Overview of Blood Product Safety
The safety of blood products, like those used in transfusions, is a priority for health organizations all over the world. The World Health Organization is always working on ways to secure safe blood for transfusions everywhere. To achieve this, numerous steps are taken from the time the blood is donated to the moment it’s used in a patient.
The process starts with gathering information from the donor before they give blood. After blood is donated, it’s then collected, prepared, and tested. More information is collected post-donation, and the blood products receive a label for distribution. These products then get added to the hospital’s inventory. Once it’s time to transfuse the blood into a patient, hospital staff handles this step. Afterward, the patient’s condition is monitored to ensure their safety and to lessen the chances of any health complications related to the transfusion. This process is continually improved to better protect each patient.
Several techniques are used to increase the safety of blood transfusions. These include improvements at every stage of the process – from before the blood is donated until after it’s used in a patient. Enhancements have been made in the collection, storage, management, distribution, utilization, and monitoring of blood used in transfusions.
Before the blood collection even takes place, there are safety measures in place. These include commitment from the government and professional organizations to increase safety, proper training of staff, and the presence of a specialized blood transfusion organization to oversee the entire process. Once the blood is donated, it’s important to ensure it came from the right type of donor. Ideally, blood should come from volunteers who don’t get paid, as they have the least amount of transfusion-related infections. Whereas in the past ‘replacement’ and ‘family’ donors were more common, this is now changing. Donors are asked several screening questions to decrease the chances of infection being passed through the blood. Depending on their answers, donors may be temporarily deferred, for instance in a minor health issue like anemia, or indefinitely, like when a donor has HIV.
Next, laboratory testing of the donated blood is carried out to prevent any possible adverse effects from the transfusion. Various tests are administered, including testing for blood group compatibility and known infections that can be transmitted through blood transfusions. Guidelines on how to properly use blood transfusion help improve safety and decrease any negative outcomes for patients receiving a transfusion. Monitoring patient responses and detecting any reactions to the transfusion has also become a more important aspect of the process over time. New alternatives to traditional transfusion methods and improved storage techniques are being developed to further enhance the blood supply.
In summary, making blood transfusions safer involves a variety of steps and techniques used all throughout the process.
Why do People Need Blood Product Safety
When someone donates blood, that blood can typically be separated into different parts – red blood cells, platelets, and plasma. These different parts each have their own functions and can be administered separately, depending on the patient’s needs.
Red blood cells help to increase the oxygen-carrying capacity of the blood and are often given to people who are anemic. Traditionally, the decision to give red blood cells was based on certain measurements like hemoglobin (a protein in red blood cells that carries oxygen) and hematocrit (the proportion of red blood cells in the blood), among other symptoms. If someone had a hemoglobin measurement of less than 10 g/dL or a hematocrit of less than 30%, they might be considered for a transfusion. However, recent studies show that waiting to give a transfusion until these measurements are even lower can be just as safe and helps conserve blood resources. This is even true for people who are critically sick. There might be some exceptions, like in cases of sepsis, heart issues, blood loss during surgery, or for elderly patients. In these cases, the thresholds might be a bit higher.
Platelets might be given if someone has a low platelet count, or if the platelets aren’t working right due to medications or other health issues. Platelets are a part of the blood that helps to form clots and stop bleeding.
Plasma is another component of blood that can be given separately. Plasma contains proteins that help your blood to clot, and it can be used in certain situations, like when someone is bleeding excessively due to liver disease, to reverse the effects of the medication warfarin, or to treat certain illnesses. Sometimes, it’s also used in a procedure called plasmapheresis, which is used to remove, treat, and return blood plasma from circulation.
Cryoprecipitate is derived from plasma and can be used in emergency situations when someone needs clotting factors. It can be used for people who have certain inherited conditions like von Willebrand disease or hemophilia A, if the specific concentrates often used to treat these conditions aren’t available. It can also be used to replenish fibrinogen, which is a protein in the blood that helps it to clot, in certain situations like significant bleeding during trauma or childbirth.
When a Person Should Avoid Blood Product Safety
When doctors are deciding whether or not to give a patient a blood transfusion, they have to think about a few important things. This is often referred to as Patient Blood Management. Some patients can’t have a blood transfusion because it would be too risky. For example:
If a patient has too much fluid in their body, a condition known as volume overload, a transfusion could make this worse.
If a patient has had a bad reaction to a blood transfusion in the past, it might not be safe to give them another one.
Doctors also need to make sure that the patient’s blood is compatible with the blood they would receive in the transfusion. They do this with tests that check for blood type and for any antibodies that might cause a reaction. However, in an emergency, they might have to give a transfusion without these tests.
Equipment used for Blood Product Safety
According to guidelines set by the American Association of Blood Banks, utmost care is taken to ensure the blood donation process is safe and clean. Every blood bag and needle is sterilized, used only once, and then thrown away to prevent any possible spread of infections from one donor to another, which could potentially harm the people who receive the blood transfusions.
