Donating granulocytes

In rare cases, the following can occur as side effects following brief treatment with cortisone: 

• Critical elevation of blood sugar in diabetics
• Elevated blood pressure in individuals with poorly managed high blood pressure
• Stomach complaints in sensitive patients
• Sleep disorders
• Worsening of symptoms in patients suffering from depression and other psychiatric disorders    

If you have one of the above conditions, we would advise you not to proceed with a granulocyte donation.
The G-CSF injection site may feel a little painful or produce a slight burning sensation. Occasionally, the skin may also show minor bruising or reddening. If taken only once, this drug may cause flu-like symptoms (such as aching limbs and muscles, breaking out in a sweat) as well as headaches. These symptoms are not dangerous for the donor. From records kept on the administration of G-CSF to more than 100,000 healthy stem cell donors, we know that this drug causes no permanent side effects over the long term. In very rare cases, allergic anaphylactic reactions (fever, chills, skin rashes, fall in blood pressure or circulatory collapse) have been described in patients very soon after receiving a dose of G-CSF. 

Your donation is made with the help of ‘cell separators’ – like those you are familiar with from blood platelet donations. These are tested and approved devices that only extract certain constituents from the blood while allowing the rest of the blood to be returned at the same time. Essentially, a cell separator consists of pumps that control the flow of blood plus a centrifuge that separates the blood into its constituent parts. A venous access port is placed in the left and right arm for the donation. The tube set is first prefilled with a saline solution to remove any air present. You are then connected to the system, and your blood is drawn out of the vein while administering a sedimentation accelerator (6% hydroxyethyl starch solution) and an anticoagulant (citrate), which binds to calcium, and routed into the cell separator. Inside the cell separator, a centrifuge rotates with a centrifuge insert made from plastic. The granulocytes are enriched by the centrifuge and then collected in a pouch. This method is able to collect a large proportion of the mobilised granulocytes. The remaining constituents of the blood are then routed back into the donor’s body. At the end of the separation, the tube set is again flushed with a saline solution to reduce the amount of blood left in the hose system to a minimum. Overall, the process lasts between two and three hours. A maximum of two donations can be made on consecutive days. Since the cell separator is fitted with a new, sterile single-use system for each donation, no diseases can be transmitted as a result of the cell separation process. The transfusion of granulocyte concentrates to the recipient is made a few hours after the donation.

Side effects are rare and almost always harmless. Laying the venous access port can cause bruising, but this typically disappears completely in a short space of time. In very rare cases, injury to other vessels and nerves may occur. Occasionally, skin allergies may occur in response to the use of some disinfectants and plasters. As with any blood donation, symptoms such as sweating, dizziness, fainting, vomiting, hyperventilation and seizures may occur. These are all responses of the vegetative nervous system and do not result from the loss of blood. Citrate, which is an anticoagulant, is administered to ensure that your blood does not clot inside the tubes in the separator. This anticoagulant works by binding to calcium. However, since calcium is also important for muscular and nervous activity, you may feel some strange sensations during your donation (a tingling feeling or ‘ants running over your skin’, especially in your fingertips, toes, lips and around your mouth) as well as muscle cramps and an irregular heartbeat. These changes to your feeling of wellbeing can be resolved quickly by administering calcium (as a tablet or infusion). Potassium values may also drop during your donation, which can be compensated for by administering a potassium-rich drink. Allergic reactions to the plastic material in the single-use hose set or to citrate are very rare. The HAES solution is macromolecular and is required in order to be able to separate granulocytes from the other constituents of the blood. This drug can temporarily cause fluid retention, elevated blood pressure, an increased tendency to bleeding and, in very rare cases, severe allergic reactions. Accordingly, it is important that you tell us immediately about any unusual physical sensations that you experience during cell separation. Depending on the dose, HAES can also cause temporary pruritus (itching) in some donors a few weeks after being administered. This itching can last for several days and, although unpleasant, is absolutely harmless and always completely resolves itself afterwards. Technical problems, such as the tearing of the hose/pouch system, followed by blood loss and microbial contamination, air embolisms (air bubbles) caused by equipment failure, blood disintegration (haemolysis) caused by pump malfunctions, pressure fluctuations or shearing forces in the separation system and the formation of blood clots are extremely rare but specific risks involved in cell separation.

You will receive a medical exam before your first granulocyte donation, and blood will be taken (for analysis, to determine your blood group and check for any infections). We are obliged by law to check blood samples for hepatitis B and C, HIV (AIDS pathogen) and syphilis. Your lab values are checked again before each donation that you make. If any results from these preliminary tests are anomalous, further diagnosis is conducted from control samples, and we will make the necessary notifications required by law. If we discover that you have an infectious disease, we will discuss the results and treatment options with you personally.

Donating can temporarily lower your level of physical fitness. Your ability to participate actively in traffic as a road user and to operate machinery will also be temporarily affected. You should therefore avoid all physical activity for at least 30 minutes after granulocytapheresis.

Bus drivers, pilots, truck drivers, crane operators, roofers and any other individuals whose activities involve an elevated level of risk if motor skills become impaired (including diving, mountaineering, skydiving, etc.) should wait 24 hours before returning to work.

Yes, you can also continue to help patients needing transfusions by donating your blood platelets. After donating granulocytes, we recommend waiting roughly four weeks before your next blood platelet donation.