All of Australia's blood donors are voluntary and unpaid. Australia is also one of a handful of countries which is self-sufficient in the supply of fresh blood and components. Another factor that contributes to Australia having one of the safest blood supply systems in the world are the regulations by which eligibility to give blood is determined.
There are a range of reasons why anyone could be 'temporarily deferred' or 'permanently deferred' from giving blood, including age, recent short-term illness, medical history, pregnancy status and lifestyle issues.
Every time you give blood, the Blood Service is required to verify your identity and ensure you complete a detailed and confidential questionnaire, to make sure that the blood you are kindly and generously giving fulfills the eligibility criteria. This ensures it is as safe as possible for you, the donor, as well as for the recipients.
Donors must be:
- 16 - 70 years of age (in Queensland and WA, state legislation requires donors who are 16 or 17 to have parental consent)
- in good health
- weigh at least 45 kg (at least 50 kg for donors who are 16 or 17)
- have a Hb level of between 120 and 165 g/L for females and between 130 and 185 g/L for males, and
- pass a physical and health history examination prior to donation
The physical checks includes measurement of weight, blood pressure, pulse, and temperature as well as a test for anaemia, which requires just a few drops of blood from your finger.
To protect the health of both the donor and the recipient, the health history questionnaire asks about potential exposure to transfusion-transmissible diseases, such as viruses like HIV, hepatitis B and C, as well as parasites that cause diseases such as malaria.
Certain people are not permitted to donate blood to protect the health of the donor or recipient. Some of these include:
- Anyone who has ever injected or been injected illegal or body building drugs
- Men who have had sexual contact with other men
- Anyone with a positive test for HIV, or anyone who thinks they might be HIV positive
- Men and women who have engaged in sex for money or drugs
- Anyone who has had hepatitis B, or C virus
- Anyone who has had a blood transfusion in the past 12 months
- Anyone who has had acupuncture, body piercing or a tattoo in the last 6 months
- Anyone who has been pregnant in the past 9 months
There also may be some restrictions if you are taking certain medications at the time of donation. You may be ineligible to donate or deferred for a period of time. There are also varying deferral periods if you have been vaccinated recently. For more details visit the Australian Red Cross Blood Service website.
Donors have a personal responsibility to help ensure the safety of the blood supply. You should express any concerns or questions you may have about past illnesses you had or may have been exposed to before donating. Who knows? Maybe someone close to you will be the recipient of your blood donation.
Where can blood be donated?
Blood can be donated at blood collection centres, or mobile sites temporarily set up in public areas like colleges, workplaces, and churches. For more information on where you can go to donate or receive blood, visit the Blood Service website (http://www.donateblood.com.au/) or phone 13 14 95.
What is donated and how often?
Usually one unit of 470 ml of blood is collected into a blood bag from a vein in the inner part of the elbow joint using a new, sterile needle and blood collection set. This donation is less than 10% of your total blood volume. Your body replenishes the fluid lost during donation in 24 hours, but it may take up to 2 months to replace the lost red blood cells. Therefore blood can usually be donated only once every 3 months.
What are the components of blood?
Blood is made up of several components which can be separated. These individual components mean multiple patients, each with different clinical needs, can benefit from a single blood donation of whole blood. The different components include:
Red blood cells
Red blood cells are the carriers of haemoglobin, which is a protein needed to transport oxygen around the body. You may be given red blood cells if your haemoglobin level or red blood cell count are low, or if you have lost a lot of blood from an injury or during surgery.
Platelets are pieces of cells that help to stop bleeding by sticking together to form a plug. Some people have low numbers of platelets. This may be caused by disease, certain medications (such as chemotherapy) or treatments (such as radiation therapy). Platelets are given to prevent or control bleeding in these people.
Fresh frozen plasma and cryoprecipitate
Fresh frozen plasma and cryoprecipitate, which is produced from fresh frozen plasma, contain clotting factors which work with platelets to seal wounds. If any of the clotting factors are not present in the blood, bleeding can occur very easily and is difficult to control. You may be given plasma products if your blood is not clotting properly.
Separation of these components is performed by the Blood Service in blood processing centres. A whole blood donation is centrifuged which causes the various components to form layers with the red blood cells at the bottom, white blood cells and platelets (also known as 'buffy coat') in the middle and finally plasma at the top.
The plasma is then removed into another sterile blood bag and further processed to separate cryoprecipitate containing anti-haemophilic factors. Plasma from several donors may also be pooled and processed further (fractionated) to provide purified plasma proteins, such as albumin, immunoglobulins and clotting factor concentrates.
The 'buffy coat' layer with platelets and white cells is also transferred into a new bag for additional processing. The 'buffy coats' from four donors are pooled together and treated to remove the white blood cells. The remaining platelets are re-suspended in a special nutrient solution for subsequent transfusion.
What is autologous blood donation?
Another type of blood donation is autologous donation. This refers to transfusions in which the blood donor and the transfusion recipient are the same. People may elect to do this before a surgical procedure in which the likelihood of needing a transfusion is high. Although there are still risks with this process, autologous donation minimises many of them because it is the person's own blood that is being returned to his or her body.
A person can donate their blood up until 72 hours prior to their surgery, which allows time for the body to replenish its blood supply. Iron supplements or erythropoietin also may be prescribed to help increase the person's red blood cell count. Any blood that remains unused during the surgery is discarded.
The decision should be made together by the patient and his or her doctor. Other options may be preferred, such as intra-operative blood salvage, in which any blood lost during the surgery can be collected and returned to the patient's body.