Blood Donation Failure and Success.

Yesterday I walked over to the 66 College Street Canadian Blood Services clinic with the intention of donating a pint of my blood. However, this is the sign that greeted me (p.s. Yesterday was Monday):


Oh well. Write off. No donations on Mondays, okay! And sure, I would have known this, if I had made an appointment… but making appointments is counter to how I like to do most things.

On the plus side, trying to check in on Foursquare showed me all the other Canadian Blood Services locations in the city (crowdsourcing for the win!) and I realized there was one much closer to me (at University and King). So I decided when I woke up this morning to try again at one of the other locations.

My last donation was (according to my card) on July 12, 2010, which means that it hasn’t been more than a year since my last donation (Which I didn’t realize). This one went really well and I asked about plasma and platelets. Oddly enough, they don’t accept platelet donations from women that have had a history of pregnancy, abortion or miscarriage (I don’t have a history of any of those, so I would be a standard donor.)

The phlebotomist that took my blood didn’t elaborate (either she didn’t know the details, or didn’t think I would understand them), so I did a search for issues with female platelet donation and found out about transfusion-related acute lung injury (or TRALI.) Canadian Blood Services has a good amount of information on their website about it, plus there are a few medical journals that discuss the problem.

Basically what happens is that women women who have been pregnant, including ectopic pregnancies, miscarriages, and abortions are at the highest risk to develop the antibodies that may trigger a TRALI reaction in a transfused patient. A TRALI reaction is an uncommon and serious adverse effect following a transfusion of plasma containing products. It involves the sudden onset of acute lung injury (ALI) but is often hard to diagnose because recipients tend to be very sick as it is.

The cause of TRALI is not well understood but it  has two main hypotheses:

  • One is that preformed donor antibody to white cells directed against Human Leukocyte Antigen (HLA) class I or II or against granulocyte specific antigens agglutinate white cells in the lung capillaries leading to complement activation, capillary damage and capillary leak. 
  • Another, is a “two hit” process which involves inflammatory mediators in a susceptible patient. In this case the patient’s underlying condition leads to primed neutrophils in the circulation. The second hit occurs when neutrophils are activated by cytokines or lipids in the plasma of stored transfused blood components and injure the pulmonary capillaries leading to damage and capillary leak. (here)

Back to my actual goal, it doesn’t sound like they do plasma only donations like I used to do in Edmonton. I might have to adjust my blood donation goals for the duration of 101 in 1001. The whole process was really easy, and took a little less than 30 minutes. I caught up on my reading, and watched a bit of the news. Free snacks after donations (a few things were even accidentally vegan friendly (Dad’s Oatmeal Cookies) or in the vegan friendly grey area (Oreos) but I forgot to ask if they had soy milk… somehow I doubt it). As a total aside, they have a new magazine called Pulse, that is actually really interesting (with little anecdotes from donors and recipients, recipes, and some science info.) it’s readable online here.


Related links:
Transfusion  Ontario -ORBCON newsletter trali (PDF file)
Transfusion Medicine – Complications
Canadian Blood Services – Reducing The Risk Of Transfusion Related Acute Lung Injury
An article in the Transfusion Journal: Ten years of hemovigilance reports of transfusion-related acute lung injury in the United Kingdom and the impact of preferential use of male donor plasma.