As the only steward of the local blood supply, Hoxworth Blood Center often issues pleas to the community to donate whole blood, red cells, plasma, or platelets to support patients in area hospitals. These types of donations make up the majority of Hoxworth’s daily collections, but there is also a lesser-known, but just as crucial, need for granulocytes—a blood component that requires specifically matched donors.
Granulocytes are a type of white blood cell, and they make up a crucial element of the body’s immune system. Produced by stem cells in the bone marrow, granulocytes help protect the body from infectious disease and foreign invaders. In healthy adults with functioning bone marrow, white cells like granulocytes prevent and eliminate infectious agents in the body.
For certain immunocompromised individuals, however, their white blood cells are either too few in number or do not function correctly in order to protect from infection. Cancer patients or patients with immune deficiency disorders are just a few examples of individuals who might need white cell transfusions in order to survive treatment.
“The white cells we collect are going to neutropenic patients (people with low white blood cell counts) who have a concurrent fungal or bacterial infection. We frequently see this in our bone marrow transplant patients,” says Dr. Jeffrey Papiernik, Assistant Medical Director. “Giving white cells to these critically ill patients may help to fight off the infection and improve survival outcomes, and we rely on healthy donors to fill that need.”
While many Hoxworth donors may be familiar with donating whole blood or platelets, white cells donations are a bit different than Hoxworth’s typical collections in a number of ways. First, while a whole blood donor can walk into a donor center and give whenever they have the time, white cell donations only occur when there is a specific patient need. White cells have a shelf life of only 24 hours, and are transfused to the patient on the same day as the donation. If a patient is in need of white cells, their physician will call Hoxworth to put in an order for a specifically matched blood type.
“We mostly receive granulocyte requests from Cincinnati Children’s Hospital Medical Center,” says Papiernik. “If we feel granulocyte collections are warranted for a particular patient, we will then ask the incredibly hard working folks at our appointment center to reach out to donors that have the same blood type and CMV status as the patient to see if they would be willing to donate granulocytes.”
Just as with whole blood and platelets, white cell recipients will require a transfusion that is compatible with their own blood type. However, white cell donations require another layer of typing that determines the donor’s CMV status. CMV, or cytomegalovirus, is a common virus that infects people of all ages and stays in the body for life. Typically, it causes no symptoms; a healthy person’s immune system can neutralize the threat before it causes illness. In an immunocompromised individual, however, the CMV infection can cause serious health problems. If a recipient is CMV-negative, it is crucial for that person to receive white cells from a similarly CMV-negative donor.
Gina Hakes, a recruiter at Hoxworth’s Appointment Center, specializes in finding donor matches for white cells patients. “It can be a challenge sometimes,” she says. “Obviously, we want someone who can donate as soon as possible, but that donor also has to be the right blood type and CMV status. We have to be totally sure that the products we collect are safe for the patient.”
Before donating white cells to a CMV-negative patient, a donor will have to be tested for the virus at a Hoxworth donor center. Once the donor is confirmed to be CMV-negative, Gina will work with the individual to schedule a white cell donation.
In addition to extra testing, white cell donation also requires a bit of extra preparation ahead of time. While all blood and platelet donors are encouraged to stay hydrated and eat a good meal before giving, white cell donors will also need to take a minor steroid to increase the production of white cells by the bone marrow.
“The donor will take three pills of prednisone throughout the day before and the morning of their appointment to stimulate their white cell count,” says Papiernik. This ensures that Hoxworth can collect a sizeable donation of granulocytes for the specific patient in need. The steroids can have side effects, but most individuals tolerate them well and rarely have issues.
So, who is the ideal candidate for white cell donation? A white cell donor will need to be a frequent and a preferably recent platelet donor, who can make the time for a 3-hour donation process and does not frequently miss or reschedule appointments. He or she must be eligible to give platelets, plasma and red cells. The donor must not have a history of diabetes, tuberculosis, or peptic ulcers, and should be in generally good health.
Most importantly, though, the donor must have the desire to help a local patient in need.
“It’s a real privilege to recruit white cell donors,” said Gina Hakes. “For me, it’s a constant reminder that people are innately good, because white cell donors in particular are so generous with their time and so committed to helping others.”
Dr. Jeffrey Papiernik agrees. “The granulocyte donors we work with are amazing. They always seem eager and self-motivated to come in and help a local patient.”
With orders for white cells coming from hospitals like Cincinnati Children’s Hospital Medical Center, a white cell donation is a way to make a real, tangible difference in the life of someone in our own community.
Interested in more information? Call Gina Hakes at 513-451-0910 to talk more about the need for white cells, and see if you are eligible to donate!