Blood Donation - Science topic

Yes; blood components are alive. For differing durations, of course.

Red blood cells are stored in a mixture of anticoagulant (citrate) phosphate buffer to keep the medium at the ideal pH, glucose to feed the cells and adenine to keep intracellular enzymes from exhausting. At a constastne temperature of 4 deg C the red cells are viable for 45 days.

Platelets develop the 'storage lesion' rapidly if refrigerated. Stored at 20 deg C with constant agitation they remain alive and able to initiate haemostasis for up to 10 days but during this entire time they could be incubating bacterial pathogens. If your system does not have regular pathogen checks on stored platelets, use them as son as possible.

Neutrophils and monocytes have a normal life-span of less than a day, so no issue.

The BIG one is lymphocytes. Memory lymphocytes, particularly T-cells, have an extraordinary long life span in vivo and are viable as long as red cells are in vitro. This can cause outbreaks of graft-versus-host-disease, as happened in Japan in the early 1990s, and immune chimerism (a partial graft of the donor's immune system) persisting for life. It is probably also responsible for immune modulation which increases the rates of infections in patients transfused in association with surgery.

A blood transfusion is a living tissue transplant. Use transfusion only when necessary and all other legitimate alternatives have been deployed.

Blood banks are essential to our healthcare system as it functions to provide the patients in need with a consistent supply of blood and blood products. According to Lee (2016), the foundation of today's blood service is voluntary, non‐remunerated blood donation, which is heavily dependent on community involvement and support. Some challenges encountered in recruiting blood donors include having fear of needles, misconceptions or false beliefs, donor ineligibility due to their lifestyle, lack of education and awareness, and time constraints because of conflicting schedule and distant blood donation site ("10 reasons for not donating," 2024). In order to address these concerns, strategies such as utilizing a range of media platforms, including radio, television, social media, and billboards, to disseminate awareness about the value of blood donation, to educate, and to debunk myths and misconceptions can help recruit voluntary blood donors. Apart from friends and family, who are by far the primary motivators for first-time-donors, social media has emerged as the second most significant factor in attracting new donors (Sümnig et al., 2018). In addition, hosting blood drives in places of community centers, heavy traffic areas, and educational institutions can make blood donation more accessible to potential donors. Lastly, establishing initiatives that show gratitude and recognition for donors via pins, certificates, or mentions on social media is also a great strategy in order to appreciate blood donors. Through focused strategies and coordinated efforts, blood banks can improve their ability to attract and retain voluntary blood donors, ultimately ensuring an adequate supply of blood for patients in need.

References:

10 reasons for not donating. (2024, March 1). Miller-Keystone Blood Center. https://www.giveapint.org/10-reasons-for-not-donating/

Lee, C. (2016, June 1). Update on donor recruitment and management in blood service. Semantic Scholar. https://www.semanticscholar.org/paper/Update-on-donor-recruitment-and-management-in-blood-Lee/2aa2f86a69a4d7e0062d8181e1cb11073dd0a1a7

Sümnig, A., Greinacher, A., Thiele, T., & Feig, M. (2018, September 10). The role of social media for blood donor motivation and recruitment. ResearchGate. https://www.researchgate.net/publication/327602905

Based on the study conducted by Torrent-Sellens et al.(2021), interacting with communities and raise awareness about blood donations, blood banks can utilize digital platforms such as websites and social media to disseminate information and updates about blood donation needs and events. Additionally, they can collaborate with community organizations, such as schools and religious institutions, to organize awareness campaigns and educational sessions. Conducting educational programs in schools, workplaces, and community centers can help address misconceptions and provide accurate information about blood donation. Engaging with the media through press releases and news stories can also help raise public awareness.

To encourage voluntary blood donations in the Philippines, blood banks can focus on targeted education campaigns, engage local influencers as ambassadors, organize community blood drives, and establish personalized communication channels to address individual concerns and doubts. By implementing these strategies, blood banks can effectively enlighten the public, erase misconceptions, and promote voluntary blood donations in local communities.

