Why are blood donations so important, including during a pandemic? Who benefits from them? And what happens when a person goes to donate blood? To find out, Medical News Today interviewed consultant hematologist Dr. Joel Newman.
Blood is a precious resource in healthcare the world over. According to data from the American Red Cross, in the United States alone, an estimated 6.8 million people choose to donate blood.
The World Health Organization (WHO) note that, at a global level, blood donation centers collect around 118.5 million blood donations every year.
According to the WHO, in low income countries, children younger than 5 years old are the primary beneficiaries of blood donations, while in high income countries, older adults aged 60 years and above are on the receiving end of most blood transfusions.
But, regardless of where in the world people live, why is it so important that they donate blood if they can? Who benefits from all the transfusions, and why? And why should people keep on donating blood during a pandemic?
To answer these and other questions, Medical News Today interviewed an expert, Dr. Joel Newman, consultant hematologist in the East Sussex Healthcare branch of the National Health Service (NHS), in the United Kingdom.
We have lightly edited the interview transcript for clarity.
What happens when you donate blood
MNT: What does the process of donating blood look like?
Dr. Joel Newman: It depends [on] whereabouts you’re giving [blood] and everywhere does it slightly differently, but in general, there’s either a questionnaire or a health check, either on the phone beforehand or physically in the blood donation center.
They want to make sure that you are well, because, sometimes, if people are starting to feel unwell before they donate blood and then a day or two later on, they might become unwell with an infection, there’s always that potential that that infection was in [the] bloodstream at the time of the donation. And, for some blood products, that can be an issue if that’s given through the donation to someone else.
So, it’s just a simple health check to make sure you are well, and well enough to donate blood, because blood donation is a voluntary [act] and, you know, they need to make sure they’re not going to cause you harm by taking blood from you.
There will often be a finger prick test or a blood test from the vein, just to make sure you’re not anemic prior to giving that blood transfusion to make sure they’re not going to cause you more harm by [collecting your blood].
And, as part of that health check, there would be lots of screening questions just to make sure you are in a good position — to make sure you haven’t had any exotic holidays to areas where there might be infections that you might unknowingly pass on, and so on. So there [are] lots different rules about [blood donation].
Once you’ve had your health check, and they’ve checked you’re not anemic, then you’ll sit into a chair. They will often give you a large glass of water to drink beforehand, just to try to improve your blood pressure, so that when they take your blood, it doesn’t make you feel faint or woozy.
They’ll put a cannula into one of [your] arms, and over the course of the next 5 or 10 minutes, take out around 450 to 500 [milliliters] of blood — depending on the location that you’re in — which is a donation of a unit of blood.
Then, they’ll look after you for a good half-an-hour afterward to make sure that you drink some more fluid thereafter, perhaps [offer you] something to eat, likes biscuits or something else to make sure you don’t drop your blood sugar, and if all is [OK], and you’re feeling well, off you go.
So, that’s the general overview for giving blood in most situations.
MNT: Generally speaking, who is eligible to donate blood, and who is not?
Dr. Joel Newman: Because of all the tests that [they] have to do for the first time on someone who’s new to giving blood — so, in terms of checking for viruses and things you may or may not know you have — most blood donation services will have an age limit [for donors].
In the U.K., for example, you can donate from the age of 17 up until around the age of 65 or 70.
Editor’s note: According to the American Red Cross eligibility guidelines, in the U.S., there is no upper age limit for blood donors.
Some people can donate after that; if they’ve been doing it for a long time, they can continue, but [the blood donation centers] wouldn’t normally accept anyone new after that sort of age.
Outside of the age limits, the other things they ask for are to make sure about travel history, to make sure you haven’t traveled anywhere where there are issues [such as outbreaks of viral infections]. There are often restrictions on donating blood samples if you are in an at-risk group for [infections] like HIV, but the testing for that has greatly improved.
Whereas in the U.K., for example, there was a ban on people giving blood if they were at an at-risk group for having HIV, now the testing is so sensitive that the ban is only [for] a 3-month interval after you have been at risk [of contracting the virus] before you can give blood again.
