Array ( [0] => {{Short description|Blood withdrawal for use by another person via transfusion}} [1] => {{Redirect-multi|3|Give blood|Blood donor|Blood drive|the TV episode|The Blood Donor|other uses|Give blood (disambiguation)|and|Blood drive (disambiguation)}} [2] => [[File:Blood donation pictogram.svg|thumb|Blood donation [[pictogram]]]] [3] => [[File:Saal Blutspendezentrum Basel 3.jpg|thumb|right|Blood donation center at the [[University Hospital of Basel]], Switzerland. From left to right: Two cell separators for [[apheresis]], secluded office for pre-donation blood pressure measurement and [[blood count]], and on the right, chairs for whole blood donations.]] [4] => [5] => A '''blood donation''' occurs when a person voluntarily has [[blood]] drawn and used for [[blood transfusion|transfusions]] and/or made into biopharmaceutical medications by a process called [[Blood fractionation|fractionation]] (separation of [[whole blood]] components). Donation may be of whole blood, or of specific components directly ([[apheresis]]). [[Blood bank]]s often participate in the collection process as well as the procedures that follow it. [6] => [7] => Today in the [[developed world]], most blood donors are unpaid volunteers who donate blood for a community supply. In some countries, established supplies are limited and donors usually give blood when family or friends need a transfusion (directed donation). Many donors donate for several reasons, such as a form of charity, general awareness regarding the demand for blood, increased confidence in oneself, helping a personal friend or relative, and social pressure. Despite the many reasons that people donate, not enough potential donors actively donate. However, this is reversed during disasters when blood donations increase, often creating an excess supply that will have to be later discarded. In countries that allow paid donation some people are paid, and in some cases there are incentives other than money such as [[paid time off]] from work. People can also have blood drawn for their own future use ([[autologous blood donation|autologous donation]]). Donating is relatively safe, but some donors have bruising where the needle is inserted or may feel faint. [8] => [9] => Potential donors are evaluated for anything that might make their blood unsafe to use. The screening includes testing for diseases that can be transmitted by a blood transfusion, including [[HIV]] and [[viral hepatitis]]. The donor must also answer questions about [[medical history]] and take a short [[physical examination]] to make sure the donation is not hazardous to their health. How often a donor can donate varies from days to months based on what component they donate and the laws of the country where the donation takes place. For example, in the United States, donors must wait 56 days (eight weeks) between [[#Whole blood|whole-blood donations]] but only seven days between [[platelet apheresis]] donations{{cite web |url=https://www.redcrossblood.org/faq.html |title=Frequently Asked Questions About Donating Blood |access-date=2021-04-15 |publisher=American Red Cross Blood Services |archive-date=2021-04-18 |archive-url=https://web.archive.org/web/20210418010657/https://www.redcrossblood.org/faq.html |url-status=live }} and twice per seven-day period in [[plasmapheresis]]. [10] => [11] => The amount of blood drawn and the methods vary. The collection can be done manually or with automated equipment that takes only specific components of the blood. Most of the components of blood used for transfusions have a short [[shelf life]], and maintaining a constant supply is a persistent problem. This has led to some increased interest in [[autotransfusion]], whereby a patient's blood is salvaged during surgery for continuous reinfusion—or alternatively, is self-donated prior to when it will be needed. Generally, the notion of donation does not refer to giving to one's self, though in this context it has become somewhat acceptably idiomatic. [12] => [13] => == History == [14] => {{See also|Blood bank#History}} [15] => [[Charles Richard Drew]] (1904–1950) was an American [[surgeon]] and medical researcher. He researched in the field of [[blood transfusion]]s, developing improved techniques for blood storage, and applied his expert knowledge to developing large-scale [[blood bank]]s early in [[World War II]]. This allowed medics to save thousands of lives of the [[Allies of World War II|Allied]] forces. As the most prominent [[African American]] in the field, Drew protested against the practice of [[racial segregation]] in the donation of blood, as it lacked scientific foundation, and resigned his position with the [[American Red Cross]], which maintained the policy until 1950.