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Jhargram
Voluntary Blood Donors’ Society All about Blood
What is the most
common blood type? What are
the criteria for blood donation? What
tests are performed on donated blood? What fees
are associated with blood? What can you
do if you aren’t eligible to donate?
What is blood?
Blood is a connective tissue. It is a liquid that
circulates through the body, carrying oxygen and nutrients to every cell and
carrying away waste products. Blood plays a central role in body’s defense
against intrudes.
It is pumped by the heart,
through a network of miles of blood vessels, to every part of the body. The
average adult body contains blood about 1/11th of his body weight.
There are two main component of blood: namely liquid—plasma and solid—the
formed elements containing red blood cells, white blood cells and platelets.
In addition blood contains various nutrients and minerals. Plasma: Plasma is the fluid in which red blood cells,
platelets, and other clotting factors reside. Plasma, which is primarily composed
of water, allows the blood to flow through the body. In addition to supplying
important proteins necessary for blood clotting and immunity, plasma
transports sugars, salts, and Hormones, and helps maintain a person's blood
pressure. Erythrocytes: These are non-nucleated, biconcave disc shaped
measured about6.7-7.7 in diameter. They contains hemoglobin- a conjugated
proteins, are the heaviest of all the formed elements of blood. The
hemoglobin is responsible for carrying Oxygen from lungs to the tissue cells
and brings back CO2 on its return to the lungs. In case of adult erythrocytes –
these only originated from red bone marrow. The mother cell is hemocytoblast.
The total number of RBC is 4.5 – 5.5 millions/mm3 of blood. Life
span of RBC is 90 – 120 days. Leucocytes: The leucocytes are the group of nucleated cells that
help in the defense process of the body against the attack of pathogenic
microbes and antigens. They have power of amoebic movement. Cytoplasm of some
leucocytes contains granules and they are known as granulocytes—Nutrophils,
Basophiles and Eosinophils. Cytoplasm of others does not contain any granules
and these are known as granulocytes – Lymphocytes and Monocytes. Granulocytes are originated from
red bone marrow where as a granulocytes originated from Lymphoid tissue
mainly Lymph nodes and spleen. The total numbers of WBC are 5000
– 10,000 cells/mm3 of blood. The life span of Leucocytes is 5 – 6 days. Platelets: Platelets are specialized blood cells that help the blood
clot. Platelets control bleeding by allowing the blood to clot. Chemotherapy
and radiation treatments often interfere with the body's production of
platelets. Without regular platelet transfusion, patients undergoing these
treatments can literally bleed to death. How Blood Travels? Blood moves in two large,
continuous circles through a network of blood vessels. The 'right circuit'
moves blood from the right side of the heart through the lungs back to the
heart (left side). The 'left circuit' moves blood from the heart to the rest
of the body and then back to the heart. There are different types of blood
vessels: arteries, capillaries, and veins. Arteries carry blood away from the heart. They branch
out into smaller arteries, which connect to capillaries. The capillaries are
very narrow; only one cell wide. Inside the capillaries, the red blood cells
release oxygen, which passes through the thin capillary walls and into the
surrounding tissue. The tissue releases waste products, like carbon dioxide,
which passes through the thin capillary walls into the blood. Blood returns
to the heart in the veins. Veins contain one-way valves to keep low-pressure
blood flowing toward the heart, even against the pull of gravity.
Because the blood in veins contains
so little oxygen, it appears bluish in comparison to the bright red of
oxygenated blood. What is the most common blood type?
