Blood Donation and Registry Health Article

Definition

Blood donation, also called blood banking, refers to the process of collecting, testing, preparing, and storing whole blood and blood components intended primarily for transfusion. Blood donors are typically unpaid volunteers, but they may also be paid by commercial blood donation and processing enterprises, such as independent blood banks and donor centers. Blood registry refers to the collection and sharing of data about donated blood and donors. Donors who have been determined to be temporarily or permanently ineligible to donate blood are listed in a confidential national data base known as the Donor Deferral Register. The quality and safety of the U.S. blood supply is governed by physician-established guidelines for the practice of blood banking as found in the Standards of the American Association of Blood Banks (AABB) and through the organization's inspection and accreditation program. The Food and Drug Administration (FDA) controls federal licensure of blood banks. Hospital blood banks are also inspected by The College of American Pathologists (CAP) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHC).

Purpose

Blood is collected, processed, stored, and distributed to maintain an adequate supply of whole blood and blood components for transfusion as needed. Blood replacement may be needed by people who have lost blood through accidents, burns, hemorrhage, or surgery. Blood or blood components are also used in the treatment of certain types of anemia, various disease conditions, and for medical research.

Healthy donors may be called upon to donate periodically to help maintain the overall blood supply or when their specific blood type is needed. People may sometimes donate blood to benefit a specific person. Directed donor blood is reserved for an intended recipient, such as a family member or friend; it is tested and processed as all other donated blood to ensure that it is appropriate for the recipient. People preparing for elective surgery may have their blood collected and held, and then returned to them if needed during their surgery. This process is known as autologous blood donation. Donors are advised to give blood only once in an eight-week period to maintain the iron stores in their blood. Autologous donors may donate more often if it is determined by their physician to be to their benefit.

The National Blood Data Resource Center reports that about 13.9 million units of whole blood (one unit of whole blood equals 450 ml, or about 1 pt) are donated annually in the United States, of which about 695,000 are autologous donations for elective surgery. The country's blood supply is donated by about eight million people, representing a broad cross section of the population, although fewer than 5% of those eligible donate. About half of the total amount needed is processed, stored, and delivered by the 36 regional blood centers of the American Red Cross; hospital blood banks, community blood centers, mobile blood drives, and independent blood banks collect, process, and distribute the other half.

Blood is donated as whole blood, collected in a plastic bag containing an anticoagulant that will keep the blood from clotting and allow it to be separated into multiple components. By dividing blood into components that each offer different clinical benefits, one unit of donated blood can meet the transfusion needs for more than one person. This practice is essential to meet the constant demand for blood; every year in the United States, more than four million people require blood transfusions. About 26 million transfusions are administered either as whole blood or components that have been prepared from whole blood. About 34,000 units per day, for example, are transfused as red cells.

Whole blood and blood components are used in various ways to meet the clinical needs of recipients. Whole blood is sometimes used to replace blood volume when a significant amount of blood has been lost through accidents or surgery. Red blood cells, which carry oxygen, are used to treat certain anemias and are often the preferred component when multiple transfusions are being administered to one person, as in open heart surgery or organ transplants. Platelets, part of the complex coagulation (clotting) system that helps control bleeding, are commonly used in the treatment of acute leukemia and some types of cancer. Fresh frozen plasma, which contains critical coagulation factors, is used to control bleeding in people who lack these factors. Cryoprecipitated (prepared from frozen plasma) antihemophilic factor (AHF) is transfused to provide a specific coagulation factor that is deficient in hemophilia and other diseases. Blood for transfusion is requested by physicians. Pre-transfusion testing and issuance of blood and components to the recipients is performed by a transfusion service, which is commonly provided or supervised by a hospital blood bank.