Stem cell and bone marrow transplant patients have an extraordinary need for blood and platelets. The blood cells and platelet cells that are destroyed by their treatment can be replaced by the cells of healthy donors through transfusions. Since it can be difficult to maintain the Blood Bank supply of platelets because of the lack of general public donations, we rely strongly on our patient's family and friends to, whenever possible, help us by donating.

So far, we have found the best arrangement to be that the Medical Center assumes the responsibility of meeting the transplant patient's packed red blood cell needs, while the patient's family members and/or friends concentrate their efforts towards meeting platelet needs. This arrangement seems to work out best because blood donors can only donate once every eight weeks, while a platelet donor can donate every three to five days; hence, the family needs to enlist fewer donors for platelets.

Since the time before admission to the hospital can be busy, and once you are in the hospital, you will not have the energy or interest to deal with this situation, we suggest that a non-immediate family member or friend be your coordinator and organize your booklet. Your coordinator should contact the blood center(s) you may be interested in using for platelet donations. Each center will review the donation process and eligibility requirements with your coordinator. Donors will be medically screened to ensure their safety, as well as yours, before donation. Those platelets which are donated for you and are compatible with you will be "designated" specifically for you.

Call the Blood Donor Room at 201-996-4818 to discuss which blood centers are to be used and the timing of donations. Also, you must call each blood center you are using to register the patient and pay any fees that are associated with directed donations. Please note that the more blood centers you use, the more fees you will incur. Also, the farther the blood center from Hackensack University Medical Center, the more transportation fees you will be charged. Each blood center has its own individual policies and procedures. If you have a question concerning a medical condition or medication or any donor requirements/exclusions, please call the individual blood centers.

In some cases, transplant patients will only be able to receive blood and platelets from donors who have never been exposed to Cytomegalovirus (CMV), a particular virus which is relatively common in healthy individuals. Approximately 50 percent of donors will be found to be CMV-positive while the remaining are negative. Thus, in instances where CMV-negative donors are required, approximately half of those willing to donate will be ineligible. Blood will be drawn during your transplant work-up to determine your CMV-status, if need be. Discuss with the patient's nurse clinician or the Blood Donor Room if the patient is going to require CMV negative products.

A pre-screening of donors can be done at Hackensack University Medical Center for those donors wanting to know their CMV status prior to donating. The Blood Donor Room will send an order for CMV/ABORh testing to the laboratory. Donors can come to the laboratory without an appointment and have their blood drawn. Please inform the patient prior to the screening as they will be charged for the testing on their account, and verify that this charge is acceptable. Only the potential donor will be able to call for their results at the Hackensack University Medical Center donor room at 201-996-4818.

Unlike regular blood donations (packed red blood cells), which can stay refrigerated for up to 35 days, platelets can only be transfused up to five days after being donated. Because of this short life span, it is very important that the schedule for donations be planned and timed according to when they are most needed and to provide a constant supply.

Once the Transplant Service has determined an admission date for your transplant, they will be able to give you a specific time frame for your transfusion needs, and a prescription will be faxed to the designated blood centers.

Red Blood Cell Needs Are as Follows:

Your needs will vary depending upon your type of transplant.

Platelet Needs Are as Follows:

For patients undergoing autologous peripheral stem cell transplant - one platelet donor per day for 10 days.
For patients undergoing autologous bone marrow transplant - one platelet donor per day for 18 days.
For patients undergoing allogenic bone marrow transplant - two platelet donors per day for 21 days.
Please note: Patients cannot receive blood products from blood relatives prior to transplant date, so we ask that blood relatives donate only starting the day before the transplant date.
How much you need will depend on how quickly your bone marrow makes enough of your own platelets.

Have your donors call the blood center you have chosen and schedule an appointment. Donors should notify the patient's coordinator with confirmation of the appointment and also post appointment as to whether or not they were able to donate. The blood centers cannot give out information about individual donors.

