Blood transfusion is a life-saving medical therapy where, transfusion of blood or blood components must be ordered and administered safely and appropriately. Transfusion is more than a single discrete event, but a process. The transfusion chain begins with donor considerations (whether their donation is safe for them to make and whether the donation is safe for any patient to receive). Once blood is collected, the safety of the blood product is a focus of activity (infectious disease testing, compatibility testing, necessary modifications such as irradiation or leukocyte reduction). The endpoint of the transfusion process involves recipient considerations, proper identification of the unit and the patient, appropriateness of blood as the best treatment modality, administration of the unit, and evaluation of the recipient.
The division of Transfusion Medicine provides a stable supply of blood and blood components to patients in RCC and also to patients in hospitals outside the Centre. The division also works to provide blood products to the full fledged stem cell transplantation unit in RCC. The Transfusion Committee meets regularly under the chairmanship of the Medical Superintendent to discuss ways and methods for improving our patient services.
The division has a long cherished past since its modest beginning as blood bank in 1992. Right from inception, the division started 100% component separation technology to make optimum use of the collected blood unit. Over the years, the RCC blood bank has grown into a full-fledged Division with 100% blood component separation facility, including apheresed products. We have the state-of-the-art equipments in commensurate with technological advances in blood component preparation and immunohaematology. The division was accorded the status of Regional Blood Transfusion Centre (RBTC) in 2009.
With the continued support of a pool of repeat regular donors, voluntary blood donation organisations, officials and students from institutions in and around the city, the percentage of voluntary blood donors have doubled over the past five years. We have been conducting regular public awareness programmes on voluntary blood donations, with an objective of achieving 100% voluntary blood donation in the coming years.
The division offers training to postgraduate students of pathology and students undergoing BSc (MLT), BSc/MSc (Nursing) and DMLT. We also conduct one year course in Quality Excellence in Blood Banking Technology with 2 seats on an annual basis.
What are the types of blood donation?
Whole blood donation and platelet donation are the two types.
What is meant by whole blood donation?
This is the most common type of blood donation during which one unit of blood (350ml or 450ml depending on your body weight) is collected. The collected blood is separated into different components like red cells, platelets, plasma and/or Cryoprecipitate AHF. This type of blood donation normally takes less than an hour, though the actual donation process takes only about 5-10 minutes.
What are the eligibility requirements for whole blood donation?
A person is eligible to donate whole blood every 90 days. To ensure the safety of both donors and recipients, all volunteer blood donors must be evaluated to determine their eligibility to donate blood. All blood donors must be at least 18 years of age and weighing more than 50kg. Donors must have a Haemoglobin value more than 12.5gm% in order to qualify for blood donation. Donation frequency should be strongly adhered to. Other aspects of each potential blood donors' health history are discussed as part of the donation process before any blood is collected.
How is the donation process in whole blood donation?
Registration: Our staff and volunteers will sign you in and go over basic eligibility and donation information. Our Counsellor will brief you about blood donation and you will answer some questions during a private and confidential interview about your health history and places you have travelled. You will complete donor registration which includes information such as your name, address and phone number.
Mini-Physical: We will check your temperature, pulse, Blood Pressure and your medical history will be assessed by the Medical Officer. Female donors will have their Haemoglobin value checked by a quick method which takes less than 3 minutes, to see if it is not less than 12.5gm%.
The Donation: You will be called to the blood donation room according to your turn. The actual donation takes about 5 to 10 minutes during which you will be seated comfortably. The process is safe and sterile. We will cleanse an area on your arm and insert a brand new sterile needle for the blood draw. It feels like a quick pinch and is over in seconds. Blood is collected into a closed system of interconnected bags. Staff and volunteers will be available if you have any queries. You may relax while the bag is filling. When the process is complete, a staff will place gauze over the phlebotomy site and ask you to keep your arm flexed at the elbow.
Refreshment: You will spend a few minutes enjoying refreshments to allow your body time to adjust, to be slight decrease in fluid volume. You cannot leave the refreshment area before 15 minutes as you will be under observation for any donor reactions. After about 15 minutes, your phlebotomy site will be observed for arrest of bleeding and a staff will place a band-aid at the site. You can now leave the room and continue with your normal daily activities. Enjoy the feeling of accomplishment knowing that you have helped save lives.
