Steps taken to make sure that the blood patients receive is safe

There are many safeguards on our national blood supply to ensure safe blood for patients. First, blood is donated by volunteer donors. Before giving blood, donors must answer questions about their health and risk factors for disease, and only a person with a clean bill of health can give blood. Blood from each accepted donor goes through extensive testing. In addition to tests for blood type, nine separate screening tests are run for evidence of infection with hepatitis, HIV, HTLV and syphilis. Finally, a carefully identified blood sample is tested against blood from the patient who will receive it, a process called crossmatch.

Risks of receiving blood

If a blood transfusion is indicated during a surgical procedure or other medical treatment, the risks of NOT receiving blood far outweigh the risks of transfusion. Some patients may experience minor changes in the body's immune system after a transfusion, causing mild symptoms, such as fever, chills or hives, which typically require little or no treatment. A small number of patients may also react to donated blood by developing antibodies (immune reactions).

The transmission of disease and the destruction of red blood cells occur only very rarely, and seldom threaten life. The potential risk of contracting AIDS from a blood transfusion has received a great deal of attention. But it is important to know that all donated blood in the United States is tested for the AIDS virus, reducing the risk to a negligible level. When you consider the risks of transfusion, it may be helpful to know that many common activities carry far greater risks for example, smoking cigarettes, driving a car or being pregnant.

Steps taken to reduce the risks involved in receiving a transfusion

Steps to ensure maximum transfusion safety involve both donor and recipient. Donors are screened very carefully using a detailed questionnaire for health problems or circumstances that increase risk of transmitting infection. After blood has been drawn, it is tested for numerous viruses and other potentially harmful disease agents, and positive or doubtful units are discarded. Donor blood is tested for ABO, Rh and the presence of possibly dangerous blood group antibodies. After the recipient's blood has been tested for ABO, Rh and the presence of blood group antibodies, donor units are selected that lack antigens that might react with any antibodies present in the recipient. Additional checks are then performed to compare the specific donor unit selected with the patient's blood.

Blood Safety Issues

Systems for ensuring the safety of the blood supply generally are described as having five steps, which work together to screen out infectious agents.

Step 1: Blood Donor Screening

Efforts are made to recruit volunteer blood donors only from the safest and most suitable donors. Blood for transfusion is collected from volunteer blood donors. Improper donor incentives and coercion, which could alter the truthfulness of some donors, are prohibited.

Step 2: Individual Screening

Each individual blood donor is required to read information about blood safety and is encouraged to leave, without explanation, if he or she recognizes that giving blood would be inappropriate. Potential donors are also asked a series of questions about their health and lifestyle (including direct questions on sexual behavior designed to identify high-risk activities) and undergo a miniphysical before being allowed to donate. The questions and examinations are designed to prevent individuals who are at high risk for HIV, hepatitis and other infectious diseases from donating blood. This process is continually refined in order to ensure that blood is drawn from the most appropriate individuals.

Step 3: Laboratory Testing

The third layer involves testing collected blood for possible infectious diseases. Nine laboratory tests for different infectious diseases are currently conducted on each unit of donated blood. All results must be negative for a blood unit to be labeled and released. Tests for hepatitis B and syphilis were in place before 1985. Since 1985, the following tests have been implemented: HIV-1 and -2, HIV antigen, HTLV-1 and -2, two tests for hepatitis B and a test for hepatitis C. Nucleic acid amplification testing (NAT) employs a form of testing technology that directly detects the genetic material of viruses like hepatitis C and HIV. An investigational NAT to screen for West Nile virus is now available.

Step 4: Confidential Exclusion

Blood donors may be offered a confidential opportunity to exclude their blood from use in transfusion by attaching stickers to the paperwork identifying the collected unit for use or withdrawal. If a donor knows of any reason why his or her blood should not be used for transfusion, he or she places the sticker indicating that the unit should not be transfused on the label. This is done to ensure that no pressure is exerted on the donor to give blood.

Step 5: Donor Record Checks

Every donation is checked against existing records. If a donor has been indefinitely deferred, the collected unit is withdrawn from circulation and potential use. This process acts as a barrier to prevent the release of any blood from a donor who was previously judged to be indefinitely unacceptable.