Blood Donation.O ,A ,AB,B

Blood Donation

Collection of blood is the most important function of a blood transfusion centre. If the procedure of donor selection and blood colection is carried out meticulously, it will assure a safe and adequate blood supply. To obatain safe blood and blood components it is important to ensure that the donors are healthy and free from transfusion transmissible infections. Therefore, the practice of recruiting voluntary, non-paid donors should be followed.


Donor Selection

Aim

The aim of the subsection is to acquaint the medical officers with different types of blood donors and the need to build up a panel of regular, voluntary non-paid donors. Also to make them aware of the criteria for selection of safe donors and the conditions for permanent and temporary rejection of donors.


Types of Blood Donors

Blood donors may be of 3 types

1. Paid commercial donors

2. Replacement donors

3. Voluntary donors


Paid Commercial donors or professional blood donors (blood sellers) receive monetary returns for donation of blood. These donors are usually not healthy, are often anaemic and at risk of transfusion- transmissible infections.

Replacement donors usually are the family members or friends of a patient and donate blood for their relative in need. This type of donation help to maintain blood stock when voluntary donations are not available. However, pressure from the family may force an individual to donate blood even when he or she is not suitable as a donor. Voluntary donors are individuals who are self-motivated and onate blood with the prime aim of hleping an unknown patient. They receive no payment for it and do not have any desire for personal benefits. These donors more often meet the criteria fo safe donors. They are more likely to be free from transfusion-transmissible infections and hence assure a safe blood supply. They can be motivated to become regular donors.


Recruiting Safe Donors

Many people are reluctant to donate blood due to lack of information, Education of the community at large may help change the attitudes and beliefs about blood donation and encourage people to donate blood. Educational leaflets, films and posters may be used for this purpose.

Educational talks can be arranged for small groups. This has the advantage that people can ask questions and clarify their apprehensions. Emphasis should be laid during the talk on conditions when blood should not be donated particularly regarding high risk behaviour. The ensures the potential donors that their safety is as important to the transfusion centre as that of the recipient.

The objective of a blood transfusion centre should be to retain individuals who donate blood once, as regular donors. Individuals who donate blood at least twice a year or whenever called upon to do so can be regarded as regular donors. They are considered to be safe donors as their blood is regularly tested at the time of each donation. They can be relied upon in emergencies to donate blood. Each transfusion centre must develop ways to recruit donors and retain them. Newer and more efficient methods may be developed according to the needs of the hospital.


Donor Education & Information

Common forms of risk behaviour which disqualify a potential donor from blood donation are
* Heterosexual / Homosexual promiscuity
* Sexually transmitted diseases
* Intravenous drug abuse
* Chronic alcoholism


Individuals practising such behaviour may be at risk of blood borne infections which can transmitted during transfusion.

It is the responsibility of the transfusion centre to educate all donors about what constitutes risk behaviour. A leaflet which enlists the various high risk activities permanently disqualifying a potential donor may be provided to donors. If the donor discovers that his blood may be unsafe for transfusion, a confidential means of self-exclusion should be developed by the transfusion centre.

Self-deferral means that donors make the decision not to donate blood as they understand their blood may be unsafe for the recipient. This may be due to their high risk behaviour or poor health.

Some donors may be under family or peer pressure to donate blood and may be afraid to self defer. They man inform the transfusion centre later of their risk category. It is also important that strict confidentiality must always be maintained under such circumstances and the donor assured of it. Self- deferral ensures blood safety as recently acquired transfusion transmissible infections may not be detected even by most sensitive laboratory tests.

In Indian situation is total voluntary blood donation, self-deferral and other strategies appear as distant goals. The level of education in the predominant donor population i.e. replacement donors may not be very high, however donor education does play a significant role in deferring donors with high risk and assuring safety of blood.

Voluntary donors usually are college students who are young and enthusiastic but very few of them actually become regular donors.

All efforts must be made to motivate voluntary donors to become regular donors. Donor Identification/Registration

It should be possible to trace every unit of blood donated by the donor. The following information pertaining to each donor must be recorded.

1. Date of donation
2. Name, age (date of birth) and sex of donor
3. Father’s/Husband’s name
4. Address and telephone no - office -residence
5. Blood group, if known
6. Type of donor voluntary, replacement, professional or autologous.
7. Date of last donation
8. Donor adverse reaction, if any, during last donation
9. Previous rejection from donation and its reason
10. Consent in writing


Criteria for Donor Selection

Stringent and critical donor selection is a very important approach for the ultimate objective of blood safety. Recruitment of healthy blood donors is important both for the safety of donor and the recipient.

The suitability of a donor for blood donation is determined by medical history, physical examination and few preliminary laboratory tests. These guidelines ensure that the donor is in good health and protects the recipient from any ill effects of disease transmission.


Medical History

A brief medical history should be recorded for all prospective donors. The donor must be explained the need to give accurate information about his health status and any medication or drugs that he may be taking. Donor must be assured that donfidentiality will be maintained under all circumstances. A medical officer/trained nurse should take the history.

It is preferable to record the medical history on the day of donation. Each time a donor comes to donate blood, a standard history questionnaire should be filled. This ensures a systematic collection of the information. It also provides a permanent record of the health status of the donor. In donors who donate blood regularly it provides base line data regarding their health.

All donors must be treated courteously and any doubts/apprehensions must be cleared. This will encourage them to become regular donors. Careful donor selection plays a major role in determining donor and recipient safety.