Apheresed Platelet Donation Information

Apheresis is a very special type of blood donation given by very special people...people who don't mind giving up a small portion of their time to add time to a patient's life. Advanced medical technology has made it possible to treat patients with blood disease and other illnesses by using blood and its components. Apheresis platelets (a-fur-EE-sis PLATE-lets) is the unique type of blood donation that makes it possible to collect large enough quantities of platelets to help patients who do not have enough of this blood component. This process, which takes approximately one and a half hours, makes it possible for a donor to give the equivalent amount of platelets that it would take seven to 10 donors giving whole blood to do. Platelets are needed to control bleeding and are essential in keeping these patients alive until their own platelets can repopulate to a normal and safe level. At some centers, donors must first undergo a "vein check." This involves having an experienced hemapheresis nurse visually check the veins in a donor's arm to determine if they would be suitable for donation. Note: This requires a separate visit and is not needed at Hackensack University Medical Center.

When it is time for the donation, a needle is inserted into each arm; one is for extracting blood, and the other is for returning blood. The donor's blood is drawn from one arm into a blood cell separator machine where it is spun at a high speed. Because of density differences in the various types of blood cells, the high speed separates the blood into various components. The platelet component is then removed and the remaining red cells and plasma are recirculated back into the donor through the other arm. Each donor has his/her own sterile software (tubing set) so there is absolutely no worry for the donor about contamination or infection (such as HIV). Your donor's platelets are tagged with your name on them, and held for your use. If you do not use them after four days, the Blood Bank will check with your doctor to see if you'll need them. If you don't need the platelets at that time, they will be given to someone else, before they outdate.

It may take up to 3 hours for apheresed platelet donations, including registration, testing, and refreshments afterwards. Apheresis platelet donations can be made (depending on individual blood center policies) usually every 72 hours, up to 24 times per year.

The process does not make the donor feel weak or tired because essentially he/she loses very little blood. Less than a pint of blood is withdrawn from the donor at any one time. Nor is the procedure painful. It may however, be somewhat uncomfortable because of the length of time required to complete the process, and the limited movement of both arms. For this reason, it is suggested that donors bring a Walkman with cassette tapes to entertain and relax them.

The coordinator should pre-screen donors for eligibility as per the list of blood donor qualifications. Please be aware that even if you pass all the qualifications on the list, you may still be rejected at the time of donation due to low platelet counts, blood pressure, hemoglobin, etc.

Directed Apheresed Platelet Donations by Appointment
Family members and friends are permitted to use blood centers other than Hackensack University Medical Center's. Sometimes it may be more convenient for individuals donating to do so at another center because of location and/or hours. For this reason, please find a list of blood centers, where individuals can donate. The platelets will be shipped to Hackensack University Medical Center.

Regardless of the center(s) you wish to use, our Transplant Service needs you to contact the Blood Donor Room at Hackensack University Medical Center, at 201-996-4818.

You are urged to contact the center(s) you may be using as soon as possible so that they will have sufficient time to prepare and better assist you in meeting your needs. Regardless of which center you choose to use, be certain to specify directed apheresed platelet donations and inquire about appointment times, registration papers, release forms, fees, and specific donor requirements/exclusions. Each blood center has its own individual policies and procedures. If you would like to know how many platelets are available at any given time, you can call the Hackensack University Medical Center Blood Bank at 201-996-4813. They will tell you how many are available and when they expire.

Donor Qualification Requirements
The following are some general requirements to qualify as platelet donor. These may differ from blood center to blood center.

1. You must be in general good health - no colds, sore throats, or any type of infection on the day you donate.
2. You must weigh 110 pounds or more.
3. You must be 17 to 75 years of age (17 year olds must be accompanied by parent).
4. If you have donated whole blood recently, you must wait eight weeks before donating again.
5. If you have donated platelets recently, you must wait two - three days to donate again.
6. You must bring some form of identification with your signature on it.
7. You must eat a good meal within one to three hours before you donate.

The following are some general reasons why one would not be accepted as a platelet donor. Again, these may differ from blood center to blood center.

