Are our apheresis donation interval too long?

[Shan Xue]

The interval between apheresis donation in HSA is now 4 weeks. This is much longer than other countries. In Taiwan and Hong Kong, donors are allowed to donate at 2 weeks interval, up to 24 times a year. By shortening the interval to 2 weeks, apheresis donors can donate more often.

The references for the 2 weeks interval are as follows: http://www5.ha.org.hk/rcbts/e_donation.html
http://www.tc.blood.org.tw/index-qa-detail.php?id=81

how good will it be if singapore can further reduce the aphersis donation interval. i would like to be able to donate at blood bank every 2 weeks.

[SUBA]

Hi

I applaud your desire to donate. I've have gone through your referred sites.

Thanks for giving information about apheresis donation in other countries.


Suba

[Shan Xue]

Our donation intervals are too long. you see, our best champion blood donor, champion of champion donate about 160 times.

in other countries, such as Taiwan (not to mention western countries)their champion blood donors donate 650 times :!:


六百五十次者有林英哲等二人；六百次者有宋方英等七人；五百五十次者有丁銘松等十一人；五百次者有王利仁等 二十一人；四百五十次者有王進榮等二十四人；四百次者有丁乃鋼等四十人；三百五十次者有尤明華等五十人；三 百次者有王北福等五十人；二百五十次者有方進祥等三十九人；二百次者有孔燈田等六十七人；一百七十五次者有 王元章等五十三人；一百五十次者有方敏剛等六十五人；一百廿五次者有力博生等九十三人；一百次者有方文村等 一百八十五人

http://www.cdnnews.com.tw/20040501/news/dfzh/860060002004043017592648.htm

i saw the following article pasted on the board at HSA when i donated platelets sometime ago. with our donation interval, no one in singapore can ever donate so many times. pasting the article at the board motivates me to donate but i am capped at the donation interval here :cry:


The Australian Red Cross Blood Service (ARCBS) will announce the Guinness World RecordTM holder for the “most blood donated by one person” at the official launch of National Blood Donor Recognition Week next Monday (embargoed 7 July 2003).
Mr James Harrison will receive this impressive award having donated over 804 times in his life (equating to approximately 480 litres of blood).

[z]

It's too long.

In M'sia, interval is 2 weeks also.

[Shan Xue]

if a significant number of platelet donors feels the interval is too long, maybe blood bank will revise it upon receiving feedback.

i wrote feedback a couple of times. one on the interval between platelet donations and one on interval between whole blood and subsequent platelet donation. appears that my feedback is effective. Aphereis (plasma/platelet) donation interval used to be 8 weeks, then reduce to 6 weeks and further reduce to current interval of 4 weeks. Blood bank does take into consideration donors' feedback. remember they did a survey with the apheresis donors whether they will donate every 4 weeks if interval was reduced from 6 weeks? also shortly after my feedback on the 12 weeks long interval between whole blood and subsequent platelet donation, blood bank now reduces the interval to 4 weeks.

so, apheresis donors, if you feel current 4 weeks interval is short, write in to blood bank to let them know, at http://www.hsa.gov.sg/internet/dcController?next=i_feedback

they may not know there are so many "xiao on" donors :D

[jt]

good idea. Wrote in, waiting for their reply.

[Shan Xue]

Thanks. if not too troublesome for you, pls let me know their reply. :D

[jt]

The lady doctor left me an email when i could not take her call.



Thank you for your strong support of the national blood programme.
CTM is currently doing a study to look at the effect of 4 weekly
plateletpheresis /plasmapheresis. So far some of the results showed
that the protein level of donors dropped significantly. Therefore, although
we very much would like to, I regret that we are unable to shorten the
donation interval until the study completed.


To quote a senior nurse who told me this once: "we want you to donate to a ripe old age" :twisted: [/quote]

[Shan Xue]

i wonder how many % of the donors had protein level dropped when they donate every 4 weeks. i guess it is a low %. most of them have no problem. i just had my blood test done and protein level is ok.

even for whole blood donation at 12 weeks, there are still blood donors who failed the Hameoglobin (Hb) test because they have not fully recovered the Hb level since the last donation.

if there is monitoring for platelet donors, blood bank can advise on individual basis.

in the study below where the interval is 2 weeks or shorter (but up to 24 times a year), protein level was normal for platelet donors.


Among the three groups there were no significant differences in total white blood cell counts, percentage or absolute number of lymphocytes, or percentage or absolute number of lymphocyte subsets. Serum total protein, globulin, albumin, and IgG concentrations of platelet donors were within normal ranges. These data support the current Food and Drug Administration (FDA) and American Association of Blood Banks' standards for the frequency of platelet donation allowed and monitoring required for plateletpheresis donors.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10174686&dopt=Abstract

it is like normal distribution. where to set the "norm" donation interval. some countries set the norm interval at 2 weeks whereas singapore set at 4 weeks.

frequent platelet donation may decrease the donor's platelet count. however the blood bank is also keeping track of the platelet count and can advise interval for individual accordingly. donors with a strong body can donate more often.


Safety of apheresis donation

Significant decreases in donor platelet count were noted following repeated platelet apheresis. However, only a few donors became thrombocytopenic (platelet count less than 150,000/microliter). Interestingly enough, if the donor was allowed time to recover a normal platelet count, subsequent repeated platelet collection did not induce thrombocytopenia. Rebound of platelets has also been a common finding.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3679530&dopt=Abstract

[momo_siao]

i think the current wait is too long. if like 1 mth for whole blood 2 week for platet i think should be better man... the current wait is too long... maybe they should allow and ask donor sign some forms indicating that they ownself willing?