Reference:

Torrent‐Sellens, J., Salazar-Concha, C., Ficapal‐Cusí, P., & Saigí-Rubió, F. (2021). Using Digital Platforms to Promote Blood Donation: Motivational and Preliminary Evidence from Latin America and Spain. International Journal of Environmental Research and Public Health (Online), 18(8), 4270. https://doi.org/10.3390/ijerph18084270

The lack of clarity in Western Kenya's legal framework for blood donation could significantly impact the blood supply in the area. Ambiguity in legal matters may confuse potential donors, healthcare providers, and blood collection agencies, thereby reducing voluntary donations. A clear legal framework is essential for establishing guidelines on who can donate, how donations are managed, and the enactment of safety protocols.

The Kenya National Standards for Blood Transfusion Services, 2nd Edition, prepared by the KNBTS Standards Committee with support from the World Bank through the COVID-19 Health Emergency Response Project (C-HERP), were reviewed by the Ministry of Health to contextualize desired standards. The book outlines requirements for patient consent, blood component inspection, and expiry date verification, covering guidelines for resources, records, suppliers, inventory, equipment, safety protocols, and risk management.

Emphasis is placed on establishing policies and procedures to meet standards, including a donor suitability questionnaire and consent. This guide can serve as a vital legal framework ensuring quality and safety in Kenya's blood transfusion services.

Reference:

Kenya National Standards for Blood Transfusion Services 2nd Edition (2nd ed.). (2022). Ministry of Health Kenya. http://guidelines.health.go.ke:8000/media/Kenya-National-Standards-for-Blood-Transfusion-Services-_-F.pdf

Yes, there are certain populations and groups that are at a higher risk of transfusion-transmissible infections (TTIs) than others. Here are some key factors to consider:

An autologous donor is someone who donates their own blood, which is later stored for their own potential future use, typically in anticipation of a planned surgeries.

Autologous blood donation is done to ensure that the blood used in a medical procedure is compatible with the patient's own blood type, reducing the risk of transfusion reactions. It also eliminates concerns about bloodborne infections or immune reactions that can sometimes occur with allogeneic blood transfusions.

Erythrocytes don't carry any genetic information and plasma even less. Some leucocytes come in every transfusion but they are generally only harmful.

Procedures involving apheresis are typically highly received. During or after the procedure, adverse events of varying degrees of severity could happen. There are two types of reactions that it causes in donors: local reactions and systemic reactions. Hematomas from extravasation from the veins brought on by improper needle positioning during venipuncture are the most common local responses. At the extravasation location, discomfort, hyperemia, and edema could appear. Localized thrombophlebitis and phlebitis are extremely rare. Vasovagal reactions, which make up the majority of systemic reactions, can be brought on by venipuncture discomfort, stress associated with donating blood, etc. They are characterized by pallor, perspiration, nausea, dizziness, bradycardia, hypotension, and syncope. The use of acid-citrate-dextrose (ACD) in apheresis results in citrate toxicity.

Philip, Joseph, et al. “Adverse Events Associated with Apheresis Procedures: Incidence and Relative Frequency.” Asian Journal of Transfusion Science, vol. 7, no. 1, 2013, pp. 37–41, www.ncbi.nlm.nih.gov/pmc/articles/PMC3613659/#:~:text=%5B1%2C2%2C6%5D, https://doi.org/10.4103/0973-6247.106730.

In blood donation, there is this term 'deferral period' wherein a donor is not allowed to donate blood at a specific range of time for reasons such as recent immunization, surgery, etc. According to the Philippine Society for Microbiology and Infectious Diseases, 'deferral' or 'waiting period' is required for the patient safety consideration. This is because blood from a recently vaccinated donor may contain an infective agent which although not harmful to the donor, but may theoretically pose a risk to patients who are immune-suppressed or immunocompromised.

