Donor Information

Blood Safety

What are the risks of receiving blood?

If a blood transfusion is required during surgery or in other medical treatment, it is always essential to weigh up the risk of transfusion against the risk of NOT transfusing. In most cases when blood is required, the patient would certainly not be able to do without the required transfusion. There is still no substitute for human blood.

Blood safety in the age of AIDS has however received a lot of publicity. It is important to know that in South Africa steps are taken to reduce this risk to a negligible level. Today, having a blood transfusion is safer than it has ever been before due to technological advances and more stringent donor screening. Receiving blood is far less risky, for example, than smoking, driving a car, normal childbirth, receiving an anaesthetic and most major surgery.

What steps are taken to ensure a safe blood supply?
Our commitment to safeguard the blood supply rests on multiple layers of protection, not just blood tests. Our goal is to reduce the risk of infection to as low a level as is possible.

Step 1 : Selective recruitment

We recruit only volunteer non-remunerated donors. We don't use incentives, which could affect or alter the altruistic motivation to donate. We have stringent donor selection procedures and programmes encouraging donors to donate regularly. Research has shown that regular donors who give blood freely have little reason to conceal information about their lifestyle. Regular donors have been shown to be the safest source of blood (85% of our donations are from regular donors).

Step 2 : Continuous education of donors

Current and prospective donors are informed about safety issues prior to donation through presentations and literature handouts. Topics such as lifestyle choices and medical history are strongly emphasised.

Step 3 : Pre-donation screening

Each individual donor is required to read information about blood safety before donation. At each donation donors are asked a series of questions about their health and lifestyle.
Donors are questioned confidentially about any behaviour, which might pose a risk to the patient. The questions coupled with a physical examination of the donor are designed to prevent individuals who are at risk for HIV, Hepatitis and other infections from donating blood. Donors are also given
a confidential exclusion hotline number so they can withdraw their unit after donation if they feel there may be some risk.

Step 4 : Testing

Every unit of blood donated is tested for the following infections, which would affect the safety of the blood:

• Hepatitis B
• Hepatitis C
• Syphilis
• HIV 1 and 2 Antibody
• HIV p24 Antigen

All results must be negative for a blood unit to be labeled and released. Blood found positive on any of these tests is quarantined, removed and incinerated. The HIV seroprevalence rate of our carefully screened and selected donors is approximately 250 times less than that of the general population in the Western Cape.

There is a period of time right after exposure to HIV infection, called the "Window Period", where HIV is not detectable with blood testing. With new screening tests and rigorous quality assurance procedures, the Window Period has been reduced to an average of 14 to 16 days .

Step 5 : Sterilisation of blood products

Certain plasma products are sterilized to inactivate residual viruses. This means they cannot transmit viruses such as Hepatitis or HIV. Examples: Factor VIII and IX, Immunoglobulins, Stabilised Serum and Albumin.

Step 6 : Information

Although the ultimate decision of whether to use blood rests with the physician, WPBTS actively promotes effective transfusion practice to all medical staff at government and private hospitals. The Transfusion Services have also published a booklet entitled "Clinical Guidelines for the use of Blood Products in South Africa", which is widely distributed. This should result in blood being used appropriately and judiciously.

What other options are available?

There are alternatives to using the blood from the general donor supply:

• Autologous donation where you can donate a number of units of blood for your own use during surgery.
• Designated donation: family and friends can donate for you.
• Intra-operative blood collection, where the blood lost during surgery is saved and transfused back to you.
• Erythropoietin, a bone marrow stimulant can be utilized in specific conditions (e.g. anaemia of renal failure).

Safe Blood Starts with You, the Donor!

At WPBTS our donors are our most precious assets. Thousands of people would die every day if others
did not donate their blood. One donation can save up to four lives. Although blood is tested, we still rely on the honesty and integrity of every blood donor when giving us their information. According to the World Health Organisation (WHO) all blood donations should be voluntary and non-remunerated, thus no financial incentive is given for donating blood.

Donor safety

Are there any side effects from donating blood? We establish that the donor is in good health to withstand the rapid withdrawal of about 10% of his blood volume without compromising his cardiovascular system. We try to ensure that the donor does not experience any adverse effects of
blood donation. Adverse effects are minimized by checking whether the donor has eaten, is generally healthy, and by offering him some refreshment after donation.

Can I get HIV from donating blood?

There is no risk of acquiring diseases such as HIV, Hepatitis B or C, through donating blood as only new, sterile and disposable equipment is used for each donation.

Donor selection

The first concern of the blood service is to ensure that blood donation does no harm to the donor. We carefully question all donors about their health. We also ask questions about personal "risk" behaviour, which may expose the blood recipient to the risk of infection. Donors who have been
exposed to risk are deferred as confidentially and discreetly as possible. Donor confidentiality is maintained through the use of a code number and barcode system.