1. History of diabetes - if controlled with insulin - permanent deferral; if controlled with oral medication, it is OK to donate.
2. Any history of heart problems including chest pain, heart attacks; Mitral valve prolapse or murmurs must be evaluated before donation and are not acceptable if symptomatic.
3. History of kidney, lung, or liver disease - permanent deferral.
4. History of fainting, convulsions, seizures and/or unconsciousness - permanent deferral.
5. History of cancer - permanent deferral.
6. History of hepatitis, jaundice (yellowing of the skin, eyes) and/or any positive hepatitis test - permanent deferral.
7. Current pregnancy, recent pregnancy, or recent termination of pregnancy in the last six weeks - six week deferral.
8. Recent C-Section delivery - six week deferral.
9. Exposure to someone with hepatitis in the last 12 months - 12 month deferral.
10. Earpiercing, skin, or body piercing in the last 12 months - 12 month deferral.
11. Tattoo in the last 12 months - 12 m-nth deferral.
12. Electrolysis in the last 12 months - 12 month deferral.
13. Acupuncture in the last 12 months - 12 month deferral.
14. History of malaria, travel to malarial zone in the last 12 months, or living in a malarial zone within the last three years - three year deferral.
15. Received a blood or blood product transfusion in the last year - 12 month deferral.
16. Some medications - check with the donor room at 201-996-4818.

You must not take aspirin or any aspirin-containing products (e.g., Anacin, etc.) within three days of donating. Products containing ibuprofen (e.g., Advil, Nuprin, etc.) also may interfere with platelet functioning and should not be taken within three days of donating. Tylenol is the only commonly used analgesic/antipyretic allowed. Some medications (both prescription and over-the-counter) as well as some immunizations, vaccinations, and injections may have certain deferral times.

1. Hepatitis B vaccine - 48 hour deferral.
2. Rabies vaccine - if due to animal bite - one year deferral.
3. Tetanus vaccine - 48 hour deferral.

Please have donors check with the individual blood center if they have any questions about medications or physical requirements.

Blood Centers

Hackensack University Medical Center 30 Prospect Avenue Hackensack, NJ 07601 201-996-4818 Fax: 201-996-2495 Bergen Community Regional Blood Center 970 West Linwood Avenue Paramus, NJ 07652 201-444-3900 Monica Heller Fax: 201-444-1885 North Jersey Blood Center 45 S. Grove Street East Orange, NJ 07018 201-676-4700 Linda Woodley Fax: 201-676-4933 New Jersey Blood Services 167 New Street New Brunswick, NJ 08901 732-220-7110 Mary Solewin (platelet donors) 732-220-7032 Susan Keach (whole blood donors) Fax: 908-220-7199 New Jersey Blood Services Exxon Research & Engineering Headquarters 220 Park Avenue Florham Park, NJ 908-220-7110 Mary Solewin Fax: 908-220-7199

Central Jersey Blood Center 494 Sycamore Avenue Shrewsbury, NJ 07702 908-842-5750 Jan Fax: 908-842-1617 Community Blood Council of Mercer County 1410 Parkside Avenue Trenton, NJ 08638 609-883-9750 Diane Kearn Fax: 609-883-9454 Hudson Valley Blood Services Grasslands Road Valhalla, NY 10595 914-345-3070 ext. 215 Jenna Renna Fax: 914-592-4436 New York Blood Center 310 East 67th Street New York, NY 10020 516-752-8411 Fax: 516-752-8415 to schedule platelet donor appointments: 1800-933-3339 #1 Long Island Blood Services 155 Duryea Road Melville, NY 11747 516-752-8411 Fax: 516-752-8415

Your donors are not limited to using the centers listed here. Once you have chosen the center(s) you would like to use, please contact the Blood Donor Room at Hackensack University Medical Center 201-996-4818, so that a prescription can be faxed to the center(s). If you choose another center, please provide The Blood Donor Room with the phone number and fax number so that a prescription can be provided.