What are the tips for successful whole blood donation?
By following a few recommendations before, during and after your blood donation, you can make your blood donation experience as safe, successful and pleasant as possible.
Before donation:
- Maintain a healthy Iron level in your diet by eating Iron rich foods such as spinach, red meat, fish, poultry, beans, cereals and raisins.
- Get a good night's sleep.
- Drink extra 1-2 glasses of water or fluids before donation.
- Eat a healthy meal before your donation.
- Avoid fatty foods, fries or ice-creams before donation.
- Bring the names of medications you are taking.
During donation
- Wear clothing with sleeves that can be easily raised above the elbow.
- Let the phlebotomist know if you have a preferred arm and show the staff any good veins that have been used successfully in the past to draw blood.
- Relax, listen to music, or read during the donation process.
- Take time to enjoy a snack and drink in the refreshment area immediately after donating.
After donation
- Drink plenty of fluids over the next 24-48 hours to replenish the lost fluids.
- Avoid strenuous physical activity or weight lifting for about 6 hours after donation.
- Keep your band-aid on and dry for the next 5 hrs.
- In rare cases when bleeding occurs after removing the bandage, apply pressure to the site, raise your arm for 3-5minutes.
- If bleeding or bruising occurs under the skin, apply a cold pack to the area periodically for the first 24 hrs.
- Because you could experience dizziness or loss of strength, use caution if you plan to do anything that could put you or others at risk of harm.
- For any hazardous occupation or hobby, follow applicable safety recommendations regarding your return to these activities following a blood donation.
- If you get dizzy or lightheaded, stop what you are doing, lie down, and raise your feet until the feeling passes and you feel well enough to safely resume activities.
Is it safe to give blood?
Donating blood is a safe process. Each donor's blood is collected through a new, sterile needle that is used once and then discarded. Although most people feel fine after donating blood, a small number of people may feel light headed or dizzy, or experience a bruise or pain where the needle was inserted.
Can I get HIV from donating blood?
No. Sterile procedures and disposable equipment are used in RCC. We use a needle only once and then dispose of it. You cannot contract HIV or any other viral diseases by donating blood.
What tests are done to ensure by blood is safe to distribute to patients?
- ABO and Rh Blood types.
- Hepatitis B surface antigen, indicating a current infection or carrier state for hepatitis B virus.
- Antibody to Hepatitis C virus, indicating a current or past infection with Hepatitis C virus.
- Antibodies to HIV 1 and 2 viruses and HIV 1 Antigen
- VDRL
- Malaria
If my blood is positive for any infectious disease, will I be informed about the result?
Yes. Donors who are tested positive for any infectious disease are notified and have the opportunity to receive counselling with a specially trained professional Counsellor. Since all tests done in blood bank are screening tests, you will be redirected to a higher centre where there is facility for confirmatory tests.
How will the Blood Bank contact me if I have a disease?
RCC Blood bank regards blood test results as private and confidential information. The blood bank may contact you over the phone to arrange a counselling appointment, but will not disclose information regarding the type of test done or its result to anyone, but the donor.
How long will it take to replenish the unit of blood I donate?
The plasma from your donation is replaced within 24 hours but red cells need about 12 weeks for complete replacement.
Why does the Counsellor ask so many personal questions when I come to donate blood?
Our highest priority is the safety of the blood supply and our blood donors. Some individuals may be at risk of transferring communicable disease though blood donation due to exposure via travel or other activities or may encounter problems with blood donations due to their health. We ask these questions to ensure that it is safe for patient to receive your blood and to ensure that it is safe for you to donate blood that day.
What is meant by platelet donation?
In this type of donation, a machine collects the platelets and some plasma and returns the red cells and most of the plasma back to the donor. Platelets are a vital element of cancer and organ transplant treatments as well as many surgical procedures as they help prevent massive blood loss. A single donation of platelets collected by aphaeresis can constitute one or several transferable units while it takes about six whole blood donations to constitute a single transferable unit of platelets.
What is the process in platelet donation?
During a platelet donation, a small portion of your blood, (approx. 400 ml) is drawn from your arm and passed through a sophisticated cell-separating machine. The machine collects the platelets and safely returns the remaining blood components, along with some anticoagulant, back to you. After the donation, you can resume your normal activities avoiding heavy lifting or strenuous exercise that day.