Due to this deferral period, it is assured that the blood that is transfused to the recipient is assured in terms of quality and safety of the blood products. Additionally, there are further tests performed in the blood to screen for pathogenic agents that may put the recipient in increased risk or harm. In recent literatures, there are no evidence of transfusing recently immunized blood to patients as there are protocols for deferral on blood banks.

Timing of blood donation among donors who received covid-19 vaccines. (2021, March 16). Retrieved February 24, 2023, from https://www.psmid.org/timing-of-blood-donation-among-donors-who-received-covid-19-vaccines/

Zabeida, A., Lebel, M. H., Renaud, C., Cloutier, M., & Robitaille, N. (2019). Reevaluating immunization delays after red blood cell transfusion. Transfusion, 59(9), 2806-2811. doi:10.1111/trf.15433

A study was conducted by Al-Hazimi A. entitled “Effect of stress on immunity: a study among healthy blood donors at King Abdul Aziz University Hospital, Jeddah'' examined the physiological reaction that induced psychological stress in blood donation. It demonstrated that there is an imbalance in lymphocyte subpopulations that may have been caused by a decrease in the total blood volume. The imbalance caused by the decline in CD4+ cells, or T helper, and the rise in CD8+ cells, or T-suppressor, led to a general decline in the CD4/CD8 ratio. The suppressive properties of the CD8 lymphocyte subset may have led to the decline in CD4 cells.

A rise in CD56+ cells or NK cells was also observed in the findings, which might indicate an improvement in the immune system as a result of a psychologically positive consequence that alleviated the stress. There was a notable increased concentration of IgG, IgA, and IgM as a result of the stress brought on by the blood donation. The rise in immunoglobulins may have been caused by increased adrenaline levels, which prepare the body's defensive mechanism to fight off foreign agents like bacteria that may attack under stressful conditions. The researcher stated that further investigations are needed to assess the long-term impact of moderate stress on the quantity and functionality of T cells. Additional researches is necessary to clarify the effects of blood donation in the mechanisms involving immune systems of blood donors.

References:

Al-Hazimi A. (2004). Effect of stress on immunity: a study among healthy blood donors at King Abdul Aziz University Hospital, Jeddah. Annals of Saudi medicine, 24(1), 52–54. Retrieved February 24, 2023 from https://doi.org/10.5144/0256-4947.2004.52

What are the side effects of donating blood? (n.d.). HDFC | ERGO. Retrieved February 24, 2023 from https://www.hdfcergo.com/blogs/health-insurance/what-are-the-side-effects-of-donating-blood#:~:text=Giving%20blood%20reduces%20the%20red,state%20within%20a%20few%20weeks.

According to a published article by Rubin (2022), Blood transfusions typically do not result in the transmission of respiratory viruses including SARS-CoV-2, and the FDA noted that there have been no examples of this type or any other coronaviruses spreading from donor to recipient anywhere in the globe. To maintain the recipients’ safety, certain conditions are to be followed first before donating blood. It is known that one is only allowed to donate blood if their health is in good condition and have normal temperature. Moreover, the FDA advises patients who have COVID-19 to refrain on giving blood for at least 10 days after their symptoms have fully resolved or, if they never experienced symptoms, for at least 10 days following a positive test result.

Rubin, R. (2022). COVID-19 and Blood Donation. JAMA, 327(7), 615. https://doi.org/10.1001/jama.2022.0763

Frequent blood donation is associated with reduced blood pressure and a reduced risk of heart attacks. It contributes significantly to reducing cardiovascular risk factors. If your hemoglobin level is too high, blood donation helps to reduce blood viscosity, which has been linked to the development of blood clots, heart attacks, and stroke. Excessive iron reserves might also increase a person's risk of heart attack. Donating blood depletes your iron reserves and assists your body in producing new blood.

Hi Murad Yasawy . I agreed with

Andrew Paul McKenzie Pegman .

Please go through the following RG links.

To obtain reliable information, a full course of human vaccination is required.

Antibodies in the plasma of treated healthy corona patients, reduces the virulence of virus in the corona patients. One can opt this way of treatment.

It should be implemented because it cover dual purpose i.e. a free health check up to students as well as the reserve blood for the emergency.

Thanks Jyoti

Yes I am planning to study this in the Middle East, especially in Turkey. I would like to be in touch for further studies in the Middle East. Thank you for your interest.

Repeat voluntary blood donors are always the back bone for safe blood supply for any country. Along with that high sensitivity and specificity serology (ELISA/CLIA) testing for screening of blood is a mandatory requirement in most of the countries across the world. NAT or Molecular testing is considered an additional layer of safety after improving the donor base and serology at a blood center.

Serology detects the Antigen and/or Antibody where as NAT will detect the nucleic acid of the virus hence both of these technologies are not replaceable to each other. There is a high incidence of serology positive and NAT negative results when screening of donors (reported from India) hence both of the technologies are mutually exclusive from each other.

It will be worthwhile in your case to conduct a look back study of new incidences of Transfusion associated hepatitis to track the donors. This could help you to evaluate that where they truly missed on serology (either due to window period or poor quality of kits) or they were purely serology negative and NAT reactive (NAT yields).

This might help you to better evaluate that you require better serology with NAT or not.   

regards 

The short answer is no, they can't, given that they will generate a very strong immune response in the recipient. Even in immunocompromised (IC) patients the time required for few blood cancer cells to give rise to a full-blown cancer is typically very long, so only a very severe and long lasting IC could lead to cancer. In this context however, the chances of getting cancer simply because of the severe IC will be much higher than those of getting it due to blood donations. In the SCANDAT (Scandinavian Donations and Transfusions) database there was no evidence of increase in cancer risk among recipients of blood from "precancerous" donors i.e. from donors that later on were discovered to have cancer. It is also true however that cancer can be transmitted after transplant of solid organs, which suggests that the global number of 'transplanted' cancer cells and the subsequent immunosuppression therapy required to avoid organ rejection are also a critical factors.

My dear friends. I think that high commited blood transfusion specialists like ourselves are actually paying attention very carefully and closely about the insurgence of this quite unknown virus. There is no doubt that it is very important, particularly for pregnant women, and for them, all attention must be driven from authorities in order to avoid new cases. But most importantly, if we do not fight the real culprit, the mosquito, we will certainly lose not only this battle, but the whole war. Unfortunately, this I haven´t seen not only in my country, but in several places.  This is a great forum for discussion. Regards

Dear Denny, ---- donating one own time is the most one can do as a volunteer and donating money is one way a loss to the donor in sparing the fund which does make a difference in his saving in the long run----- this is one of the best example of "Contribution Psychology"  of our human community  --- you dont need a survey or study but you can create one of your own like " Take the number of donors who donate blood and donate money you will see that the donors to contribute money is more than to donate blood" because in all ones mind they feel it is a loss to their living good body ----BUT----the same people if asked a question as " Would they make a confirmed amount as donation from their money? OR would they want to volunteer for service for few hours?" the answer would be they would want to volunteer Or deny both the choice made.

Contribution psychology states that " All contribution decided to make by all human ONLY if they can afford and shall be at no risk to their own well being" .    Thanks

Its quite tricky by Ficoll density gradient centrifugation. However, the layer beneath buffy coat (white in color) and above RBC layer may contain granulocytes, like neutrophils.

In response to colleagues’ inquiries about any relevance to blood donors of recent MERS-CoV spread to the Korean peninsula, the following reflects what recently came from colleagues in the US and Europe. So far, there has been no evidence of parenteral transmission published. No specific intervention related to blood donors has been recommended, and there are no new recommendations related to ongoing transmission in the Middle East or the outbreak in South Korea at this time. Donors must be well on the day of donation, and in the unlikely event that a history of MERS-CoV infection is provided by a donor, they should be fully recovered before being accepted for phlebotomy.

