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Old 03-23-2020, 01:09 PM
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Blood donation - whole blood, platelets, or power red?


Years ago when I first started donating blood regularly, the donation center encouraged me to donate platelets, and that's been my only method of donation since. The facts: a single apheresis donation provides as many platelets as 5-6 whole-blood donations (and I typically do a double dontation), platelets last only 5 days versus ~40 days for whole blood so a steady supply is needed, they are critically needed for patients with low platelet counts (a common effect of cancer treatment), and because donation takes longer and you're mostly immobile, it's harder to get people to donate. And selfishly - you think you're treated like royalty for a regular donation? Try platelets. It's like sitting on your throne while your personal servants fan you and feed you grapes, except it's blankets and a juice box.

Now I'm wondering how much more they really like platelet donors. I'm not looking for an answer to what I personally should donate, because that depends on a lot of factors: regional need, current shortages, blood type, etc. I'm just curious about usage of the various components: things like how many units of whole blood versus platelets versus red blood cells are used each year, and how does that compare to what is donated? How many units of whole blood are processed to extract platelets or red blood cells? How many units of platelets or whole blood typically expire?

I've seen the stat that 2 million units of platelets are transfused in the U.S. each year, and someone in the U.S. needs platelets every 15 seconds. I'm looking for additional facts that help put that into context.
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Old 03-23-2020, 02:07 PM
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What's your blood type? That may be a relevant consideration in terms of what's best.

Another point in favor of platelets, though, is that many women who have been pregnant can't donate them even if they could donate whole blood.
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Old 03-23-2020, 06:16 PM
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I'm O+, which means I'm useful for any donation type except plasma. But I'm asking more because I'm curious about how often the different blood components are used, not to help me personally decide.
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Old 03-23-2020, 07:45 PM
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Back in the 90s I went in to donate blood and was asked if I'd be willing to donate platelets instead. In addition to being O+ it turns out that there's something about my blood that allows it to be used for newborns so they were eager to take as much as I was willing to give. I donated regularly for a number of years, including one time when I was set up for directed donations for someone who was getting cancer treatments. Unfortunately, I can no longer donate due to a liver condition.
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Old 03-24-2020, 08:16 AM
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I don't know about platelets, but I think that the only benefit to a power red donation is that you can donate the same number of red cells in half as many visits. The hard part of getting people to donate is over once they walk through the door of the donation center, but they have no guarantee of when you're next going to walk through the door. So they want to get as much out of that one visit as possible. But if you know that you're going to be able to keep that 8-week schedule, then whole blood is just as good for the red cells, and better for the plasma and platelets.
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Old 03-24-2020, 08:27 AM
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Originally Posted by LurkMeister View Post
Back in the 90s I went in to donate blood and was asked if I'd be willing to donate platelets instead. In addition to being O+ it turns out that there's something about my blood that allows it to be used for newborns so they were eager to take as much as I was willing to give. I donated regularly for a number of years, including one time when I was set up for directed donations for someone who was getting cancer treatments. Unfortunately, I can no longer donate due to a liver condition.
You are CMV Negative:
""CMV negative" means you have never been infected with cytomegalovirus. For most people with healthy immune systems, infection with CMV or not is usually of little consequence, but people with damaged or immature (like newborns) immune systems are susceptible to life-threatening CMV infection." (from a Google search)

I am, or was, the same way and donated platelets on a regular basis for about 11 years.
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Old 03-24-2020, 09:18 AM
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You can donate platelets every seven days, up to 24 times a year. You can do this in and around your whole blood donations, which are every 56 days.

Platelet donations are a longer process, about two hours, and cannot be done on a bloodmobile because of the length of time to donate and the size of the equipment.

I would say check with your donor branch to see what is needed. Because of the length of time it takes to donate they can only take a certain number of platelet donors a day and the platelets only last five days, so there's pretty much a constant need.
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Old 03-24-2020, 10:11 AM
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Is platelet donation the one where they put stuff back into you? I have no problem donating whole blood, and do so, but I am squicked out over the thought of having a machine take something out and giving me back the remnants.
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Old 03-24-2020, 11:00 AM
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Platelet and power red donation both work by "putting stuff back into you". As for whether that's worthy of squicking, that's a matter of opinion, and hence not worthy of GQ.
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Old 03-24-2020, 11:29 AM
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Originally Posted by BwanaBob View Post
Is platelet donation the one where they put stuff back into you? I have no problem donating whole blood, and do so, but I am squicked out over the thought of having a machine take something out and giving me back the remnants.
Yes. I've only been hooked to the machines that take it from one arm and return it in the other, although I understand some machines remove and return blood in the same arm.

Needles overall squick me out, so the idea of a return trip isn't really any worse for me. Both arms are covered by blankets so you don't see what's happening. And beyond the benefit of being treated like royalty, it doesn't leave you light-headed and tired out like a whole blood donation.
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Old 03-24-2020, 12:28 PM
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Yes. I've only been hooked to the machines that take it from one arm and return it in the other, although I understand some machines remove and return blood in the same arm.