A single platelet donation can provide enough platelets for a full therapeutic dose for a patient in need. In fact, some platelet donations yield enough platelets for 2 or 3 therapeutic doses. By contrast, it takes 4 to 6 whole blood donations to produce a single therapeutic dose.
Many patients who need platelets are undergoing chemotherapy or organ transplant and have weakened immune systems. A platelet dose from a single donor reduces the patient’s exposure to multiple donors and is therefore preferred by many physicians.
Since the need is great for platelet donations, all blood donors are encouraged to consider platelet donations. It has been discovered that women who have previously been pregnant are more likely to carry antibodies that are believed to sometimes cause post transfusion complications for blood recipients. Hence, females who have previously been pregnant are better suited for red cell donation than platelet or plasma donations.
Platelet donation in a cell separator uses a disposable kit which is imported for the purpose. Since the kit used is costly, testing of the donor for infectious diseases is done beforehand so that wastage following discarding of a positive sample is avoided. Hence, unlike in whole blood donation, donors are tested for Infectious serology before the actual procedure and only donors who are serology negative are selected for the procedure. Since serology testing takes about 3 – 3½ hours, donors for pheresis should be brought to blood bank sufficiently early so that the procedure can be completed and product issued on the same day, if needed.
What are the eligibility criteria in platelet donation?
While all eligibility criteria for whole blood donation apply to Platelet donation as well, there are few additional criteria also.
Medication: Donors on Aspirin or aspirin-containing drugs should have a medication free interval of 3 days or 72 hours before they can donate platelets.
Previous donations:
Body weight: For platelet donations, the minimum recommended body weight is 65 kg as against 50 kg for whole blood donation.
Precount: A pre-count of more than 2 lakh/mm3 platelets and Haemoglobin of more than 12gm % is required to be eligible for platelet donation.
Good forearm veins: One or more good veins are required for a successful platelet donation.
Blood Group: For platelet pheresis, the donors’ blood group and patients’ blood group should be identical.
What are the steps involved in platelet donation?
Registration: Our staff and volunteers will sign you in and then go over the basic eligibility and donation information. You will answer some questions during a private and confidential interview about your health history and places you have travelled.
Mini-Physical: We will check your temperature, pulse, BP. Further, both arms will be checked for prominent veins and a suitable vein will be identified for phlebotomy. Now a small quantity of blood sample (usually 5ml) will be collected from a site different from the selected phlebotomy site and subjected to haematological evaluation and infectious serology testing. The haematological parameters are evaluated and samples with platelet count more than 2 lakh/mm3 and haemoglobin >12.5 gm% are selected for the procedure. Depending on the type of Infectious Serology Test employed, it may take 2 to 3½ hours for the result. Once the results are obtained, the procedure is scheduled for the same day itself or the next working day.
The donation: One the day of the procedure, you should come prepared to spend a couple of hours in the blood bank. A disposable Kit (to be used for the procedure) along with a bag of anticoagulant solution will have to be purchased from the pharmacy. Loading the kit in the cell separator takes a few minutes only. The instrument draws blood from the previously selected phlebotomy site through a sterile tubing into the centrifuge bowl. The self-contained sterile tubing assures that your blood never comes in contact with the instrument.
Platelet donations may be a single or dual arm procedure depending on the collection device used. For a dual arm procedure, one arm is used for drawing the necessary blood components and the other arm is used for returning the unused components. For a single arm procedure, only one arm is used for both collection and return.
The Cell Separator collects about 400ml of blood at a time, processes it, separates platelets (or the desired component), and returns the unused components, which completes one cycle. The machine uses multiple such cycles (usually 6 or 7) to collect the desired number of platelets. The number of cycles may vary and is calculated by the machine depending on your pre-count, blood volume and the yield of the product required.
In most cases, the donation process will be complete in 90 minutes. You can watch TV, listen to music or read books during the process. When the blood components have been collected, the donation is complete and a staff person will place a bandage on your arm.
Refreshment: After donating, you should have a snack and something to drink in the refreshment area. You can leave the site after 10-15 minutes and resume normal daily activities. You are eligible for another platelet donation after 48 hrs, but not more than twice a week. Enjoy the feeling of accomplishment knowing that you have helped save lives.
