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While there is only a slight increase in demand for donor blood over holidays, there is also a corresponding decrease in elective surgery during these times. So the demand for donated blood remains pretty steady all-year round. Blood usage in South Africa is more or less at a plateau, but slight increases are visible as the population increases.

These facts transpired in and interview with Dr Arthur Bird, medical director of the Western Province Blood Transfusion Service.

Shortages in donor blood do not occur – as is the general perception - due to an increase in demand, but as and when regular donors skip or delay a donation over a long weekend or when on holiday. Two factors are at play to create shortages in donor blood, namely the smaller number of regular donors and the fact that platelets (one of the components of blood) can be stored for only five days.

Blood banks in South Africa run into shortages as soon as a percentage of regular donors go on holiday at the same time without donating blood, or if regular donors don’t (or can’t) donate blood over a long weekend.

Who needs blood?
Eight out of every ten people will need donated blood at some time in their lives. Without blood donated by other people, many of them would have died. Still, many people don't give the blood transfusion service a second thought until they are the ones needing the blood.

Blood gets used for different medical procedures. These are as follows:

• 28 percent for patients with chronic diseases that are not surgically treated and for blood cancers, such as leukaemia and bone marrow cancer
• 26 percent for women who haemorrhage during or after childbirth and for premature babies
• 26 percent for patients undergoing surgery such as hip and knee replacements, heart surgery and gastrointestinal surgery. Many operations would be impossible without donated blood.
• 10 percent for sick children
• 6 percent for research and
• 4 percent for people injured in accidents

“Just in the Western Cape, we need up to 130 000 donated units per year,” according to Dr Bird.

The donated blood is divided into three different components: red cell concentrate, plasma and platelets, all of which get used for different things. Red cell concentrate is mostly used when patients suffer severe haemorrhage as a result of surgery, for childbirth complications, trauma or cancer. Fresh frozen plasma is used to control bleeding and platelet concentrate is used for leukaemia and cancer patients and patients with bone marrow deficiency. Donating one unit of blood could mean helping three different people.

The red cell concentrate can be kept for five to six weeks, the frozen plasma for a year, but the platelets can only be stored at room temperature for about five days, and it is here where problems arise over long weekends like the Easter weekend.

While blood banks keep a three to five day reserve of donated blood, problems can arise when there are several public holidays in a row. On the Monday after Easter, the services often run an emergency donation clinic to make sure they don't run out of reserves.

Who can donate blood?
Anyone who is over 17, weighs at least 50 kilograms and who has not donated blood in the preceding 56 days, who is healthy, not anaemic, not on certain types of medication, or whose social behaviour does not place them at an increased risk of transmitting the HI-virus or a hepatits virus. People who have recently traveled to malaria areas are usually also excluded.

Before you can donate blood, you will be asked about your lifestyle, personal details and medical history. These questions are asked to make sure that it is medically safe for you to donate blood and that the person who receives your blood, will not be harmed in any way. A finger prick test is done to determine your haemoglobin levels, and your blood pressure and pulse rate will also be checked. If everything is in order, you will donate about 480 ml of blood, which will take between six and 10 minutes. The average person contains about 5 litres of blood, which is continuously replaced. Donating blood is thus not usually a problem. It is not possible to contract any disease by giving blood.

What about artificial blood?
Much has been written about the development of artificial blood and there have been advances in this field, especially in producing the active oxygen-carrying chemical in the blood, but clinical trials have not yet been completed. But there are problems, which include possible toxicity, and the very high cost of producing artificial blood, explained Dr Bird.

The safety of donor blood
The WPBTS utilises the latest international technology to test donor blood. Nucleic Acid Testing (NAT) uses DNA technology which effectively narrows the detection period of HIV infection to between 5-11 days. This technology is being used by the blood transfusion services nationally and is currently the largest application of single-donor testing in the world. This ensures that South African transfusion services are in line with the highest standards of international blood transfusion practices.

Dr Bird agrees that there is “an outside chance” that infected blood could slip through. But new screening tests and rigorous quality assurance procedures, has reduced this 'window period' to between 5 and 11 days. Given the fact that the general population is estimated to have an HIV-infection rate of between ten and twenty percent, depending on the region, the fact that fewer than one in a thousand potential donors are HIV-positive, says a lot for the screening procedures, he says.

But there is still a risk. However, weighed up against the dangers of not transfusing when blood is required, this risk turns out to be minimal.

If you still have doubts about the safety of donated blood, you can pre-donate your own blood, which many people do, especially before they undergo orthopaedic surgery. By doing this, a very minimal risk turns into no risk at all. This should be done mot less than three to seven days before surgery. If you need more than one unit, allow four to seven days in between each donation. – (Health24)

Click here for the Western Province Blood Transfusion site.
 

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