Needles overall squick me out, so the idea of a return trip isn't really any worse for me. Both arms are covered by blankets so you don't see what's happening. And beyond the benefit of being treated like royalty, it doesn't leave you light-headed and tired out like a whole blood donation.
We have probably crossed paths at the donation center in PDX. I'm B+, so they were happy to have my type for platelet donations instead of whole blood.

I used to get the one arm treatment. I preferred it because I can scratch my nose during the donation. I don't feel right asking them to do it during a two arm donation.
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Old 03-24-2020, 02:10 PM
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Everything I've read indicates all whole blood donations are separated into components. And your donation probably isn't traveling very far. So your question as to "how much more they like platelet donors" is inseparable from the factors you dismiss. It's like trying to decide whether to cook pork or beef for a group of refugees, and saying you don't want to talk about cultural differences and how they affect what people eat; you just want to know which meat gets thrown out more often.


I did find this interview with a blood donation coordinator in India:
Quote:
The demand is most for red blood cells, less for platelets, and least for plasma.
https://www.google.com/amp/s/amp.scr...r-blood-donors


By contrast, this article talks about platelets being "needed more" than other blood components. However, that was in the context of a brief but catastrophic interruption in donations due to the polar vortex last year, which disproportionately affected the platelets supply due to their shorter shelf life:
Quote:
The record cold exposed a key problem underlying our nation’s blood donation system. It relies exclusively on volunteer donors to provide blood for transfusion. But bad weather routinely keeps potential donors away — as do good weather and holidays.


That means we are constantly dealing with shortages of lifesaving blood components. Platelets are needed more than others because they are so perishable. Red blood cells that carry oxygen can be refrigerated and used for up to 42 days. Plasma, the straw-colored liquid that carries cells, can be frozen for as long as a year. But platelets — the Band-Aids of the body that stop bleeding — have a shelf life of only two days after they are screened for disease.
https://www.statnews.com/2019/02/28/...ew-approaches/


But that short shelf life means also means platelets can go to waste. Estimates of wastage vary widely bit there does seem to be consensus that platelets are most likely to go bad before being used:
Quote:
Because of spoilage, more than 25 percent of all platelets taken from donated blood must be discarded.
http://www.nbcnews.com/id/3077012/ns...elets-doubled/


Quote:
Maintaining a robust blood product supply is an essential requirement to guarantee optimal patient care in modern health care systems. However, daily blood product use is difficult to anticipate. Platelet products are the most variable in daily usage, have short shelf lives, and are also the most expensive to produce, test, and store. Due to the combination of absolute need, uncertain daily demand, and short shelf life, platelet products are frequently wasted due to expiration.
[...]


Therefore, a common strategy employed by many blood centers is to aim for an expiration rate of 8 to 9%, with 2 million units transfused annually and the outdated rate for apheresis platelets in 2013 being 11.0% of total units produced (6), effectively producing a surplus buffer so as to always have enough platelet units on the shelf for unanticipated patient demand.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5664553/


Quote:
Abstract
Objectives:
Blood component waste is an important issue at all hospitals. As an initiative of the patient blood management program at a regional health care system, the causes and extent of blood product wastage were identified, and targeted interventions to effect a reduction were implemented.


Methods:
Multiple low-cost interventions, including educational outreach, print and digital messaging, and improved transportation and component identification modalities, were implemented beginning in January 2013. The impact on reducing RBC, platelet (PLT), and plasma wastage in the 16 months after intervention implementation was compared with the wastage rates in the 16 months before these interventions had been implemented.


Results:
Overall, the RBC wastage rate as a percentage of the number of units issued decreased from 0.67% to 0.56% (P = .001) after the interventions were implemented, while the PLT wastage rate decreased from 3.71% to 2.81% (P < .001). The plasma wastage rate increased from 1.14% to 1.40% (P < .001).
https://academic.oup.com/ajcp/article/143/3/329/1766348


The Southern California Blood Bank takes a very needs-based approach:
Quote:
As more and more of our blood donors are giving more often, the supply of red blood cell donations has improved. As a result the Southern California Blood Bank is now working to improve the supply of other blood components, specifically platelets and plasma. At the same time, the blood bank is also working to manage its red cell inventory by collecting a consistent amount in each type.


So the next time you come to the Southern California Blood Bank, you may be asked to change your typical whole blood donation to a platelet/plasma donation. Platelets, in particular, have a lifespan of only five days, so these products are always needed.


If you are asked to make a different type of donation, it means that there are hospital patients that have a specific need for these components in your blood type. It may also mean that the Southern California Blood Bank has an adequate supply of red cells in your blood type, but is critically low in other blood components that you can give.


In addition, there may be times when you are planning to make a double red cell donation, but are asked instead to make a whole blood donation. That means that the supply in your blood type is not critically low, and that we want to invite you back in 8 weeks, instead of 16, when your blood type will be needed again.


