In order to ensure that platelet donations are safe and available at the point of care, state health ministry will soon introduce nucleic acid amplification testing (NAT) in government blood banks across the state to test candidates for safe platelet donation. This comes as a welcome change as a voluntary platelet donation drive for the city has recently been kick started at Tata Memorial Hospital (TMH) to bridge the demand-supply gap in platelets. The voluntary platelet donation drive will complement the first voluntary platelet donor registry started at TMH.

According to an official, NAT testing has not been taken up due to the high cost associated with it with each test costing Rs. 1200 which itself is a government notified price. HIV in most blood banks is still tested through enzyme-linked immunosorbent assay (ELISA) test that has an innate shortcoming. If a person has recently contracted HIV, this test may not show it. It can detect HIV antibodies that take a minimum of three months to show in the blood.

Maharashtra government would be a pioneer in introducing NAT testing facility for the first time in the country. The project which will be covered under National Rural Health Mission (NRHM) will provide NAT testing facilities in Pune, Thane, Amravati, Nagpur, Nashik and Mumbai to begin with for safe platelet donations.

Meanwhile, National AIDS Control Organisation (NACO) has also been spearheading a plan to set up component separation facilities across the country to address the shortage of platelets, according to an official associated with the development. The initiative from NACO has led to the component separation facilities growing from 3 per cent to 20 per cent over a period of three years. In Mumbai alone, 45 per cent of blood banks have component separation facilities which was only 15 per cent three years ago. There are 450 component separation facilities in the country.

An eligible platelet donor is first evaluated for eligibility for plateletpheresis after taking a blood sample for blood grouping, complete blood counts (CBC) and mandatory tests for screening transfusion transmitted infections. He/she should be between 18 to 50 years of age and weight above 55 kgs. In platelet donation, the platelet donor is attached to a cell separator, a computer controlled machine that draws donor blood with the help of a disposable set, removes the platelets and returns the plasma and all other blood components back to the donor. The whole process takes about 2 hours.

"Platelet donations on the cell separator machine collected by Apheresis technique, called single donor platelets (SDPs), are at least six times as effective as platelets separated from donated whole blood units called as random donor platelet (RDP) method. Voluntary blood and platelet donations are the best means of providing safe blood components to bridge the gap in demand and supply," said Dr Sunil Rajadhyaksha, head, department of transfusion medicine, Tata Memorial Hospital.

In order to ensure blood and blood component safety, experts advocate the need to use only HIV-screened blood, use blood judiciously - only when it is really indicated, preferably use fractions (plasma, platelets or red cells) than whole blood and avoid its commercialisation and follow the highest standards of medical ethics. Use donor deferral if any high risk activity among donors is suspected during counseling, use pool testing (pooling of 10 samples and doing test at one place to reduce cost of tests like polymerase chain reaction (PCR) or NAT.