Editor’s note: According to the revised April 2020 Food and Drug Administration (FDA) guidelines for blood donations, potential donors in the U.S. are advised not to donate blood for 3 months after they have had sex with a man, if they are male, or for 3 months after they have had sex with a man who has had sex with another man if they are female.
Now, if you have other health problems, then there may be restrictions on you giving blood, and that includes whether you have any underlying cancerous processes, in case that might impact on your health and also on the donation.
And, occasionally, some medications can predispose you to not being able to give a donation. But the majority of people who are adults, who are healthy, they can donate blood.
MNT: Why is it important for black people, specifically, and for people of different ethnicities to donate blood?
Dr. Joel Newman: We all often think about blood groups as just being A, B, and O, and rhesus (Rh) positive and negative, but there are a number of other antigens ([that is what] we call them), the markers on red cells that are present in different frequencies in different populations.
And there are certain groups of patients, particularly those with [conditions] like sickle cell disease or thalassemia, who will need blood transfusions on a frequent basis.
Some people need to have them every month for their [entire] lives to make sure they don’t become unwell. And as the immune system sees these different antigens, it can develop an immune response to them.
So, for some people in some groups, they want to try and match those antigens as much as possible, and the frequency of those antigens changes in different populations, so it’s really beneficial if we can get blood transfusions from people of different ethnicities with different frequencies of these antigens to try and match up for some people as best we can, [for] these unusual antigens that are present.
The different types of donations
MNT: Can you tell us a little about what difference there is between blood donation, platelet donation, and plasma donation?
Dr. Joel Newman: When you donate for blood, actually, what is stored is the red cells, so all the plasma is not given in a donation of blood. So, if you have a bag of blood in the hospital to give to a patient, there will be a very small amount of plasma in it. The rest of it will be some fluid with nutrients to try and maintain the health of that blood, but it would be what we call “packed red cells” — it’s just the red cells suspended in that fluid.
As part of the donation process, the plasma is settled out, and that is taken off separately from that blood donation and can be used. It could be frozen, and we could call it “fresh frozen plasma,” or FFP.
Now, that can be used to help clotting because there are lots of different proteins in FFP, which we use for clotting, say if someone has clotting problems or bleeding problems in hospital. That’s what we’ll use often to help treat them.
You can also get platelets from that donation when you settle it out, and you centrifuge it; there’s a little band where the platelets sit called “the buffy coat,” and they can extract those. And, in the hospital parlance, we call it “a pool of platelets,” because usually, you need platelets from four different people, four different donations to put together to make one pool of platelets.
These days, however, the majority of platelets [collection] is done by a different technique — [in the U.K.] also through the National Blood Service — called “apherisis.” And that [process uses] a special machine that [works in the following way]: Rather than donating a unit of blood, you have two cannulas, one on each arm, and your blood is taken out and is passed through a machine where it centrifuges it, and it takes off the platelets and returns the blood back to you.
So, there are some people who are platelet donors rather than blood donors, and often that is men because they have fewer antibodies, and there’s more plasma in platelets [donations]. So there’s [a lower] chance for antibodies to be present in there and have risks of reactions.
When you go to donate blood, they might say to you after your first time: “Actually, have you thought about donating platelets?| [It is a] slightly different procedure, different process, and you can donate platelets more often than you can donate blood because they’re not taking blood off of you.
Your platelets recover quicker, and it [platelet transfusion] can be a useful thing for those people who are on treatments like chemotherapy that lower your platelets and make you at higher risk of bleeding.
So, you have a pool of platelets to try and recoup that, or for surgery and things like that where people’s platelets are too low.
MNT: Could you tell us more about how plasma donation works, compared with blood and platelet donation?
Dr. Joel Newman: Plasma donation can be done through apheresis, but it’s generally done by pooling the blood from donations. So, when they centrifuge the blood, the plasma will be at the top, and that can be pooled off, and they call it “pooled plasma.”
Why blood donations matter
MNT: Why is it important to donate blood? Who benefits from it?
