In light of the recent guidelines regarding TRALI, what are blood centers doing with their female donors, especially plalelet donors? Over 50% of our platelet donors are female.

I do know that the American Red Cross is moving toward "predominantly male donor plasma". I use those terms because we are not yet making a claim that all plasma is from a male donor. This was presented at AABB, so this isn't a secret or anything.

I was actually the project lead for Dr. Benjamin for that initiative at ARC and how to manage apheresis donors is definetely a large concern for ARC as well. We also collect double red cells, which... are usually from a male donor. You risk cannabilizing one initiative for another.

A have since taken another job within ARC (so if anyone wants to talk equipment- call me!) but when I left manufacturing, there were no talks (yet) regarding plts. Apheresis plasma yes, but not plts.

Our supplier plans to go to the 24 hour plasma so that they can then do all male plasma. We expect the conversion around the first of the year. We have no resolution for the apheresis platelets yet.

As some studies indicate that platelets may be the leading cause of TRALI, we need some resolution on this ASAP. It's becoming clearer that not all cases of TRALI are associated with the kind of antibodies you might see in multiparous women. Many, many transfusions of donor products with these antibodies are given every year to recipients who at least partially "match" for HLA or PMN type, (due to the mix of HLA types in the population) but in whom no TRALI results. So much depends upon the condition of the patient prior to transfusion. Have they received the "hit" of a trauma, surgery, etc, to "prime" their PMNs? Do they have enough neutrophils to mount such a response? Is it biological mediators in the stored unit that cause the reaction? It's a complex issue.

I'm going to stick my neck out and say that this sort of "blanket" deferral (which in reality it is, even tho we are so far singling out one product) reminds me of some of the early HIV deferrals by geographic area, prior to testing being available. Not very effective, like killing a fly with a sledgehammer, and terrible PR. How are we as a donor collections community going to handle the inevitable misinterpretation of this donor selection in the popular press? How many donors who don't have good information on what this is all about will be turned off enough not to donate? I haven't seen any of these questions answered yet; maybe we have to wait and see. But we'd sure better have a strategy to deal with it.

Red cells also cause TRALI. I have yet to see anyone suggest that we turn away females from donating red cells! Another case of, half a loaf is better than none--or, the precautionary principle in action!

MJ:cool: