Mon Feb 14 2022 ~5 min read
By Damu Sasa.
Over the past
couple of months, there has been rising public interest, on where their blood
goes after donation. In part, this interest was sparked by claims that donated
blood was being illegally sold in Somalia.
The claims not
only caused uproar from members of the public, but also likely negatively
impacted regular, voluntary, and non-remunerated blood donations.
The worst of
this was experienced in 2020, during what is generally considered as the peak
of the COVID-19
pandemic in Kenya. Accordingly, total collections for that year were less
than 100,000 blood
units, according to the Kenya National Blood Transfusion Service (KNBTS).
This is despite the target being 500,000 to 1 million (at
least 1% of the Kenyan population) blood unit collections set by the World Health
Organization (WHO).
Such shortfalls on blood donations place many patients at an elevated risk of losing their
lives due to delayed or lack of transfusion. Mothers and children bear the
brunt of this risk as they account for close to 60% of all transfusions in
Kenya.
Fortunately,
there was an upswing in 2021 with doubling of units collected, in part as a
result of collective efforts on blood donor education and mobilization from
both the public and private sectors. However, the rise was still not enough to
meet the required blood unit collection targets.
While a lot has
and continues to be done to mitigate blood
donor apathy, there still remains a lot to do, especially in the space of
blood donor education. Donor awareness will lay stark the impact donated blood
has on saving lives as well as demystify the whole subject to potential donors.
A key aspect of enlightenment is what happens
to one’s blood once donated. Specifically, the process and procedures between blood donation and
transfusion need to be understood by the public. Doing this will allay public fear, especially
on the aspect that some parties could be selling blood; a ‘commodity’ that is
freely given to save lives. If well-executed, this understanding could start
denting the levels of apathy witnessed today.
Once donated,
blood is kept in 2-6?
C refrigerated storage. This is so as to prevent bacterial growth in the blood,
and by so doing, stretch its ‘shelf-life’ to at least 35 days. This is
especially the case for whole
blood donations, which are the most common in Kenya.
If the blood
was donated in open air, it is prepared for transportation to an approved lab for
screening. Preliminary screening involves grouping to determine the blood group of the
donated unit, and establishing the volume of the blood unit. The WHO
recommendation is for each unit to be 450ml to qualify to be transfused to a
patient. This is because, in some cases where the donated volume is below
450ml, the blood is likely to be contaminated by the anticoagulant present in
blood bags, thereby losing its utility for safe transfusion to patients.
After the
preliminaries, the donated blood is tested for TTIs (Transfusion Transmitted
Infections) to ascertain its safety and suitability for transfusion. The
various TTI tests include: HIV, Hepatitis B and C, Syphilis, and Malaria.
Beyond TTI testing, nowadays most labs
test for convalescent
plasma, due to the ongoing COVID-19 pandemic.
Units that fail
even one of the TTI tests are normally either earmarked for disposal, or
further testing and analysis. Donors of these particular units are normally followed
up on for referral to needed care.
Units that pass
all the tests are then approved for transfusion, pending component preparation.
It is becoming more and more common to transfuse components of the blood rather
than whole blood.
Component
preparation is the separation of various blood products from whole blood
donations. This is done with the use of specialized equipment known as
refrigerated centrifuges. The blood products separated normally include red
blood cells, platelets, and plasma.
According to
the American
Family Physician Journal, Red blood cells are used in transfusion to treat
haemorrhage and to improve oxygen delivery to tissues. This is especially for
patients with either symptomatic anaemia or acute sickle cell crisis.
Platelets, on
the other hand, according to Medscape, are
used for treating patients who suffer the risk of acute bleeding as a result
low platelet volume count. This is especially patients with leukemia.
Last but not
least, according to the Red
Cross, plasma transfusions are for patients with liver failure, severe
infections, and serious burns.
Once all
components are ready, and have been approved as safe for transfusion, they are
then sent to inventory, awaiting compatibility testing against patient samples,
before final transfusion to patients.
We hope you now
have a good idea of where or what happens to your donated blood. We trust that
you will use and share this information towards your conscious decision to save
lives through blood donation.
Please feel
free to download the Damu
Sasa mobile app from the Google Play Store, to find your nearest centre for
blood donation, as well as join a community of like-minded individuals keen on
saving lives through blood donation. In any case, life is worth sharing.