Blood platelet demand outstrips supply

Diagnosed just hours earlier with acute leukemia and unable to stop his nose from gushing blood, 18-year-old Josh Downing was in a St. Louis hospital bed last week in desperate need of blood platelets.

But there were none to be found.

The nurse at Barnes-Jewish Hospital put the situation to the Cape Girardeau family in blunt terms: "We're out of platelets. When we get some, he'll get some," she said.

That was a problem the young man's father hadn't anticipated.

"When that happened, we knew he was in real trouble, real fast," said Nate Downing. "I looked at his empty IV stand, and I started to get angry. I never considered they'd be out."

It happens more often than you'd think.

Platelets are a component of blood necessary to control bleeding. They are used primarily in treating cancer patients undergoing chemotherapy, patients with blood disorders such as aplastic anemia and leukemia, and people undergoing bone marrow transplants and other types of organ donation.

But platelets are the most rare -- and vulnerable -- component of the blood. They aren't as readily available as whole blood because platelet donations take longer than whole blood donations, generally 90 minutes to two hours. That's because a special machine is used to remove platelets and put the red blood cells back into the body.

"Platelets are in high demand," said Marilyn Hughey, the blood bank specialist at Saint Francis Medical Center. "The demand is high, but they are not easily obtained. You really have to have a dedicated donor."

Not only is donating platelets time consuming, donors also must have appointments -- unlike whole blood donors -- to make a donation. That fact dissuades some potential donors from giving platelets. Appointments are needed because there aren't enough machines to accept walk-in patients.

Making the problem of scarcity worse, platelets have a shelf life of only five days, much shorter than whole blood. If they aren't used quickly, they must be discarded.

Around Christmas, donations decrease even more.

"We have shortages of all blood products this time of the year," said Julie Wengert, supervisor of the blood bank at Southeast Missouri Hospital. "Especially around the holidays when people are doing so many other things. The big snow hurt us, too, because people couldn't get out to donate. The university also provides us with a pool of college donors, and when school lets out, it hits us, too."

Downing -- the former manager of Ruby Tuesday's in Cape Girardeau who is now the restaurant chain's district manager -- learned all this in a short while, so he had to resort to other sources -- friends -- to get platelets for his son.

"I called the restaurant here, I called anybody I could think of to see if they could come to St. Louis and donate platelets," he said.

Employees of the Cape Girardeau restaurant sent out mass e-mails. Pleas for platelets were faxed. Blood drives were organized. That it was the week of Christmas apparently didn't deter some. By the end of the day, more than 30 people had donated platelets at Barnes-Jewish.

"I don't know how many of them were for Josh," Nate Downing said. "Maybe all of them. But I was so grateful, because I knew it put them in a pinch to get to St. Louis."

Nate Downing hopes his son's situation will raise awareness about the need for blood platelets so others won't have to go through what his family has.

It's a hope seconded by area doctors and blood bank workers.

Dr. Stanley Sides, a local blood and cancer specialist, referred Josh Downing to St. Louis for more tests. Sides said donors need to be applauded.

"There are people who take time out once every month or two," he said. "These are the real heroes who do this. We just need more of them."

Peggy Kitchen is the American Red Cross supervisor of distribution for blood and platelets. She said the situation is getting better. The local Red Cross chapter began taking donations more frequently just within the last year. Before, the Red Cross had to borrow machines from St. Louis twice a month.

Making room to donate

When the Red Cross opened its new location on Mount Auburn, it had room for its own machines and now takes donations four times a week. It's improved the situation.

"We've had good luck with donations in this area," she said. "People are pretty generous."

Ninety percent of the time, she said, they have what the hospitals need. But on occasion they run out of platelets -- sometimes because of low donations and other times because the platelets donated here have to be sent to St. Louis to be tested. That usually eats up a day or two of the platelets' shelf life.

"Maybe once, twice a week, we'll hit a snag," she said. "But some weeks we don't run out at all."

On Wednesday, two people were at the American Red Cross office at 20 S. Mount Auburn Road. Both Dawn Eichholz and Sydney Herbst were donating platelets. Both said they were at blood drives when they were told how vital platelet donations can be.

"I like doing it," Herbst said. "I can schedule it around my schedule, and I realize it's more needed. And needles don't bother me."

If more people were like Herbst and Eichholz, there wouldn't be a problem, Kitchen said.

"We're constantly trying to educate people," Kitchen said. "We want people to realize how needed platelets are."

smoyers@semissourian.com

335-6611, extension 137