Dr. Joel Newman: There are lots of different uses for blood and [for] the components that we use in it. The classic one is the red cells for people who are anemic.
And there are lots of different causes of anemia; [there are] the ones that you might think of more classically, [such as] bleeding from an accident or a trauma, or from an operation [where there] happens to be a lot of blood [loss]. And there are a lot of procedures, lots of surgeries where people do tend to lose blood and may need a blood transfusion to keep them safe through that procedure.
But then there are lots of other people, like people with sickle cell disease and thalassemia, who may need blood transfusions on a regular basis to maintain their health.
Or cancer patients who are in chemotherapy that suppresses the bone marrow function that stops people’s blood counts recovering temporarily, who may need a blood transfusion in-between times [when they receive treatment] just to keep them well while they’re having their treatment.
So there are lots of different reasons why we use blood [in transfusions], and donating it is really useful.
MNT: Can you tell us a little about how blood is important in research?
Dr. Joel Newman: So, at the moment, they’re looking at researching […] plasma for [COVID-19] — and that’s a [hot] topic at the moment, what we call “convalescent plasma,” plasma which contains lots of proteins and antibodies. So people who have had [COVID-19] will have antibodies to [COVID-19] in their plasma.
And that sort of idea has been used in the past for other conditions, and it is being looked at now actively, and there are some good results.
Convalescent plasma may give someone else the benefit of those antibodies to fight off [COVID-19] if they’re given that plasma.
So, it’s used in research in those sorts of areas. There is other research going on into whether or not we need to have blood donation. Can we make synthetic blood? There’s been lots of research [into] that over the years, and as of yet, we haven’t yet got a definitive answer.
But in the future, it would be really useful if we could develop red cells that carry the oxygen for you, take the carbon dioxide away, but don’t have all those antigens on the top that make people allergic to them, or react to them. And [it would be useful to] somehow be able to produce that in the laboratory, so we don’t have to have donations.
They may be a bit far off at the moment, but you know, that’s something we are still looking into.
MNT: Finally, what would you say to someone who may be anxious about donating blood for the first time?
Dr. Joel Newman: First thing to say is that everyone there [at the blood donation centers] is lovely! You’ll be looked after, and they’ll make you comfortable, and it’s not a scary thing to do.
If you’ve ever had a blood test taken, the needle size isn’t a huge amount more than that. And the people who are doing it are so expert at doing that, that actually often you don’t feel it going in.
And just think about all the people who could benefit from that blood donation. So, it may be that the red cells will go to one patient, the plasma from it can go to another, the platelets can be pooled from it to go to another person.
So, all that benefit for people from just that one visit — just think all the things you’re doing to help!
Why donate blood during a pandemic
MNT: And what would you say to people who may be specifically scared of coming in to donate now, during the pandemic? Why is it still important to donate at this time, and is it still safe to do it?
Dr. Joel Newman: [Donating blood] is still important now, although the use of blood transfusions from the perspective of surgery has decreased a little [because] there are fewer operations happening.
[Health centers and hospitals] are still recovering in terms of procedures, and so the need for blood transfusions will start to increase again.
The areas where you give blood are made safe; people are wearing the appropriate protective equipment, the spacing of chairs is done appropriately; they are safe places for you to go and have these things done.
And the other thing to think about is that blood has a “shelf life.” After it’s been donated, depending on where in the world you have it done, its “shelf life” is between about 35 and 42 days, depending on which area you are in, and after that, it can no longer be used.
So if no one donated blood from the beginning of the pandemic till now, we would have run out of blood.
People need to keep donating. Yes, the usage isn’t as high at the moment as it normally is, there aren’t many traumas [accidents] out there because people are staying indoors, but there is still a need for it.
MNT: Is there anything else you would like to say to our readers as we draw to a close?
Dr. Joel Newman: [I’d like] to say, you know, this is one of the few things that is completely altruistic. This gives so much benefit to so many people.
And it is a sacrifice from some people — they do that for others. And it’s really very welcomed, and we’re very, very grateful for anyone who donates their blood and their free time to do this.
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