Special platelet donors help save newborn lives

Gord Somerville has been following in his father’s footsteps by donating blood since he was 17 years old. He would have started earlier if he was allowed to. But, to his surprise, it’s his platelets that make him special. They can save the life of a newborn baby.

If you’ve been pregnant or know someone who has, you may be familiar with the need for your physician to know your blood type. That’s because if you are Rh negative (the most common types being A-, B-, AB-, and O-) there’s a chance that the baby could be Rh positive, causing an incompatibility which spurs the immune system to attack the fetal red blood cells in subsequent pregnancies. Thankfully this is easily preventable by giving pregnant patients who are Rh negative an immunoglobulin injection to prevent her body from creating antibodies.

Since about 17 per cent of the Canadian population has an Rh-negative blood type, this is not an uncommon occurrence. What is less common, but much more dangerous, is when there is an incompatibility between a different component – platelets.

Platelets are small cells that circulate through the body and play a key role in prevention of bleeding. When a blood vessel is damaged, platelets recognize the disruption, cluster over the area of damage and help form a clot over the hole to stop bleeding. Just like red blood cells, platelets may express different proteins on their surface. Most people have the platelet type HPA-1a1a or 1a1b, but two percent of the population have the rare platelet type of HPA-1b1b.

Similarly to red blood cells, if a pregnant woman has type 1b1b platelets and the baby doesn’t, the immune system may form antibodies that can destroy the baby’s platelets. This results in baby having a low platelet count, meaning that normal bumping and bruising could lead to significant bleeding. Unlike with red blood cells there is currently no routine screening for platelet incompatibility due to the rarity of this event. That means doctors typically don’t know there’s an issue until after the baby is born.

“With platelets there is no way to monitor whether or not they're low on platelets until they bleed, which is often too late,” says Dr. Akash Gupta, Medical Officer at Canadian Blood Services. “It’s the trauma of birth which causes more bruising or bleeding than expected and unmasks the issue.”

While it’s rare to have a newborn need these special platelets, it’s a serious emergency if it does happen. In the worst-case scenario, a baby could have a brain hemorrhage causing a brain injury or even death.

“So, having those platelets ready is helpful to immediately transfuse this baby who is suddenly born unexpectedly with bleeding or severe bruising,” Akash explains.

Gord is part of a small group of donors, less than 100 across the country, who have the rare HPA-1b1b platelet type. Since the platelets must be used within seven days, they donate regularly to make sure there is a reserve supply on hand in case of a neonatal emergency.

With such a small group of donors to draw from and the severity of the emergency if platelet incompatibility becomes an issue for a baby, the stockpile of these special platelets is spread out across some of the major population centres in Canada so that they can be more easily delivered to hospitals when needed.

So, what does Gord think of being a lifeline to brand new parents in those critical first moments of their child’s life?

“It’s just the Canadian thing to do.”

Find out if donating platelets is right for you.