{{citation needed|date=November 2021}} [16] => [17] => == Types of donation == [18] => [[File:JRC Hyogo Blood Center bloodmobiles 2008-01-14.jpg|thumb|A blood collection bus ([[bloodmobile]]) from [[Japanese Red Cross]] at [[Myōdani Station]] in [[Suma-ku, Kobe|Suma-ku]], [[Kobe]], [[Hyōgo Prefecture]], [[Japan]]]] [19] => Blood donations are divided into groups based on who will receive the collected blood.M. E. Brecher, Editor (2005), ''AABB Technical Manual'', 15th ed., Bethesda, MD: AABB, {{ISBN|1-56395-196-7}}, pp. 98–103 An 'allogeneic' (also called 'homologous') donation is when a donor gives blood for storage at a [[blood bank]] for [[Blood transfusion|transfusion]] to an unknown recipient. A 'directed' donation is when a person, often a family member, donates blood for transfusion to a specific individual.{{cite web|url=http://www.mayoclinic.org/donateblood/directed.html|title=Directed Donation|publisher=Mayo Clinic|access-date=2008-06-25 |archive-url = https://web.archive.org/web/20080524004449/http://www.mayoclinic.org/donateblood/directed.html |archive-date = 2008-05-24}} Directed donations are relatively rare when an established supply exists.{{cite journal |vauthors=Wales PW, Lau W, Kim PC |title=Directed blood donation in pediatric general surgery: Is it worth it? |journal=J. Pediatr. Surg. |volume=36 |issue=5 |pages=722–725 |date=May 2001 |pmid=11329574 |doi=10.1053/jpsu.2001.22945 }} A 'replacement donor' donation is a hybrid of the two and is common in developing countries.T. Brown "Strengthening Blood Systems In Africa: Progress Under PEPFAR and Remaining Challenges" ''AABB News''. April 1998: p. 30 In this case, a friend or family member of the recipient donates blood to replace the stored blood used in a transfusion, ensuring a consistent supply. When a person has blood stored that will be transfused back to the donor at a later date, usually after surgery, that is called an '[[autologous blood donation|autologous donation]]'.{{cite web|url=http://www.aabb.org/Content/About_Blood/Facts_About_Blood_and_Blood_Banking/fabloodautoallo.htm|title=Autologous (self-donated) Blood as an Alternative to Allogeneic (donor-donated) Blood Transfusion|publisher=[[AABB]]|access-date=2008-06-25|url-status=dead|archive-url=https://web.archive.org/web/20080612135452/http://www.aabb.org/Content/About_Blood/Facts_About_Blood_and_Blood_Banking/fabloodautoallo.htm|archive-date=2008-06-12}} Blood that is used to make medications can be made from allogeneic donations or from donations exclusively used for manufacturing.{{cite web|url=http://www.aabb.org/Content/Members_Area/Members_Area_Regulatory/Blood_Component_Preparation_and_Testing/plasbpac061302.htm|title=Recovered Plasma|publisher=[[AABB]]|access-date=2008-06-25|url-status=dead|archive-url=https://web.archive.org/web/20080612060217/http://www.aabb.org/Content/Members_Area/Members_Area_Regulatory/Blood_Component_Preparation_and_Testing/plasbpac061302.htm|archive-date=2008-06-12}} [20] => [21] => Blood is sometimes collected using similar methods for [[therapeutic phlebotomy]], similar to the ancient practice of [[bloodletting]], which is used to treat conditions such as [[hereditary hemochromatosis]] or [[polycythemia vera]]. This blood is sometimes treated as a blood donation, but may be immediately discarded if it cannot be used for transfusion or further manufacturing.{{citation needed|date=November 2021}} [22] => [23] => The actual process varies according to the laws of the country, and recommendations to donors vary according to the collecting organization.