Moreover, all the tools used in blood collection, like blood pressure monitors, weighing scales, and even the machines that mix the collected blood, are routinely checked, cleaned, and serviced. The blood is then sealed in sterile bags and stored in special transportation boxes and fridges ready for use.
Not to mention, even the seats where donors sit during donation are made from materials like vinyl which are easy to clean. This way, the entire environment remains sanitary in line with the World Health Organization guidelines.
Lastly, all blood bags undergo regular checks. They are inspected for sterilization, checked if they are within the use-by date, and examined for any signs of damage or leaks when the blood donation is made. These steps help ensure the safety and effectiveness of the blood donation process.
Who is needed to perform Blood Product Safety?
Blood collection for tests and transfusions is done by trained professionals skilled in blood donation. Someone like a doctor or another health care professional is in charge, ensuring that everything goes smoothly. If any problems occur, such as a reaction by the person giving blood, this qualified person is able to handle it.
When a patient needs a blood transfusion, this is also done under the direction of a trained health care professional. They monitor the patient during the transfusion, which means they keep a close watch on the patient. This is to make sure no transfusion reactions happen; if they do, they can identify it quickly and take the necessary actions immediately.
Lab technicians, who are also trained, check the blood for any infectious agents before it is used in a transfusion. They also make sure the blood is both the right type and a match for the patient. They screen for any potential risks or negative effects, such as possible antibodies. After the transfusion, they will check if the patient’s body is breaking down red blood cells too quickly, a condition known as hemolysis.
Everyone involved in the transfusion process, who abide by accepted guidelines and constantly monitor the threshold for transfusion, has greatly contributed to ensuring the safety of blood products.
Preparing for Blood Product Safety
When it comes to ensuring blood safety, there are several procedures that need to be carried out during the process of blood collection, processing, and storage. The World Health Organization encourages a global effort to secure a safe and enough supply of blood. After the blood is taken, it’s examined for the donor’s blood type and checked for any harmful antibodies in the donor’s blood. The collected blood is stored by the facility until they prepare it and conduct standard screening for potential diseases that could be passed through blood transfusion. Once they’ve confirmed that it meets the legal and industry standards and is ready for transfusion, it’s labeled as ready-to-use.
All around the world, putting a priority on testing for transfusion-related diseases has helped make blood products safer. The World Health Organization 2016 Global Status Report on Blood Safety and Availability includes information on how different countries handle blood donor testing. Findings show that most countries that answered the survey had guidelines for testing transfusion-related diseases including HIV, hepatitis C, hepatitis B, and syphilis. Some countries also test all blood donations for human T-lymphotropic virus (HTLV-I/II) in addition to other tests specifically for new blood donors.
Once a blood donation is made, several processes can be performed to prepare the blood for transfusion. A procedure known as “Leukodepletion” lessens the number of white blood cells in a blood product to reduce the risk of fever, immune response, and transmission of certain diseases. They may also test platelets for bacterial contamination to prevent infection reactions from a transfusion. Another procedure, known as plasma fractionation, allows for deriving specific factors and immune proteins from the blood. Reducing the amount of plasma within a blood product can also reduce the risk of allergic reactions or effects of incompatible blood group antibodies. Checking the blood type and screening for antibodies in both the donor and recipient’s blood is an important part of preparing for transfusion.
The latest advancement in blood safety is pathogen reduction, which uses various methods to reduce the risk of transmitting disease-causing agents from donated blood. These methods can protect against many types of infectious agents including viruses, bacteria, and parasites. They can also help inactive white blood cells in the donor’s blood, reducing the chance of a serious complication known as transfusion-associated graft-versus-host disease. These modern approaches are becoming more common and should enhance the safety of blood products.
How is Blood Product Safety performed
When you donate blood, there’s a routine questionnaire that you’ll have to fill out. This survey helps identify if the blood donated is safe to be used for transfusion. People are motivated to donate blood due to various reasons. Some are monetarily compensated while others are unpaid volunteers. It’s been observed that unpaid volunteer donors have the safest blood for transfusion because they are less likely to hide conditions that may cause infection.
The process of blood donation is more likely to yield safe blood to transfusion if the donor is completely honest during the screening. The blood we donate could be of significant help to someone in an immediate need of transfusion, so it’s important to be truthful during the screening process.
There might be slight differences in the blood collection procedures based on the hospital or clinic where you’re donating. However, they all follow the guidelines set by the World Health Organization to maintain safety and prevent any chance of infection during the blood transfer. One key factor for maintaining safe blood is cleanliness, particularly at the site where the needling is done for blood extraction.
Usually, a mixture of 2% chlorhexidine gluconate and 70% isopropyl alcohol is applied at the site to keep it sterile. Moreover, a “closed collection system” is used where the collection bag directly attaches to the needle, thus avoiding any contact with air. Also, the first bit of collected blood is only used for lab testing as it could be contaminated by bacteria from the skin.