Blood groups further classified
as Rh-positive or Rh-negative are called blood types. Blood
is Rh-positive if the blood antigen labeled "D" is present and it
is Rh-negative if the "D" antigen is absent. O-positive is the most common blood type. Not all racial and ethnic groups have the same mix of these blood types. Hispanic people, for example, have a relatively high number of O’s, while Asian people have a relatively high number of B’s. The common blood types are as follows: A Rh-positive
B Rh-positive O Rh-positive AB Rh-positive A Rh-negative B Rh-negative O Rh-negative AB Rh-negative
In an emergency,
anyone can receive type O red blood cells, and type AB individuals can
receive red blood cells of any ABO type. Therefore, people with type O blood
are known as “universal donors” and those with type AB blood are known as
“universal recipients.” In addition, AB plasma donors can give to all blood
types. The ABO System If you have blood group A
then you've got A antigens covering your red Cells. Blood group B means you have B antigens, while group O has
neither, and Group AB has some of both. The ABO system also contains lots of little antibodies
in the plasma, Antibodies being the body's natural defense against foreign
antigens. So blood group A has anti-B in their plasma, blood
group B has anti-A. To complicate matters though, group AB has none and
group O has both of the antibodies. Which means giving someone blood from the
wrong ABO group could be fatal. The anti-A antibodies in-group B attacks group-A cells
and vice versa. That’s why group A blood must never be given to a group B
person. Rh negative is a different story. The Rhesus system Well, it gets more complicated here on in, because there's
another antigen to be considered - the Rh, (or rhesus) antigen. Some of us
have it, some of us don't. If it is present, the blood is RhD positive, if not
it's RhD negative. So, for example, some people in-group A will have it, and
will therefore be classed as A+ive (or A positive). While the ones that don't, is A-ive (or, wait for it...A
negative). And so it goes for groups B, AB and O. This effectively doubles the number of different blood
types to be matched, because you shouldn't mix blood type A- positive with
blood type A- negative. 84% of the world population is Rh-positive that means
the other 16% of the population is running around with Rh-negative blood. Frequency
of major blood groups in the world population:
Distribution may be different for specific racial and ethnic groups:
O Rh (D) Positive 38%
45% O Rh (D)
Negative 07% A Rh (D)
Positive 36% 43% A Rh (D)
Negative 07% B Rh (D)
Positive 08% 9% B Rh (D)
Negative 01% AB Rh (D) Positive 02%
3% AB Rh (D)
Negative 01% Total Rh (D) Positive 84% TotalRh
(D) Negative 16% Frequency
of major blood groups in ASIAN
population: Distribution may be different for specific racial and ethnic groups: O Rh (D)
Positive 37% 40% O Rh (D)
Negative 07% A Rh (D)
Positive 24% 30% A Rh
(D) Negative 03% B Rh (D)
Positive 22% 27% B Rh (D)
Negative 04% AB Rh (D) Positive 02%
3% AB Rh (D)
Negative 01% Total Rh (D) Positive 85% TotalRh
(D) Negative 15% Who needs blood? The need for blood is great
— on any given day, an average of 38,000 units of red blood cells are needed.
Blood transfusions often are needed for trauma victims — due to accidents and
burns — heart surgery, organ transplants, and patients receiving treatment
for leukemia, cancer or other diseases, such as sickle cell disease and
thalassemia. And with an aging population and advances in medical treatments
and procedures requiring blood transfusions, the demand for blood continues
to increase. Why donate blood? What are the criteria for blood donation? To be eligible to donate blood,
a person must be in good health and generally must be at least 17 years of age.
Minimum weight requirements may vary among facilities, but generally, donors
must weigh at least 110 pounds. Most blood banks have no upper age limit. All
donors must pass the physical and health history examinations given prior to
donation. Volunteer donors provide nearly all blood used for
transfusion. The donor's body replenishes the fluid lost from donation in 24
hours. It may take up to two months to replace the lost red blood cells.
Whole blood can be donated once every eight weeks (56 days). Medical professionals are
available at each blood collection center and details of each donor's health
and activities are discussed in a confidential setting prior to blood
donation. The final determination of eligibility is made at that time. DONORS SCREENING: 1.
Identification: It
includes the name, age, sex and weight of the donor. 2.
History: It
includes a few questions about present state of health, recent illness, if
any major operation, if he/she has been transfused blood within 90 days, if
he/she had malaria, Hepatitis, Syphilis, tuberculosis, diabetes and filaria
etc. 3.
Physical
Examination: Physician should take the temperature, Pulse rate, Blood
pressure etc. The physician should examine the chest and heart sound. 4.