[Shan Xue]

in many other countries, the interval for whole blood donation is 8 weeks and 2 weeks for plasma and platelet donations.

i have heard excuses like other countries people are bigger size, eat better and stronger than ppl in singapore. hence they can donate more often. :twisted:

[jf]

I applaud the enthusiasm of our donors who want to donate more often. Those who can should be allowed to.

But just wondering if shortening the interval would really help improve the stocks significantly? There are practicalities regular donors have to face in achieving them.

For example, I tried to schedule my apheresis session as short as 4 weeks, but can rarely achieve it. This is because
(a) the desirable timeslots are often taken up (Saturdays are popular), or
(b) due to work & family commitments (4 kids at home can upset any plans!) or
(c) just simply falling sick close to the appointed date (like this week, I have to postpone, as a responsible act, but it is for a good 4 weeks because of no other slots next few weeks on Sats).

Perhaps, Red Cross finds it more worthwhile to commit resources to recruit new donors or encourage dormant ones to donate (to create a larger potential donor pool, some of whom would become regulars like us), instead of "squeezing" more from regulars.

Nonetheless, may the enthusiasm of regulars continue!

[Shan Xue]

current interval of 4 weeks means we can't donate on interval shorter than 4 weeks. and when things happen such as commitment or falling sick, we have to defer donation to the 5th or 6th week. so if the interval is reduced to 2 weeks, we may be able to donate on the 3rd or 4th week sometimes. it is not always possible to donate on the minimum donation interval.

Blood bank does prefer to recruit new donors than to shorten donation interval. some donors just like to donate more often. those who prefer or can only donate on 4 weeks interval due to heavy commitments can still stick to their current donation frequencies.

when the donation interval was reduced from 6 weeks to 4 weeks, blood bank increases the number of slots on sat. if the interval is reduced further to 2 weeks, i think blood bank can just increase the resources given time to plan for it.

another possibility is to do away with the stringent 4 weeks or 2 weeks interval. for platelets donation in some countries and SGH, the donation interval is 3 days but not exceeding 24 times a year. this gives more flexibility.

[jf]

Just went for an apheresis session this morning. The nurse told me that the interval between whole blood donation has been reduced to 1 month - same as apheresis. She said policy change was only "very recent
To check, I went to HSA's website to check my earliest eligibility donation date for whole blood and apheresis, and both indicated 1 month intervals.
Sounds like good news for many donors. But wonder if anyone can confirm this once and for all!

[Shan Xue]

i think what the nurse is saying is the 4 weeks interval between a whole blood donation and apheresis donation. it used to be 12 weeks.

for whole blood to whole blood donation, it is still 12 weeks.

the intervals are indicated at
http://www.hsa.gov.sg/html/ctm/preferred_donation.html (http://www.hsa.gov.sg/html/ctm/preferred_donation.html)

i just checked the HSA system for my next eligibility date:

"Your last successful donation was on : 03 FEB 2006
Your next eligibility date for Plateletpheresis donation starts from : 03 MAR 2006

Your last successful donation was on : 03 FEB 2006
Your next eligibility date for Whole Blood donation starts from : 28 APR 2006"


if i remember correctly, there is a programming constraint in the HSA booking system. say for instance the following:

0th week: You donate whole blood
4th week: You donate plasma or platelets.
8th week: System allows you to book whole blood appointment though you are not supposed to until the 12 week. that is the reason why in the blood donation questionaire that one has to declare whether one has donated blood in the past 12 weeks. hence for booking through the internet, got to take note especially if you alternate between whole blood and apheresis donation.

i doubt the interval between whole blood to whole blood donation in singapore will ever be reduced to a month. in other countries, the shortest is 56 days. i don't think the donation interval in singapore will ever go lower than that.

[Shan Xue]

Platelet can be donated at SGH and other countries every 3 days, up to a max of 24 times a year. However at the blood bank, the minimum interval is 4 weeks. This is because blood bank also collect plasma during platelet collection and plasma can only be donated every 4 weeks.

Below is a reply why blood bank need to collect plasma during platelet collection.



Dear Mr XXX,

Thank you for your E-mail feedback dated June 23,2008.

The four-week time interval for an apheresis donation is to ensure the any platelet and plasma losses sustained after an apheresis procedure will be adequately replenished in time for the next donation. It would be prudent to abstain from making frequent blood donations with shorter intervals to avoid taxing the bone marrow excessively and thereby depleting bone marrow stores

Platelets cannot be collected alone and must be suspended in plasma during collection otherwise they will easily clump and will loose their ability to function and for this reason, cannot be used for transfusion in patients.

The four-week interval is in place to make sure that our donors will continue donating regularly for a long period of time and not just for a short-term period. Ensuring the safety and well being of blood donors is of the utmost importance during each blood donation session. Under international guidelines, additional pre donation testing must be performed before a donor can donate plateletpheresis if the interval is less than four weeks. CTM policy dictates strict adherence to very stringent guidelines regarding donor screening for eligibility and suitability to donate to ensure that the health of the donor is never compromised by the act of blood donation.

SGH Haematology Centre is separate entity from CTM, with its own policies and guidelines and for this reason we shall refrain from giving further comment on this matter.

May I take this opportunity to thank you for your strong support of the National Blood Program ....

XXX
Medical Officer
HSA-CTM


Name: PLATELET DONATION INTERVAL

Dear Blood bank,

If I understand correctly, the donation interval for platelet is also 28 days because plasma is also collected during platelet donation. SGH donation interval for platelet donation is 24 times a year, so do many other places because only platelet is collected. Is there a need to collect plasma during platelet collection?
If only platelet is collected, can the donation interval be shortened to 2 weeks?

Thanks