What is apheresis?
Apheresis is used for the collection of donor blood components (such a platelets or plasma) as well as for the treatment for certain medical conditions in which a part of the blood that contains disease- provoking elements is removed. Apheresis is also called pheresis or hemapheresis.
What are the types of apheresis?
- Platelet
- plasma
What are the indications for platelet apheresis?
Normal platelet count is 150 to 400 X 109/L. Low platelet count due to dengue infection, haematological malignancy, platelet function defect or any other cause requires platelet transfusion. The patient may need either random donor platelets or single donor platelet transfusion.
What are the benefits of single donor platelets?
- Exposure to random donor is limited. Only single donor exposure. Less risk of developing platelet
- Family needs to provide only one group specific (blood group should be that of patient to whom platelets will be transfused)
What is required by the referring physician?
- A request slip mentioning patient’s clinical details and indication for
- Number of mega units
- Should it be group specific or
What kind of donor is required?
- Donor weight of at least 110
- Prior to the first donation, collect a sample for a platelet count (should be > 200 X10E9/l).
- Apheresis from donors who have ingested platelet inhibitory drugs 7 days prior to the procedure should be deferred as it inhibits platelet
What is the donation frequency?
A donor should undergo no more than 24 platelet apheresis per year. The interval between each collection of platelets apheresis should be at least two days with no more than two procedures in a seven-day period.
What is the process for appointment and its timings?
A donor who is non-reactive for TTIs and has platelet count >200 X10E9/l is given an appointment for the procedure on the basis of availability of apheresis instrument as well as priority of platelet requirement for the patient. It can also be performed on emergency basis.
Timings are from 10 am to 10 pm, Monday to Saturday.
What is the procedure of platelet apheresis and instructions for donor?
- The donor should lie comfortably on apheresis chair / bed in a specific donor room and undergoes the procedure which usually takes 2-3
- Donor should rest for half an hour post
- He/she should take plenty of fluids in next 48
Who are the contact person for information?
Dr Azizuddin Qamruddin, Director Blood Management Department, Fatimid Foundation.
In case of his non-availability, Dr Akbar Najmuddin or Mr. Talat Iqbal can respond to your queries.
Contact number: +92-21-32225284, 32253323
What is Hydroxyurea?
It is an anti-metabolite. It reduces cell count in Haematological malignancies. It causes HbF augmentation.
What are the indications?
It is indicated in thalassemia Intermedia and sickle cell disease.
Do all patients who are prescribed Hydroxyurea require XMN1 polymorphism?
– Yes they do.
Who respond to Hydroxyurea?
Patients with the following mutation respond:
– XMN1 Polymorphism +/+
Who may or may not respond?
– XMN1 Polymorphism +/+
Who don’t respond?
– XMN1 Polymorphism -/-
Do thalassemia major patients have XMNI polymorphism +/+?
Only 3% of thalassemia major patients are XMN 1 +/+
How do you determine response?
– Thalassemia Intermedia:
Patients with Thalassemia Intermedia will have a rise in haemoglobin level of 1-3 gm/dl within 1 to 2 months, maintaining their haemoglobin at 10 gm/dl. They might need transfusion if their haemoglobin drops during fever or inflammation.
– Thalassemia Major:
These patients with have an increase in transfusion interval. They will need transfusion at a pre transfusion haemoglobin of 9 gram/dl. However, the interval will increase.
What is the starting dose?
Cap Hydroxyurea. 15-20 mg/kg daily. For children , pharmacies can prepare special syrups.
Who is eligible for a trial of Hydroxyurea?
– Thalassaemia Intermedia patients with rare blood groups (A-, O-, B-, AB-) who may be XMN 1 -/-
– Thalassemia major patients with rare blood groups (A-O-, B-, AB -). They need a baseline XMN 1 level. However they can be given a trial irrespective of the result.
Does the laboratory of Fatimid Foundation perform XMN1?
We perform XMN 1 polymorphism at Fatimid Foundation, Karachi Center if advised by the doctor.
Respiratory viruses, in general, are not known to be transmitted by blood transfusion, and there have been no reported cases of transfusion-transmitted coronavirus.
The following are the safety measure considerations for protecting donors:
1. Follow a donation-by-appointment-only policy.
2. Limit donor center access to individuals with appointments who are not accompanied by others.
3. Take the temperature of each individual at the time of arrival at the blood center.
4. Ask donors to wash their hands or use hand sanitizer before and after donation.
5. Allow for 6 feet of separation between staff and donors.
6. Arrange seating for prospective donors in the waiting area approximately 6 feet apart prior to
implementing donor questionnaire.
7. Limiting collections to only two donors at a time.
8. Consider asking prospective donors to wait outside of the center, if doing so can be
accomplished while observing the recommended distance of 6 feet of separation between the
donor and others, and to await a text message or phone call.
9. Follow procedures for cleaning and disinfecting all areas and increase the frequency, such as
cleaning the donor bed and other surfaces in the collection area after each donor.
10. Increase the frequency for cleaning and disinfecting the donor screening and refreshment areas,
restrooms, doorknobs and other surfaces.
11. Empty waste bins frequently.
12. Serve each donor individually wrapped snacks and drinks, limiting exposure to the supply, rather
than allowing all donors access to the supply of snacks and drinks.
Staff education:
1. Educate staff about the signs and symptoms of COVID-19.
2. Instruct staff and volunteers not to report to work when ill.
3. Evaluate staff, volunteers, and prospective donors for COVID-19-like symptoms as they enter the collection site.
4. Use personal protective equipment (laboratory coat, gloves & masks).
5. Maintain hand hygiene (washing hands or use had sanitizer).
Donor deferral criteria:
Blood donors must be in good health and have a normal temperature on the day of donation.
FDA does not recommend using laboratory tests to screen asymptomatic blood donors. Based on available information, detection of SARS-CoV-2 in blood samples has only been seen in severely ill patients, not in asymptomatic individuals.
1. Donors should refrain from donating blood 28 days after the last possible close contact exposure to a person with COVID-19.
2. If a donor has had coronavirus, he/she will not be able to donate for three months after recovery.
3. Anyone with minor cold-like symptoms will be deferred until they are recovered.
4. A 28-day donation postponement is recommended for donors returning from any overseas country considered to be a high or moderate risk country.
Following are the countries:
– China
– Iran
– Italy
– Spain
– South Korea
– Hong kong
– Macau