As World Blood Donor Day is observed on Friday, medical experts have urged Nigerians to voluntarily donate blood to help save lives. They said a single donation could save three lives. Despite medical and technological advances, blood cannot be made. So, donation is the only way blood can be given to those needing it, and that it has been estimated that blood is needed every two seconds.
Consultant Haematologist, and Head of Department, Haematology and Blood Transfusion, Lagos State University College of Medicine (LASUCOM and Lagos State University Teaching Hospital (LASUTH), Dr. Ebele Uche, said the goal is to try to reduce the risk of transfusing infected blood as much as possible.
She said patients usually need blood for one reason or another. However, people should know that blood must be screened before transfusion to avoid making the situation worse.She said: “One of the most important and fundamental pillars and methods of blood transfusion is donor’s selection criteria. For any blood bank to thrive, it must depend on the blood donor’s selection.
“In the developed world, most blood donors are voluntary. On their own, people go to blood banks to donate blood freely, which is World Health Organisation (WHO) standard. Therefore, 100 per cent of blood donations in the developed world are done without money involved.
“There are three types of blood donors: Voluntary donors are those that go to blood banks to donate blood free of charge. Then, there are family replacement blood donors, who go to hospital to donate blood because a family member, friend or neighbour is sick and having shortage of blood. The third category is the commercial donors, who hang around hospitals to donate blood and collect money.
“Unfortunately in Nigeria, we are still very far from voluntary blood donation, as majority of blood donors are family replacement donors. We need voluntary blood donors. Donors can be given certificates and T-shirts, among other benefits. But it cannot be financially donated, if we want to have availability of blood in Nigeria.”
Uche explained that one of the criteria in blood donation is age. A potential donor should be between 18 and 60 years, and that it is not advisable for children to donate blood, as their blood volume is low. The same applies to old people. She said: “Age is very important because, as people age, their cardiovascular systems are going down. This is why it is not advisable to donate blood at this stage. Again, it is unacceptable to donate more than 13 per cent of your blood volume.
“Another criterion is to check if the donor has hypertension, hepatitis C, diabetes, and sexually transmitted diseases. It is important to check if the person abuses drug, has history of yellowness in the eyes, any recent immunisation history, past medical and social history. All these are the questions the donor must answer during screening. Every blood transfusion has its own detailed questionnaire to ensure that infected blood is not transmitted to patients.
“The other criterion involves screening the patient to determine whether his/her packed cell volume (PCV) is okay. “Reducing the risk of transfusing infected blood depends on screening of the donor, and after the blood has been donated, a follow up screening should also be done on the blood.
“I would advise that Nigerians imbibe the WHO standard that stipulates that 100 per cent of blood donation be done by voluntary blood donors. This is only way blood banks can thrive in Nigeria. Everybody should be involved— religious organisations, churches, mosques and even social clubs should be involved by encouraging their members to donate blood voluntarily.”
“Thousands of deaths are recorded daily, due to lack of blood. This affects women who are in labour, road accident victims and sickle cell anemia patients.” To achieve this end, she advocates vibrant awareness to educate people on importance of blood donation.
“Even in the workplace, blood donation should be encouraged. There are upgraded blood banks everywhere. For instance, there is a standard blood bank in LASUTH. So, every Nigerian must make it a duty to donate blood.“There are national transfusion policies, but they cannot work without people keying into them. Everyone is expected to donate blood at least three times in a year,” she said.
Dr. Olowoselu Olusola, a Consultant Haematologist and Senior Lecturer, Department of Haematology and Blood Transfusion, Faculty of Clinical Science, College of Medicine of the University, said the need for blood transfusion is on the increase globally.He said: “In the developed world, this is mainly due to increased rate of such complex surgeries as open heart surgeries and vascular surgeries, among others. In Nigeria, most of the blood transfusion demands are from obstetric haemorrhage, childbirth related bleeding, road traffic accidents and victims of natural disaster. Incidence of obstetric haemorrhage in Nigeria is said to be about 100, 000 yearly, excluding a large number of delivery that happens outside hospital settings.
“This is so huge and calls for preparedness in blood donation to keep blood in our blood banks for these purposes and other emergencies. Blood is life. So, when someone bleeds, life gradually leaves him/her. No commercial fluid or product can do the work of blood, so it must be donated by healthy individuals to save the lives of many that might need it to live.
“There has been some improvement in our transfusion services overtime. Now, each unit of blood is separated into blood components, platelet concentrate, packed red cells and fresh frozen plasma, meaning that one unit of blood donated by an individual can be used to save up to three or more lives.” Olusola explained that safety of blood requires the general public to get blood from standard blood banks, and transfusion must be done in standard settings.
“All blood to be used for transfusion purposes must be from a standard blood bank, like the one we have in our teaching hospital, Lagos University Teaching Hospital, or Lagos State blood transfusion services and others that take safety as priority. Quality is costly and sometimes time demanding, but this is necessary for safe blood to be provided for patients. In a good blood bank, safety starts from choosing your donor appropriately, excluding people whose blood might be harmful to the recipient (infections, tattoo, unhealthy commercial sex workers), as well as people that might not be able to tolerate blood donation.
“There is also need to strictly observe what we call haemovigilance, by screening the blood appropriately for infections, store in ideal temperature, proper blood group typing of both the donor and the recipient, compatibility testing, and even proper documentations and labelling.”Olusola said donating blood is noble, as donors are lifesavers. They should also know they have chosen a good and healthy path by donating blood.
He said: “Studies have shown that regular blood donors have lower incidences of heart diseases and stroke, meaning that as they are saving lives by donating blood, they are also improving their quality of life and longevity. “From being a blood donor, you have the opportunity for health check-up.’ Through screening, donors are able to know their blood pressure, pulse rate, blood level, HIV and Hepatitis B/C status. These recommended tests normally would have cost some money, but it is offered free of charge to the donor, as part of donor screening tests with opportunity to get referral to appropriate clinic.
“A blood donor fitness is determined by the estimation of a particular blood component known as haemoglobin. No prospective blood donor should or must be allowed to donate blood if found anaemic, pregnant, sick or on medications or at risk of heart related diseases.
“So, let us jointly improve our transfusion services and emergency preparedness by becoming voluntary non-remunerated blood donors. Thus, we can save a lot of women from dying during childbirth, just like many accident victims can be saved. Blood will be available to manage patients with cancer and leukaemia, and when we have more, we will also be able to carry out more complex life-saving surgeries.”
Modupe Akinyinka, a Senior lecturer and Consultant Public Health, Physician Department of Community Health and Primary Health Care, Lagos State University College of Medicine, said government can help in the area of quality control. This is to be done through ensuring maintenance of a national blood system, with well-organised and coordinated blood transfusion services, effective evidence-based and ethical national blood policies, as well as legislation and regulation that provides sufficient and timely supplies of safe blood and blood products to meet transfusion needs of all patients.
She said: “Once the blood is donated, government needs to ensure quality-assured screening. Government also needs to ensure rational use of blood and blood products to reduce unnecessary transfusions and minimise the risks associated with transfusion, the use of alternatives to transfusion where possible, and safe and good clinical transfusion practices, including patient blood management.”She urged government to ensure standards and good manufacturing practices are adhered to, documentation, training of all staff, and quality assessment are done.