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# Platelet disorders - Whole blood and components

## Essential information

Includes

  Individuals with, or carriers of, an inherited platelet disorder. These include:

  - Bernard-Soulier disease
  - Glanzmann's thrombasthenia
  - Hermansky-Pudlak syndrome
  - Jacobsen syndrome
  - Lowe syndrome
  - Paris-Trousseau syndrome
  - Platelet release and storage pool defects
  - Thrombocytopenia with absent radius syndrome

  Acquired platelet disorders due to an underlying condition.

Excludes
  - Donors taking medications that reduce platelet function (e.g. aspirin, clopidogrel). See:
    - Nonsteroidal anti-inflammatory drugs
    - Clopidogrel
    - Cardiovascular disease
    - Other entries relevant to reason for treatment
  - Donors identified as having an abnormal platelet count on testing by the blood transfusion service. See Platelet count.
  - Thrombotic thrombocytopenic purpura (TTP). See Thrombosis and thrombophilia.
Obligatory

  Must not donate if:

  1. The donor has an inherited platelet disorder.
  2. The donor is an affected carrier of an inherited platelet disorder.
  3. The donor has an acquired platelet disorder due to an underlying condition.
  4. The donor had an acquired platelet disorder and the underlying cause precludes donation (e.g. malignancy).
  5. There is a history of excessive bleeding or bruising.
  6. The donor is requiring monitoring and/or follow-up.
  7. There is any associated immune system or organ involvement (e.g. heart, lung, kidney, that precludes donation).
  8. The donor has received a transfusion or plasma exchange since 1 January 1980.
  9. The donor has a platelet disorder and has ever:
     1. Received blood derived and recombinant products (e.g. Factor VIIa, ADAMTS13), and/or
     2. Received or is currently on treatment to reduce or prevent excessive bleeding, e.g. desmopressin (DDAVP®), tranexamic acid, oral contraceptive pill and similar hormone therapies, or an intrauterine device (IUD), and/or
     3. Needed iron supplementation.
  10. The donor has required or been advised they will require prophylactic treatment for surgery, dental treatment, or for any other procedure.
  11. The donor has required or been advised they should receive immunisations subcutaneously rather than intramuscularly.
Discretionary
  1. If the donor is a non-affected carrier of an inherited platelet disorder and fulfils all other criteria, refer to Designated Clinical Support Officer.
  2. If the donor had an acquired platelet disorder (except immune thrombocytopenia (ITP) – see Immune thrombocytopenia) that has now fully resolved, the underlying condition does not preclude donation and they fulfil all other criteria, refer to Designated Clinical Support Officer.

## Supporting information

See if relevant
  - Cardiovascular disease
  - Clopidogrel
  - Haematological disease
  - Immune thrombocytopenia
  - Nonsteroidal anti-inflammatory drugs
  - Platelet count
  - Transfusion
  - Thrombosis and thrombophilia
Additional information

  Platelet disorders can be inherited or can be acquired, e.g. due to an autoimmune reaction or malignancy such as leukaemia. Symptoms are similar whether there are too many platelets in circulation, too few platelets in circulation or the correct number of platelets are in circulation but they do not work properly.

  These disorders can cause significant bleeding, either spontaneously or in response to even minimal trauma or minor procedures. Nose bleeds, bleeding from the gums and petechiae are common. Bleeding can lead to iron deficiency anaemia.

  Individuals will have been assessed and advised about their condition and bleeding risk. Most would be at increased risk of bruising and other complications from blood donation so affected individuals must not be accepted.

  The diagnosis of the milder forms or carrier status of platelet disorders may arise from family screening, or through testing during investigation for menorrhagia (heavy periods), or bleeding during pregnancy or childbirth. Some people with the carrier state have symptoms which may or may not need treatment and/or are at risk of bleeding and therefore would be at increased risk of bruising and other complications from donation so affected carriers must not be accepted. Affected individuals and affected carriers may have been provided with a Bleeding Disorders Information Card.

  Carriers who have been diagnosed through family screening, have not had any symptoms and have had their platelet function investigated and demonstrated to be normal may be able to donate once this information has been confirmed with the donor’s specialist or GP by a Designated Clinical Support Officer.

  Treatments include plasma products, plasma exchange or more rarely platelet transfusions. Curative treatment with stem cell or bone marrow transplant is an option for the most severe conditions.

  The inherited platelet disorders are often part of a multisystem condition, but carriers are less likely to have significant organ involvement.

  The guidance contained in this entry is not intended for use for donors without a platelet disorder, for example for someone who may have taken tranexamic acid for heavy periods due to an underlying gynaecological cause.

  For donors who are identified as having an abnormal platelet count following testing by the blood transfusion service, refer to the Platelet count entry.

Reason for change:
  Clarification of the scope of this entry. Expansion of obligatory and discretionary criteria. Addition of relevant links. Additional Information section rewritten to support revised entry.
Version details:

  WB-DSG Edition 203 Release 73 (07 October 2024)

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