Five-fold increase in demand for platelets in October; indiscriminate use suspected

Blood banks in the city have been under duress to meet the unprecedented demand for platelets for the last one month, brought about by the requirement for platelet transfusions for dengue patients. While the handful of private blood banks with platelet separation facility have been able to meet only 50-80 per cent of the total requirement, the government blood banks continue to borrow platelets from medical college hospitals in Thanjavur and Madurai.

Maintaining platelet count

Drop in platelet count is an indication associated with dengue. Platelets are components of the blood essential for clotting. In the case of very low platelet count, bleeding may occur. Platelet transfusion is given for patients with various conditions including cancer.

Hospitals prescribe platelet transfusions for dengue patients to boost the count. “Calls requesting blood donation have increased three fold in the last once month. It is difficult but with volunteers, we are managing to supply the demand,” says Srinivasa Thatham, chairman, blood donation sub committee, Red Cross, Tiruchi. As there is no facility to extract platelets directly from the donor’s blood, whole blood donations are required by relatives and friends of patient for transfusion. Platelet transfusions are not blood group-specific.

The demand for platelets by hospitals has gone up five or six fold, said the three of the six or so licensed city blood banks with blood component separators to The Hindu . The average demand in two of these banks for platelets was around 120 units a day. “This is the record for the highest requirement for platelets,” said the manager of a blood bank that supplied more than 2,000 units of platelets in a month.

Another major blood bank had supplied 600 units in a month. Yet, the percentage of platelet units the blood banks are able to meet varies from 50 to 80 per cent.

Indiscriminate use

Indiscriminate platelet transfusions may be the reason behind the increased demand, believe some health professionals. Normal platelet count for individuals may range within 1.5-4 lakh. Senior government doctor cites the World Health Organisation guidelines to stress that platelet transfusion are unwarranted unless platelet count drops below 20,000. Transfusions are required for platelet count of 50,000 to 1 lakh only in the case of bleeding.

But transfusions are being done even here when count is between 60,000 to 1 lakh, note healthcare professionals. “It is of utmost importance to monitor platelet count of patients with dengue symptoms regularly. But there is no need to give transfusions for every dengue patient unless the count falls below 20,000 or rapidly declines in certain cases or the patient develops complications,” says a senior pathologist at GH.

Blood donations–the answer?

Are blood donation camps the answer to meet the demand? But pathologists and blood bank personnel disagree. “A blood camp does not make much sense as the shelf life of platelets is five days,” says a pathologist. “Platelets can be separated only from fresh blood within four hours of collection. Platelets cannot be separated from blood stored in the blood banks as the temperature is around 2-6 degrees, where platelets die. Platelets are stored in an incubator at 22 degrees. Time is a factor as separating four units of platelets takes one hour.

As eight units of blood are required to extract one unit of platelets, other life-saving blood components may go waste if a mass donation camp is done, they note.