The volume of blood collected for transfusion varies based on the requirement. Typically, 350 milliliters (ml) of whole blood is donated and 450 ml is collected when separating the blood into components. This careful quantity consideration is necessary to avoid causing anemia to the donor.
The donated blood can be separated into four components – red blood cells, platelets, plasma, and cryoprecipitate or left as a whole. As per the requirements, these components are stored under appropriate conditions to keep them safe and effective. Plates and plasma should be prepared within 8 hours of collection, with platelets stored at room temperature for up to five days. Depending on the country, plasma storage requirements vary, but they can be stored anywhere from -18 to -65 degrees Celsius for periods ranging from one to seven years.
All collected blood goes through strict testing for blood type, possible infections, and other required screenings before it’s deemed safe for transfusion. Please be aware that the health of every blood recipient highly depends on the honesty and altruism of blood donors.
Possible Complications of Blood Product Safety
The World Health Organization has guidelines on taking blood safely. According to these practices, donating blood can sometimes cause complications. The most common is developing a bruise-like area called a hematoma. Dizziness or fainting, called a vasovagal reaction, or delayed fainting, can also occur. Less common issues include accidentally puncturing an artery or causing some nerve damage.
On the receiving end, getting a blood transfusion can also come with complications. These include transfusion reactions or infections passed on through the transfused blood. The rate of infections from transfusions has greatly reduced in high-income countries, with the risk of serious diseases such as HIV or Hepatitis being less than 1 in 1 million.
This decrease is largely thanks to careful screening of potential blood donors. Blood banks have implemented various tests and questionnaires to choose donors who are at a low risk of carrying infectious diseases. These screening methods include checking the potential donor’s medical history and physical health, as well as exploring certain lifestyle choices or travel history that could increase the risk of infections.
However, no test is 100% accurate, so there can still be a small number of false negatives where an infected sample is incorrectly labelled as safe. This is why the screening questionnaires continue to be important in ruling out high-risk donors.
That said, donating blood should not be seen as a casual way for people to check whether they are infected with certain diseases, as this could put others at risk.
Despite all these precautions, sometimes harmful bacteria that live on the skin can contaminate the donated blood, especially in blood platelet donations which are stored at room temperature. There’s also a growing concern of emerging infections, like the Zika virus, being transferred through transfusions.
While the risk of infections from transfusions has reduced, other non-infectious complications have become the main focus for improvement. There are various reactions that can occur when receiving a blood transfusion, ranging from mild allergic reactions to life-threatening conditions.
Some common reactions include transfusion-associated circulatory overload (TACO), a condition where the body struggles to handle the extra blood volume after a transfusion; transfusion-related acute lung injury (TRALI), where the lungs become inflamed and filled with fluid; and others. More awareness and reporting of these reactions has helped make blood transfusions safer overall.
The incidence of TACO, in particular, has been an emerging concern for the safety of patients receiving blood transfusions. The focus towards understanding and reducing these nonspecific transfusion-related complications has considerably improved the safety of blood transfusions.
What Else Should I Know About Blood Product Safety?
Blood transfusions, which involve giving someone donated blood, are common medical procedures carried out worldwide. Ensuring the safety of the donated blood is a critical part of maintaining high-quality health care. A vast amount of blood is collected and used each year, with the World Health Organization stating that about 112 million units of blood are gathered worldwide annually. Particularly in the United States, the American Red Cross says that about 36,000 units of blood are needed each day. Blood transfusions are performed daily around the globe, saving countless lives.
Nonetheless, there has been a recent trend towards using fewer blood transfusions and creating stricter rules regarding when and how to use blood and blood products. The National Blood Collection and Utilization Survey has found that the number of transfusions in the United States has steadily decreased without causing a significant impact on overall health and death rates. This could be due to improvements in surgical management and more considered use of blood products. In fact, studies suggest an association between excessive usage of blood products and poorer patient outcomes, linking blood transfusions with increased health complications, higher chances of death, and longer hospital stays.
Based on these findings, many countries have recently adopted guidelines promoting more restrictive blood transfusion practices. This approach intends to strike a balance between treating conditions like anemia that cause symptoms like weakness and fatigue but avoiding unwanted side effects associated with transfusions.
Nonetheless, side effects, referred to as transfusion reactions, continue to present a significant problem, prolonging hospital stays and negatively affecting patient outcomes. These reactions occur in roughly 1 out of every 100 transfusions, underlining the importance for patients and doctors alike to be aware of them. Given the number of transfusions performed worldwide, the safety of blood products is crucial in continually improving patient care. A better understanding among healthcare professionals about the signs and symptoms of a transfusion reaction, along with concerted efforts to only use blood products when necessary, has improved transfusion safety.
In conclusion, despite new initiatives to restrict blood product use to only those patients who need them, improve blood collection and storage practices, and explore alternatives to transfusions, blood transfusions remain a vital, life-saving procedure. These advancements promise to further enhance the safety of this essential practice in the future.