What is aphaeresis?
The word ‘aphaeresis’ is derived from Greek word 'aphaeresis' meaning to 'to take away'. Aphaeresis is the process by which platelets and other specific blood components (red cells or plasma) are collected from a donor. The process is accomplished by using a machine called Cell Separator. Blood is drawn from the donor and platelets or any other blood component, is collected by the cell separator and the remaining components of the blood are returned to the donor during the donation. Each aphaeresis donation takes about 1½ - 2 hours.
Why are platelets donations important?
Platelets are tiny, colourless, disc shaped particles circulating in the blood and they are essential to normal blood clotting. Platelets are critically important to the survival of many patients with clotting problems (aplastic anaemia, leukaemia) or cancer and patients undergoing organ transplants or major surgeries like heart bypass grafts. Platelets can only be stored for 5 days after being collected. Maintaining an adequate supply of this lifesaving, perishable product is an on-going challenge.
How often can I give Platelets?
Every 7 days. Upto 24 donations can be made in a year.
Why does platelet pheresis take a long time?
Unlike blood donation which is completed in 10 minutes, apheresis involves separation of platelets and return of the rest of the blood back to the donor. This takes time and is done while the donor is connected to the machine.
Is there any harm in being connected to the machine?
Plateletpheresis is a very safe procedure. The donor remains comfortable and safe. The procedure is done under supervision of trained doctors. The donor can talk, listen to music, read a book during the procedure.
Are there any side effects of the process?
Some donors may a sensation of numbness on the face and lips. This can be easily corrected by intake of calcium tablets.
Will my blood become bad or get infected in the machine?
There is no chance of the blood getting infected or going bad. The donors' blood actually runs through a disposable sterile single use kit.
Can I make platelet donation without receiving the rest of blood?
No, it is not possible. The procedure is programmed in such a way that platelets are collected in 5 or 6 cycles and each cycle is completed only after the return of platelet poor blood.
Will my platelet count drop too much once I donate a very large number of platelets?
No, since platelets are much more numerous than RBC or WBCs, it is safe to donate large number of platelets without any harm to the donor. Further the machine is programmed in such a way that it prevents the donor platelet count falling below critical levels.
What is meant by Plasma donation?
Plasma is one of the key blood components needed for modern medical practice. During Plasma donation, blood is drawn from one arm and channeled through a sterile single use connection set to an automated machine. The machine collects the selected components-plasma only or a combination of plasma and platelet units-and then safely returns the remaining blood components. If you are a donor with type AB blood, in addition to donating platelets, your blood type makes you an ideal candidate for donating Plasma. Type AB plasma is universal which mean your plasma can be received by anyone, regardless of their blood type. And because you are among only 4 % of the population with this blood type, it makes your plasma in need. You can donate every 28 days, up to 13 times a year. Average Plasma donation takes 1 hour 15 minutes. If you are a regular Whole Blood donor, please find time to make plasma/platelet donations. Both gifts are vital for patients with life threatening diseases.
How do I get the required blood components from RCC?
To receive blood or blood products from RCC blood bank, you must have a doctor's prescription and a properly labelled blood sample in a plain vial. The sample, along with the request, should reach the laboratory before 1 pm on all working days. Depending upon the blood component you require, it may take 30 minutes to 2 hours. You have to pay service change as per the rate list applicable at the time. Rates are subject to periodic revision without any updating in the website. Blood products can be sometimes in short supply and it is better to check the availability over the phone before you visit the blood bank.
How much time will it take to get blood?
It takes about 1½ to 2 hours to cross match the blood sample and provide you with the required component. However issue of blood component which do not require cross match will take lesser time.
Why blood testing charges?
RCC administers only approved testing charges uniformly from all patients in hospitals in the city. The blood testing charges are fixed by the Centre, approved by the Government and are controlled by government norms. RCC follows international quality standards in blood collection, processing, storage and distribution. These activities involve reasonable cost as most equipment are imported for the purpose. The service charges recover only the costs incurred during the blood banking procedure.
Should I replace the blood that I have procured from RCC ?
RCC blood bank issues only the surplus stock of blood products to outside hospitals. We charge a fee as per standard rates for this. An additional replacement of the procured blood product is not always requested for.