Detection of ABO
group and Rh Type: Detect the blood group and Rh type of donor. It is better
to select a donor of the same to recipients. 5.
Detection of
Hemoglobin: Detect the hemoglobin of the donor. It should be more than 12gm%
in Indian population. 6.
Detection of blood
parasites: Such as malaria, microfilaria and L.D. bodies. 7.
Estimation of
Bilirubin: It gives valuable information about hepatitis. 8.
Serological
Detection: It includes V. D. R. L test for diagnosis of syphilis. 9.
Immunological
Test: It includes HbsAg for the diagnosis of Hepatitis B viruses and ELISA
test for HIV for the diagnosis of AIDS. 10.
Hemoglobin
Electrophoresis: It gives valuable information about sickle cell anemia,
thalassaemia and hereditary apherocytosis. What tests are performed on donated blood? After blood is drawn, it is tested for ABO group
(blood type) and Rh type (positive or negative), as well as for any
unexpected red blood cell antibodies that may cause problems in the recipient.
Screening tests are also performed for evidence of donor infection with
Hepatitis viruses B and C, human immunodeficiency viruses (HIV) 1and 2,human
T-lymph tropic viruses (HTLV) I and II and syphilis.
The specific tests performed are listed below:
Hepatitis B surface antigen (HBsAg) The hepatitis B virus, which
mainly infects the liver, has an inner core and an outer envelope (the
surface). The HBsAg test detects the outer envelope identifying an individual
infected with the hepatitis B virus. Hepatitis B can cause inflammation of
the liver, and in the earliest stage of the disease, infected people may feel
ill or even have yellow discoloration of the skin or eyes, known as jaundice.
Fortunately, most patients recover completely and test negative for HBsAg
within a few months after the illness. A small percentage of people become
chronic carriers of the virus, and in these cases, the test may remain
positive for years. Chronically infected people can develop severe liver
disease as time passes, and need to be followed arefully by an experienced
doctor. Antibodies to the Hepatitis B Core (Anti-HBc) the anti-HBc test
detects an antibody to the hepatitis B virus that is produced during and
after infection. If an individual has a positive anti-HBc test, but the HBsAg
test is negative, it may that the person once had hepatitis B, but has
recovered from the infection. Of the duals with a positive test for anti-HBc,
many have not been exposed to the hepatitis B virus. This kind of test result
is called a false positive, and although the individual may be permanently
deferred from donating blood, it is unlikely that the person’s health will be
negatively affected. (Note: This antibody is not produced following
vaccination against hepatitis B. Hepatitis B vaccination, by itself, will rarely cause the
HbsAg test to be positive for a few days after the shots.) Antibodies to the
Hepatitis C Virus (Anti-HCV) this test are used to screen donors for the
hepatitis C virus (HCV). It works by detecting antibodies manufactured by the
body in reaction to portions of the virus called antigens. HCV causes
inflammation of the liver, and up to 80 percent of those exposed to the virus
develop chronic infection. Eventually, up to 20 percent of people with HCV
may develop cirrhosis of the liver or other severe liver diseases. As in
other forms of hepatitis, individuals may be infected with the virus, but may
not realize they are carriers since they do not have any symptoms. Because of
the risk of serious illness, people with HCV need to be followed closely by a
physician with experience evaluating this infection. Hepatitis B core antibody
(anti-HBc)
The
anti-HBc test detects an antibody to the hepatitis B virus that is produced
during and after infection. If an individual has a positive anti-HBc test,
but the HBsAg test is negative, it may mean that the person once had
hepatitis B, but has recovered from the infection. Of the individuals with a
positive test for anti-HBc, many have not been exposed to the hepatitis B
virus. This kind of test result is called a false positive, and although the
individual may be permanently deferred from donating blood, it is unlikely
that the person’s health will be negatively affected. (Note: This antibody is
not produced following vaccination against hepatitis B. Hepatitis B
vaccination, by itself, will rarely cause the HbsAg test to be positive for a
few days after the shots.) Hepatitis C virus antibody (anti-HCV) This test is used to screen donors for the
hepatitis C virus (HCV). It works by detecting antibodies manufactured by the
body in reaction to portions of the virus called antigens. HCV causes
inflammation of the liver, and up to 80 percent of those exposed to the virus
develop chronic infection. Eventually, up to 20 percent of people with HCV
