The blood you receive is donated voluntarily by healthy adults in East Central Illinois. The donors are your neighbors and co-workers, and as a group may provide the safest available source of blood components. Potential donors are rigorously screened for any factors that might make the blood they donate less than safe. Any individual with a history that increases the likelihood of transmitting hepatitis, AIDS, malaria or other disease is not allowed to donate.
After donation, blood is tested for evidence of liver inflammation, infection by hepatitis virus, atypical red blood cell antibodies, antibodies to syphilis, HIV-1, HIV-2 and HTLV-1. All blood donations testing positive for infectious diseases are discarded according to Food & Drug Administration and Illinois Department of Public Health regulations, thus ensuring a safe supply. Donors of such units are placed on a deferral list, removed from active donor files and informed of significant laboratory findings by the blood center through its physicians.
Receiving a Blood Transfusion
Blood components are given to replace blood lost and to improve inadequate blood counts. Red blood cells, the most frequent blood component given, are used to treat low blood counts (anemia) or to replace blood lost from surgery or accidents. Platelets, a component that promotes clotting and stops bleeding, may be prescribed if a patient's platelets are depleted or not functioning properly. Plasma, the fluid portion of blood, contains clotting factors and is often used to treat victims of severe burns.
Before a red blood cell transfusion, the hospital laboratory will take a sample of your blood. This specimen will be used to assure the right blood type is chosen for you. In addition, testing is performed to identify any proteins (antibodies) in your blood that might damage (hemolyze) the donated red blood cells you receive. These destructive antibodies usually are the result of a previous transfusion or pregnancy.
Receiving the wrong blood type can cause a severe life-threatening reaction. Healthcare professionals involved in blood transfusion are aware of the necessity of accurately matching blood to the patient's type prior to transfusion. Rigorous checks have been established to prevent any error, including careful testing of all units of blood, testing your blood sample, and placing an identification band on your wrist. For safety purposes, you should not remove the identification band for any reason prior to discharge.
Making the Blood Supply Safe
Due to extensive testing of blood donations and rigorous screening of blood donors, the nation's blood supply is safer than ever.
In January 1995 the Centers for Disease Control estimated the risk of HIV infection from blood transfusion to be less than one in 420,000. All blood is tested for the HIV antibody before it is transfused. While extremely rare, some donors may carry the virus and not demonstrate positive blood tests. To minimize this risk, blood centers carefully educate and rigorously screen volunteer blood donors prior to donation.
Despite our donor screening and blood testing, there are viral diseases, including some forms of hepatitis, that escape detection by current testing methods. Hepatitis is an inflammation of the liver that has many causes.
It is important to recognize that some donors may carry a viral infection causing hepatitis without being ill. While medical science has identified hepatitis A, B and C, there may be other forms of the virus which are not detectable with current testing. The current donor screening and blood testing has lowered the chance of acquiring viral hepatitis from 1 unit of volunteer donor blood to less than one in 1,000.
Blood centers have implemented HTLV-1 antibody screening of all donor blood. This virus is associated with a rare form of acute leukemia and neurologic disease. It is extremely uncommon in the United States. Since serologic testing is available, donors are now screened for this infection.
It is also possible to transmit cytomegalovirus (CMV) through blood transfusion. CMV is harmless to the average person, but it may be harmful to fetuses or newborns. To prevent transmission of the virus, blood products are screened appropriately.
Blood products that contain red blood cells need to be carefully selected to avoid hemolytic reactions; that is, rapid breakdown of donor red blood cells. The information on your hospital identification band is critical to assure that you receive only the blood that has been tested and selected for you. Even with appropriate testing, certain types of immune reactions may occur, but are usually no more than a slight fever.
About 1 in 1,000 patients receiving blood may have delayed hemolytic reaction. In this situation, a patient's body may be immune to a particular donor cell, but the laboratory cannot detect the immunity even using sophisticated testing. Usually this does not cause illness. It may, however, result in a low blood count, jaundice or a fever. An acute or immediate hemolytic reaction is extremely rare but is a serious life threatening problem.
Minor immediate reactions such as fever or itching occur in approximately 1-2 per 100 blood recipients. These reactions are usually treatable and last for only a short time. The only problem with these reactions is that they may interrupt your blood transfusion. Finally, certain patients with weakened heart function may develop congestive heart failure if blood is given too rapidly for their heart.
Blood Transfusion Alternatives
The safest blood you can receive is your own. Many patients can store their own blood before a scheduled surgery, and receive that blood back during and after the procedure. This process is called autologous blood storage. Autologous blood transfusions are free from all risk of the previously mentioned infections and immune reactions. Eligibility for the Predeposit Autologous Blood Transfusion Program is determined jointly by you, your primary physician and Community Blood Services of Illinois.
Another way to replace blood lost during surgery is through interoperative blood salvage. During surgery, blood that is lost can be collected, filtered and given back to the patient. This procedure is not an option for all patients, and is not currently available in all healthcare institutions. Consult your physician if you are interested in learning more about this method.
If your surgery causes only a mild decrease in blood count, your body can replace blood loss with an adequate oral iron supplement rather than a blood transfusion. This decision should be made in consultation with your primary physician. He or she can best explain why a blood transfusion may still be needed. Many patients who are critically ill require replacement of various blood components. The risk of not receiving those components may be much greater than the previously mentioned transfusion risks.
It also is possible for your family or friends to donate blood for you through the blood center's Designated Donor Program. Patents considering the Designated Donor Program should consult their physician. The patient's physician will contact the hospital's Director of Transfusion Services, who will in turn contact Community Blood Services of Illinois. Because the involvement of the patient's physician is essential, Community Blood Services of Illinois is unable to accept requests for these designated donations other than through medical channels.
If you have additional questions about blood transfusions, please call Community Blood Services of Illinois at 217-367-2202 or 800-217-GIVE (4483).