of intensive Chemotherapy, and now the doctors have started with the Bone Marrow Transplant process. You can read more about how it's done here.

Currently dad is undergoing treatment at Apollo Speciality Hospitals, Teynampet, Chennai. His blood type is A -ve. He needs blood and platelets from any of the following types - A+, A-, AB+, AB- in Chennai. I have also registered on indianblooddonors.com to check for availability for the aforementioned blood types. If there is anyone on Team-BHP from Chennai with the above mentioned blood types, please get in touch with me at 9840613069/9940123666/044-45145706 anytime. Blood is needed as early as possible.

Thanks in advance for reading this post of mine. Any response to this will be deeply appreciated.

[sudev]

Wish had this posted last week - was in Chennai and would have been glad to do needful.
My best for your Dad's treatment and again bumping this up s more people get to read it and help out.