may develop cirrhosis of the liver or other severe liver diseases. As in
other forms of hepatitis, individuals may be infected with the virus, but may
not realize they are carriers since they do not have any symptoms. Because of
the risk of serious illness, people with HCV need to be followed closely by a
physician with experience evaluating this infection. HIV-1 and HIV-2 antibody
(anti-HIV-1 and anti-HIV-2)
Antibodies to the Human Immunodeficiency Virus,
Types 1 and 2(Anti-HIV-1, -2) this test is designed to detect antibodies directed
against antigens of the HIV-1 or HIV-2 viruses. HIV-1 is much more common in
the United States, while HIV-2 is prevalent in Western Africa. Donors are
tested for both viruses because both are transmitted by infected blood. Both
of these viruses can cause acquired immunodeficiency syndrome, or AIDS. HIV p24 antigen This test screens
for antigens of the HIV-1 virus. The extra safety added by doing this test derives
from its ability to detect HIV-1 infection a week earlier than the antibody
test. Thus, the HIV-1 infection can be identified sooner, and the risk of
getting HIV-1 from a blood transfusion has decreased. HIV-1 p24 antigen
testing may be discontinued in the future when we know more about the
performance of a new kind of testing called nucleic acid amplification
testing or NAT (described below). The new tests are believed to identify HIV
infection even sooner than p24 testing, and it may make it unnecessary. HTLV-I and HTLV-II antibody
(anti-HTLV-I and anti-HTLV-II)
Antibodies to Human T-Lymphotropic Virus, Types
I and (Anti-HTLV-I, -II) This test screens for antibodies directed
against portions of the HTLV-I and HTLV-II viruses. Both of these viruses are
relatively uncommon in the United States, but do occur more frequently in
certain populations. HTLV-I is more common in Japan and the Caribbean. The
infection can persist for a lifetime, but rarely causes major illnesses in
most people who are infected. In rare instances, the virus may, after many
years of infection, cause nervous system disease or an unusual type of
leukemia. HTLV-II infections are usually associated with intravenous drug
usage, especially among people who share needles or syringes. Disease
associations with HTLV-II have been hard to confirm, but the virus may cause
subtle abnormalities of immunity that lead to frequent infections, or rare cases of
neurological disease. Serologic test for syphilis This test is done to
detect evidence of infection with the spirochete that causes syphilis. Blood
centers began testing for this shortly after World War II, when syphilis
rates in the general
population were much higher. The risk of transmitting syphilis through
a blood transfusion is exceedingly small (no cases have been recognized in
this country for many years) because the infection is very rare in blood
donors, and because the spirochete is fragile and unlikely to survive blood storage conditions. Nucleic acid amplification
testing (NAT) NAT employs new forms of testing technology that
directly detect the genetic material of viruses like HCV and HIV. Because NAT
detects the genetic material of a virus, instead of waiting for the body’s
response — the formation of antibodies, as with many current tests —it offers
the opportunity to reduce the window period during which an infecting agent
is undetectable by traditional tests, thus further improving blood safety. NAT has yet to be approved by the FDA for donor
screening, because of the promise that this technology holds for improving
the safety of the blood supply blood collection organizations are already using NAT for HIV and HCV under the
FDA’s Investigational
New Drug (IND) application process. Confirmatory Testing
All of the above tests are referred to as
screening tests, and are designed to detect as many infections as possible.
Because these tests are so sensitive, some donors may have a false positive
result, even if the donor were never exposed to the particular infection. In
order to sort out true infections from false positive test results, screening
tests that are reactive may be followed up with more specific tests called
confirmatory tests. Thus, confirmatory tests help determine whether a donor
is truly infected. If the test result from a
donated unit of blood is abnormal for any of these disease markers, the unit
is discarded and the donor is notified. The donor’s name is then added to a
donor deferral list and is prohibited from donating blood indefinitely What fees are associated with blood? While donated blood is free, there are significant
costs associated with collecting, testing, preparing components, labeling,
storing and shipping blood, recruiting and educating donors, and quality
assurance. As a result, processing fees are charged to recover costs.
