What are platelets?

Blood ties

The monsoon doesn’t only bring respite from the heat, it also brings a host of diseases like malaria and dengue. Platelet transfusions are essential for the treatment of such cases. But a lack of awareness in Mumbai means platelets are in short supply

Thirteen years ago Patna-resident Sanjeev Sharma brought his son Vikas to Mumbai for treatment of blood cancer. Sanjeev had to run from pillar to post to acquire platelets that his son needed while undergoing chemotherapy at the Tata Memorial Hospital (TMH) in Parel.
“The drugs used in chemotherapy suppressed my son’s bone marrow to such an extent that he could not produce platelets in his body,” recalls Sanjeev. Platelets are cell fragments that help plug holes in the blood vessel. They help blood clot and prevent excessive bleeding. A dip in platelet levels in the body can lead to excessive bleeding and death.
In 2004, Vikas succumbed to the blood cancer. Sanjeev was a shattered man, but also a man with a mission: From then on, he took it upon himself to become a platelet donor at TMH.
Since 2010, he has donated platelets 35 times. “ I decided to stay in Mumbai after Vikas died,” said Sanjeev. He runs an NGO Sadbhavna Kendra that helps relatives of cancer stricken patients platelets.
While voluntary platelet donors are few, thousands of relatives of patients throng hospital corridors in the hunt for platelets. Mumbai requires up to 700 units of blood including separate components such as packed cells, platelets and plasma for planned surgeries, emergency accidents, malaria (especially falciparum) and dengue. As the monsoons pick up, hospitals will soon start seeing at least 15 to 20 malaria cases in a day. Of these, doctors say, five may require platelet transfusion. “Not more than 50 ml of platelets can be extracted from one unit of blood. If enough donors don’t volunteer and donate single donor platelets (SDPs) through apheresis technique then we have to convince relatives to donate,” said Dr Anita Tendulkar, associate professor, department of transfusion medicine at TMH.
The TMH apheresis section, houses four machines. Donors spend an hour or two on the machine. “A donor sits on the apheresis machine. Blood from the arm of the donor goes into a blood separator and the platelets get extracted from the blood after which the blood returns to the body,” explains Dr Puneet Jain, resident doctor. Apheresis is a process in which only one part of the blood, i.e. platelets are extracted. While acquiring platelets from a large number of random donors is not possible during emergencies, experts suggest that single donor platelets (SDPs) need to be tapped. “In the SDP method, one platelet donor donates platelets equivalent to six to eight blood donors. SDPs are safer for transfusion as chances of contamination are less,” said Vinay Shetty of non-profit, Think Foundation. On an average, TMH doctors manage to rope in 60 to 70 voluntary donors in a month while numbers of patients requiring platelet transfusion after surgery or chemotherapy roll into more than hundred. “Our donor hunt continues on a daily basis and we appeal for more donors to come as the city’s demand for platelets is far more than the supply,” said Dr Tendulkar.
Shetty says that patients have to pay for extraction and processing charges of platelets even if the platelets come from voluntary donors. This ends up burning a hole in their pocket. Each bag of SDP contains 300 ml of platelet and can cost anywhere between Rs5,000 to Rs8,000.
Praful Panda, 46, has had transfusions of 10 platelet bags since he was admitted to TMH for blood cancer. “Each bag costs us Rs 5,900, even after subsidy from the hospital. We had to arrange for five to six relatives to donate platelets as my husband requires transfusion twice a day after chemotherapy,” said Praful’s wife Sasmitha.

What are platelets?
Platelets, red cells, white cells and plasma are primary components of the blood
Platelets are cell fragments that help plug any holes in the blood vessel, acting in combination with other factors in the blood, such as fibrin, during clotting to prevent excessive bleeding
Normal person has between 1.5 – 4 lakh platelets in the body
Dip in platelet levels below 7,000 can lead to excessive bleeding and death
People suffering from blood cancer, aplastic anaemia, dengue or malaria require only platelets to be transfused which can prove to be life saving
Very few know that platelets can be donated through a procedure known as plateletpheresis or apheresis
While blood can be donated only four times a year, platelets can be donated up to 24 times a year

Why should you donate?
When the demand is more and the supply is less
Hardly 30% of city’s platelet demands are met through SDPs. The rest of the 70% is met through donations made by relatives or by extraction of Random Donor Platelets (RDPs) from whole blood bags.

The platelet donation process is very safe as the entire process is mechanised under sterilised condition with bare minimum manual intervention.

There are no side effects except that a donor might feel a slight chill during the process. It is a normal reaction to the blood anti-coagulant.

The donor does not have to incur any expenditure while donation. In fact, the hospital voluntarily spends Rs10,000 on the disposable kit, which is used on apheresis machine every time a person comes forward to donate.

How To become a donor?
Any person between 18 – 50 years can become a donor

You should be healthy with no major disease

The doctor shall evaluate an individual’s fitness

Eat iron rich foods like spinach, ragi, jaggery, dates to raise HB levels

Maintain blood HB levels above 12.5 gm/dl and body weight above 55 kilos

Enroll in a platelet donation registry. Contact TMH’s Department of Transfusion Medicine on 022-24177000 ext- 4681 for queries on donation and registration as donor or Think Foundation on 022 – 65181341/