Ciao davide,

non so se puo' esserti utile ma con una collega abbiamo studiato (tramite disegno sperimentale) sia l'intenzione di donare (tempo e denaro) che il reale comportamento conseguente, a una "buona causa". Il tutto in un ambito generale di attività di CSR d'impresa. I comportamenti da noi analizzati sono non strettamente connessi all'attività di CSR, ma di più ampio respiro: in latre parole, abbiamo studiato se e come l'attività di CSR d'impresa è in grado di favorire spillover positivi in capo al consumatore.

I riferimenti del paper pubblicato sono i seguenti (se serve, ti posso mandare copia dell'articolo):

Romani S., Grappi S. (2014) - How companies' good deeds encourage consumers to adopt pro-social behavior - EUROPEAN JOURNAL OF MARKETING, vol. 48 (5/6), p. 943-963, doi: 10.1108/EJM-06-2012-0364

Spero possa esserti utile

Ciao!

Silvia

The size of the pool, the method of detection and the techniques (such as concentration) are quite critical to the success of MP-NAAT. Low viral load sero-conversion panels have the chances of viral RNA dilution of the mini-pools, below the detection threshold of the NAAT, though some studies have confirmed its reliability.

References:

    4.  Drosten C, Seifried E, Roth WK. (2001) TaqMan 5′-nuclease human immunodeficiency virus type 1 PCR assay with phage-packaged competitive internal control for high-throughput blood donor screening. J Clin Microbiol.;39:4302–8.

   5.  Morandi P-A, Schockmel GA, Yerly S, Burgisser P, Erb P (1998) Detection of Human Immunodeficiency Virus Type 1 (HIV-1) RNA in Pools of Sera Negative for Antibodies to HIV-1 and HIV-2. J Clin Microbiol 36: 1534–1537

   6.  Nugent, C. T., J. Dockter, F. Bernardin, R. Hecht, D. Smith, E. Delwart, C.

Pilcher, D. Richman, M. Busch, and C. Giachetti. (2009). Detection of HIV-1

in alternative specimen types using the APTIMA HIV-1 RNA Qualitative

Assay. J. Virol. Methods 159:10–14.

   7. Branson, B. M. (2007). State of the art for diagnosis of HIV infection. Clin.Infect. Dis. 45:S221–S225  

   8.  Patel P, Mackellar D, Simmons P, et al.(2010) Detecting Acute Human Immunodeficiency Virus Infection Using 3 Different Screening Immunoassays and Nucleic Acid Amplification Testing for Human Immunodeficiency Virus RNA, 2006-2008. Arch Intern Med.; 170(1):66-74. doi:10.1001/archinternmed.2009.445

   9. Man Charurat, Abdulsalami Nasidi, Kevin Delaney, Ahmed Saidu, Taelisha Croxton, Prosanta Mondal, Gambo Gumel Aliyu, Niel Constantine, Alash’le Abimiku, Jean K. Carr, John Vertefeuille, William Blattner (2012) Characterization of Acute HIV-1 Infection in High-Risk Nigerian Populations J Infect Dis. 15; 205(8): 1239–1247. Published online 2012 February 21. doi: 10.1093/infdis/jis103 PMCID:  PMC3308903

10. Busch, MP, Glynn, SA, Stramer, SL, Strong, DM, Caglioti, S, Wright, DJ, Brandee Pappalardo, B, and Kleinman, SH (2005) A new strategy for estimating risks of transfusion-transmitted viral infections based on rates of detection of recently infected donors. Transfusion 45: 254-256

11. Allain J-P (2004): Occult hepatitis B virus infection: implications in transfusion.  Vox Sang 86:83–911212.

12.   Stramer, S. L., Glynn, S. A., Kleinman, S. H., Strong, D. M., Caglioti, S., Wright, D. J., ... & Busch, M. P. (2004). Detection of HIV-1 and HCV infections among antibody-negative blood donors by nucleic acid–amplification testing. New England Journal of Medicine, 351(8), 760-768.