Processing fees for the individual blood components vary considerably.
Processing fees for one specific component may also vary in different
geographic regions. Hospitals charge for any additional testing that may be
required, such as the cross match, as well as for the administration of the
blood. Who can't donate? You may not donate if: You
have ever used a needle to administer a non-prescription drug. You
have HIV infection or AIDS. You
are male and have had sexual contact with other men. You
are a hemophiliac. You
have certain parasitic infections. What can you do if you aren’t eligible to donate?
While a given individual may be unable to donate, he or
she may be able to recruit a suitable donor. Blood banks are always in need
of volunteers to assist at blood draws or to organize mobile blood drives. In
addition, monetary donations are always welcome to help ensure that blood
banks can continue to provide safe blood to those who are in need. The Donation Process The donor procedure is simple: First,
you want to register and answer a series of questions concerning your medical
history. Second, you will take a health examination and your pulse, blood
pressure, temperature and iron level will be measured. When you donate, you will feel a little
pain from the prick of the needle. The donation process will take 10-15
minutes. After donating, you will relax for a minute while you are being
served cookies and juice. Education When prospective donors enter a blood bank, they are
asked to read educational materials such as “An Important Message to All
Blood Donors.” These materials contain information on the risks of infectious
diseases transmitted by blood transfusion, including the signs and symptoms
of AIDS. Prospective donors are asked to acknowledge in writing that they
have read and understood these materials, have been given the opportunity to
ask questions, and have provided accurate information. The prospective donors
can elect to leave at this point without donating. (Self-deferral can occur
at any point in the donation process when a donor voluntarily chooses not to
complete the process.) Health History Prospective donors proceed to a detailed health
history. The history is designed to ask questions that protect the health of
both the donor and the recipient. However, donor centers often create their
own questionnaires using the same general guidelines. In addition to
questions about transfusion-transmissible diseases, prospective donors are
asked questions to determine whether donating blood might endanger their
health. If a prospective donor responds positively to any of these questions,
he or she will be “deferred” or asked not to donate blood. The health history
also is used to identify prospective donors who have been exposed to, or who
may have diseases, such as human immunodeficiency virus (HIV), hepatitis or
malaria. These individuals are further evaluated and those at high risk of
disease are deferred.
Physical Examination The next step in the donation process is an abbreviated
physical examination that includes checking the blood pressure, pulse and
temperature. A few drops of blood are taken from a finger to ensure that
anemia is not present. Abnormalities found in any part of the physical
examination may be a cause for deferral. Donors also must meet the weight
requirement of 110 pounds. The Actual Donation A prospective donor who passes successfully through
these steps proceeds to the actual whole blood donation process, which takes
about 20 minutes. The donor lies down on a bed. The skin covering the inner
part of the elbow joint is cleansed. A new, sterile needle connected to
plastic tubing and a blood bag is inserted into an arm vein. The donor is
asked to squeeze repeatedly his or her hand to help blood flow from the vein
into the blood bag. Typically, one unit of blood, roughly equivalent to a
pint, is collected. After the blood is collected, it is sent to the
laboratory for testing and component preparation. The donor is escorted to an
observation area for light refreshments and a briefest period. Adult males have about 12 pints of blood in their
circulation and adult females have about nine pints. The donor's body
replenishes the fluid lost from donation in about 24 hours. The red blood
cells that are lost are generally replaced in a few weeks. Whole blood can be
donated once every eight weeks.
Advice for
first-time donors:
Anxiety and fears are normal. Many people are afraid of donating
blood. Once you have donated, you will overcome your fears. Asking questions
helps to relax. Visualize this experience as an opportunity to help at least
three people who are ill. If you have just donated your blood recently without realizing you are actually UNFIT, kindly notify the nearest blood bank NOW. All information given will be dealt with strict confidentiality.
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