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June 2018 | Published by RCPA

Issue #081

The lifesaving gift of blood

The lifesaving gift of blood

On World Blood Donor Day, 14 June 2018, we spoke with Dr Peter Flanagan, National Medical Director at New Zealand Blood Service, about the importance of donating.

The World Health Organisation, the International Society of Blood Transfusion, the International Federation of Blood Donor Organisations and the International Federation of Red Cross and Red Crescent Societies initiated World Blood Donor Day in 2004. It provides an opportunity for a national and global celebration on a day that has particular significance: it’s the birthday of Karl Landsteiner, the Nobel Prize winner who discovered the ABO blood group system.

Dr Peter Flanagan says,

“Blood donation is important because the availability of sufficient safe blood components underpins modern health service provision. World Blood Donor Day is our opportunity to celebrate those selfless individuals in Australia and the 110,000 in New Zealand, and all of those around the world who, on a regular basis, give blood to help other people have the health treatment that they require, with no immediate benefit to themselves. It also provides a very powerful tool for advocacy to government to ensure that appropriate resources are directed towards the development and maintenance of the transfusion service.

“Having blood available is essential, and it’s worth remembering that not everybody can give blood. So, I think that those that are able to do so, perhaps it’s their civic responsibility to try to give blood when they can.”

The NZ Blood Service[1] and the Australian Red Cross[2], have a quiz on their websites which reveals whether you are eligible to donate blood in these countries.

"The criteria for giving blood in Australia and New Zealand are pretty well aligned, but it’s worth checking the blood services website in your country to see if you are able to donate. There are a significant proportion of individuals who, for a range of reasons, will not be able to donate blood. They won’t meet the very strict criteria that the blood services have, and in New Zealand at least, somewhere in the order of one in seven to one in ten first time blood donors will be found ineligible for one reason or another, so we’re talking about a significant number of people being excluded.

"Additionally, there are also many other people who would meet our criteria, but, for a range of reasons either believe that they aren’t eligible, i.e. we haven’t properly raised awareness of what the criteria are, or they may have some fears associated with donating blood. Historically, there have been fears that it’s painful, it’s dangerous, or it can impact on their own health. Fortunately, the reality is that in developed countries such as Australia and New Zealand, blood donation is a very safe and controlled process. The likelihood of individuals coming to harm as a consequence of giving blood is very low indeed but I think we need to better communicate that message to people.

"If you look at the modern world blood services, certainly in New Zealand, we have a marketing team that relies heavily on social media to get our message across. We’re constantly communicating with donors. With those who have already donated, we like to encourage them to come back when we need them and, of course, we’re always managing that very careful balance between collecting enough blood and not too much. We always aim to avoid collecting more than is needed as we wouldn’t want to waste that precious gift.

"The amount of blood that we collect is a reflection of the demand placed on us by hospitals around the country. Undeniably, over the last 10 to 12 years there’s been a changed perspective of the role of transfusion in patient care and I think that’s a good thing. We now allow haemoglobin to fall to lower levels than would have been the case say, ten years ago. This comes from research that demonstrates the so called restrictive transfusion trigger of 70 grams per litre, in an otherwise healthy individual, is quite safe and isn’t associated with any adverse outcomes. Previously, we used a haemoglobin figure of 90 to 100 grams per litre and if a patient’s haemoglobin fell below that, we would transfuse them. As a result, we collect significantly less whole blood today, perhaps 25% less, than we did a decade ago," says Dr Flanagan.

There are about five litres of blood in the human body and it’s made up of several useful components. People may be eligible to donate whole blood, plasma or platelets. Each type of blood donation is used for different medical treatments, and the individual’s blood type determines the best donation that they can make.[2]

"In Australia and New Zealand, the driver for collection now is plasma, which is used for the production of immunoglobulin. In both countries the demand for immunoglobulin is increasing and, with that demand, plasma. So, over the last decade, the pattern of blood product use has changed and, therefore, the blood collection services have changed accordingly so that plasma collections have increased. Whole blood collection has plateaued; however, I would expect that a slow gradual increase, linked to population growth and an ageing population, will occur over the next several years.

"If you look at many of the developments in clinical care over the last fifty years, they bring with them a requirement for access to safe and effective blood components. For example, the modern treatment of patients with leukaemia by chemotherapy and bone marrow transplantation wouldn’t be possible without access to transfusion. This is the case if you look at cardiac surgery and in fact most forms of major surgery today. We may have used less blood in 2018 than we did 10 years ago, but nonetheless, the availability of that blood when it is required is absolutely pivotal to enable healthcare to move forward.

"As we move into winter, which is classically a time where there is illness in the community - coughs, colds, ill heath associated with winter – it can be more difficult to maintain blood inventories. We encourage all individuals who are capable of donating blood to contemplate giving this lifesaving gift,” says Dr Flanagan.

[1] https://www.nzblood.co.nz/give-blood/donating/am-i-eligible/

[2] https://www.donateblood.com.au/eligibility




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