13. Roth, W. K., Busch, M. P., Schuller, A., Ismay, S., Cheng, A., Seed, C. R., ... & Nascimento, F. (2012). International survey on NAT testing of blood donations: expanding implementation and yield from 1999 to 2009. Vox sanguinis, 102(1), 82-90

14. Smith DM, May SJ, Perez-Santiago J, Strain MC, Ignacio CC, Haubrich RH,et al. The use of pooled viral load testing to identify antiretroviral treatment failure. AIDS. 2009;23:21518

15. Stramer SL  (2007) Current Risks of Transfusion-Transmitted Agents: A Review. Archives of Pathology & Laboratory Medicine: May 2007, Vol. 131, No. 5, pp. 702-707.

16. Rosenberg NE, Kamanga G, Phiri S, Nsona D, Pettifor A, et al. (2012) Detection of acute HIV infection: a field evaluation of the determine(R) HIV-1/2 Ag/Ab combo test. J Infect Dis 205: 528–534.

17. Westreich DJ, Hudgens MG, Fiscus SA, Pilcher CD. Optimizing screening for acute human immunodeficiency virus infection with pooled nucleic acid amplification tests. J Clin Microbiol. 2008;46:1785–1792.

18. Tang Y-W, Ou C-Y, (2012) Past, present and futur

Hi Tanya,

thanks for this very interesting question. First of all, I have never operated  a cell saver myself. However, there are some aspects to this problems which I want to discuss.

Blood is sucked from the wound, and heparin is added immediately quite close to the tipp of the suction. If this heparin rate is too low, coagulation might occur, especially if fibrinolysis is blocked by tranexamic acid (plasmin cannot "cut" fibrin fibrils any longer).

In the machine, however, there should be a filter taking out clots, bone fragments, fatty lumps and similar debris from the wound. Further down the line, the "product" is washed, and in the end there should be something similar to an erythrocyte concentrate not containing much plasma or other cells. However, you can never get rid of all plasma or thrombocytes. Did your technician make sure that the "product" contained enough anticoagulant? Was it really clotting you observed, or could it have been agglutinates (patients with autoantibodies reacting in the cold, for example)?

Again, I have never run a cell saver all by myself. However, I think it could be possible that tranexamic acid might require higher rates of heparin in the cell saver system.

Last question: Those three patients did not have a (recent) history of HIT, did they?

1. I am not convinced that "accurately" and "estimate" should be used in the same sentence.

2. No, I haven't seen any new formulas for this particular problem, but it is an issue similar to predicting plasma concentrations of drugs when using exponential-based algorithms in syringe pumps. It relates to the ratio of fat to total body weight. There have been a number of ways of dealing with this that are accessible to internet search.

However, it boils down to how "accurate" you want your "estimate" to be. Bearing in mind that your lab blood Hb can be as much as 10 to 15% inaccurate, there doesn't seem to be a lot of point in obsessing about more accurate estimates of blood volume.

If you're stuck in a rural clinic and you can only measure height and weight, and the latter is going to give you a misleading answer, you're really only left with height.

What you are sort of saying is that blood volume does not relate to weight when the body weight is outside the "ideal" range of body weight, which varies with height. What you need to use to calculate blood volume outside this range is not the patient's actual weight, but what it should be.

Just roughly eyeballing the ideal body weight charts based on the Quetelet  formula, and extracting the weight ranges associated with "normal" BMIs in the range of 18.5 to 25 (heights 1.5 to 2 m) also gives you an average weight within that range.  Using these average weights with the Nadler formula gives you the average blood volume for each height. Linear regression on the data (R² 0.9996) gives you an approximate relationship of (6100 x body height in metres) - 5500. 

Applying the process to the outer ranges of normality for weight suggests that using the average weight for each height will be =/- 15% accurate for the range.

Is that an "accurate" enough "estimate" for you?.