During the summer months or around the holidays, we may also ask you to give double red cells instead of whole blood because we are seeing the blood supply begin to decline in your type.
https://scbloodbank.org/donors/best-donation-you


The important thing, if you want your blood to go to use, is not to jump on the bandwagon and try to donate after a disaster: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC128413/
https://www.healthline.com/health-ne...canes-shooting


But also, those personal factors are valid. You feel fatigued after donating whole blood, but not platelets? That's a great reason for you to donate platelets, then. I feel great after donating whole blood, and my O+ type and hectic schedule means that makes sense for me. Someone else feels squicked about having some blood parts put back? Also a totally valid reason to donate whole blood. The most important thing is getting more people to donate, and getting them to donate more frequently. People are more likely to do that if encouraged to do so in a way that works for them.
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Old 03-24-2020, 04:23 PM
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Thanks, Esprise Me, all very interesting info. I'm surprised whole blood is always separated. Maybe the Hollywood scene of the blood bag hanging above the trauma victim is too ingrained in my head.
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Old 03-24-2020, 06:42 PM
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My mom says that she actually feels more fatigued after donating platelets than after donating whole blood. I've no idea what the mechanism could be for that, or if it's just psychosomatic, but even if it is psychosomatic, it's still what she feels.
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Old 03-25-2020, 12:53 PM
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Maybe the Hollywood scene of the blood bag hanging above the trauma victim is too ingrained in my head.
Generally, those blood bags aren't whole blood.

Quote:
This whole blood is not typically transfused unless the patient needs a massive amount of blood to counteract tremendous blood loss. Instead, packed red blood cells, which is whole blood minus the plasma portion, is typically given.
https://www.verywellhealth.com/packe...d-rbcs-3156963
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Old 03-25-2020, 01:51 PM
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My blood center likes me to give platelets.

Unfortunately, I failed the last three times. Twice the return wouldn't work (single needle), the last time I switched arms for luck and then they couldn't get any out after the initial draw to check my count went fine.

I may go back to whole blood after one more platelet try.
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Old 03-25-2020, 06:13 PM
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I've got a Friday appointment. When they asked what type I wanted to donate I gave them "dealer's choice" and they selected Power Red, a double red cell donation. Whether it's because they really need the red cells or because they're spacing out the donors because of the COVID-19; I don't know. I didn't want to question them on the telephone, I'm hoping they were busy.
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Old 03-25-2020, 11:34 PM
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My mom says that she actually feels more fatigued after donating platelets than after donating whole blood. I've no idea what the mechanism could be for that, or if it's just psychosomatic, but even if it is psychosomatic, it's still what she feels.
Try Tums during and after, an apheresis machine eliminates a bunch of calcium from your blood to keep it from clotting while going through the machine. The Calcium Carbonate gives quick relief. Not a big deal during the short time of double red, but platelet is much longer, and eliminates more Ca2+.
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Old 03-26-2020, 10:56 AM
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Now I'm wondering how much more they really like platelet donors.
In my case, they like platelet donors three times more. My local blood bank gives points for each donation, which you can redeem for gift cards or other items. Regular donations earn 100 points. Platelet donations earn 300.
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Old 03-26-2020, 12:23 PM
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Originally Posted by Hirka T'Bawa View Post
Try Tums during and after, an apheresis machine eliminates a bunch of calcium from your blood to keep it from clotting while going through the machine. The Calcium Carbonate gives quick relief. Not a big deal during the short time of double red, but platelet is much longer, and eliminates more Ca2+.
I like ice cream after platelet donation. Calcium and pleasure.
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Old 03-26-2020, 01:29 PM
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Like many older women, Mom already has a hard time getting enough calcium. Just sticking with whole blood might well be the best choice for her.
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Old 03-28-2020, 09:10 AM
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At yesterday's blood donation a sign had been posted asking donors with O+, O-, A-, or B- blood types to donate a Power Red if possible. I did the Power Red. Pretty quick and easy, but I've done them before and never had a problem. I do get a little tingling from the citrate reaction but knowing what to expect I'm not bothered by it.
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Old 03-29-2020, 10:51 AM
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You are CMV Negative:
""CMV negative" means you have never been infected with cytomegalovirus. For most people with healthy immune systems, infection with CMV or not is usually of little consequence, but people with damaged or immature (like newborns) immune systems are susceptible to life-threatening CMV infection." (from a Google search)

I am, or was, the same way and donated platelets on a regular basis for about 11 years.
Yes, you have "baby blood". Very very important blood during disasters since while it is critical for newborns, it can be quickly used by a lot of people who normally have complications.
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Old 03-29-2020, 02:45 PM
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As I had said before, I've been told I can no longer donate blood due to a combination of persistent anemia and fatty liver disease. (In fact, three weeks ago I had to go in and get an infusion of red blood cells because my blood iron count was so low.) I'm assuming this also means that I can no longer donate platelets; I hadn't thought to ask about that.
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