{{cite web| url=http://www.donateblood.com.au/page.aspx?IDDataTreeMenu=45&parent=31 | title=Giving Blood -> What to Expect | publisher=Australian Red Cross Blood Service| access-date=2007-10-06 |archive-url = https://web.archive.org/web/20070829035341/http://donateblood.com.au/page.aspx?IDDataTreeMenu=45&parent=31 |archive-date = 2007-08-29}}{{cite web| url=http://www.bloodservices.ca/centreapps/internet/uw_v502_mainengine.nsf/page/The%20Donation%20Experience?OpenDocument| title=The Donation Experience| publisher=Canadian Blood Services| access-date=2006-12-17| url-status=dead| archive-url=https://web.archive.org/web/20070203060915/http://www.bloodservices.ca/CentreApps/Internet/UW_V502_MainEngine.nsf/page/The%20Donation%20Experience?OpenDocument| archive-date=2007-02-03}}{{cite web| url=http://www.givelife2.org/donor/tips.asp| title=Tips for a Good Donation Experience| publisher=American Red Cross| access-date=2006-12-17| url-status=dead| archive-url=https://web.archive.org/web/20061214131808/http://www.givelife2.org/donor/tips.asp| archive-date=2006-12-14}} The [[World Health Organization]] gives recommendations for blood donation policies,{{cite web|url=https://www.who.int/mediacentre/factsheets/fs279/en/|title=WHO Blood Safety and Donation|publisher=World Health Organization|access-date=2008-06-01|url-status=live|archive-url=https://web.archive.org/web/20080629085919/http://www.who.int/mediacentre/factsheets/fs279/en/|archive-date=2008-06-29}} but in developing countries many of these are not followed. For example, the recommended testing requires laboratory facilities, trained staff, and specialized reagents, all of which may not be available or too expensive in developing countries.{{cite web|url=https://www.who.int/mediacentre/news/releases/2006/pr33/en/index.html|title=World Blood Donor Day 2006|publisher=World Health Organization|access-date=2008-06-26|url-status=dead|archive-url=https://web.archive.org/web/20080617183627/http://www.who.int/mediacentre/news/releases/2006/pr33/en/index.html|archive-date=2008-06-17}} [24] => [25] => An event where donors come to donate allogeneic blood is sometimes called a 'blood drive' or a 'blood donor session'. These can occur at a blood bank, but they are often set up at a location in the community such as a shopping center, workplace, school, or house of worship.{{cite web|url=http://www.givelife2.org/sponsor/|title=Sponsoring a Blood Drive|publisher=American Red Cross|access-date=2008-06-25|url-status=dead|archive-url=https://web.archive.org/web/20080526101723/http://www.givelife2.org/sponsor/|archive-date=2008-05-26}} [26] => [27] => ==Screening== [28] => [29] => Donors are typically required to give [[informed consent|consent]] for the process, and meet a certain criteria such as weight and hemoglobin levels, and this requirement means [[minor (legal)|minors]] cannot donate without permission from a parent or guardian.{{cite web|url=http://www.donateblood.com.au/admin%5Cfile%5Ccontent1%5Cc5%5Cwaconsent%20.pdf|title=Parental consent form|publisher=Australian Red Cross Blood Service|access-date=2008-06-01|archive-date=2008-06-25|archive-url=https://web.archive.org/web/20080625001730/http://www.donateblood.com.au/admin%5Cfile%5Ccontent1%5Cc5%5Cwaconsent%20.pdf|url-status=live}} In some countries, answers are associated with the donor's blood, but not name, to provide anonymity; in others, such as the United States, names are kept to create lists of ineligible donors.{{cite web|url=http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=610.41|title=FDA regulations on donor deferral|access-date=2008-06-01|publisher=US Food and Drug Administration|url-status=live|archive-url=https://web.archive.org/web/20080514040725/http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=610.41|archive-date=2008-05-14}} If a potential donor does not meet these criteria, they are 'deferred'. This term is used because many donors who are ineligible may be allowed to donate later. Blood banks in the United States may be required to label the blood if it is from a therapeutic donor, so some do not accept donations from donors with any blood disease.{{cite web | title =Variances for Blood Collection from Individuals with Hereditary Hemochromatosis | publisher=US Food and Drug Administration | url=https://www.fda.gov/cber/gdlns/hemchrom.htm | access-date=2007-07-18 |archive-url = https://web.archive.org/web/20070708113601/https://www.fda.gov/cber/gdlns/hemchrom.htm |archive-date = 2007-07-08}} Others, such as the [[Australian Red Cross Blood Service]], accept blood from donors with [[hemochromatosis]]. It is a genetic disorder that does not affect the safety of the blood.{{cite web|title=Hereditary Hemochromatosis: Perspectives of Public Health, Medical Genetics, and Primary Care|url=https://www.cdc.gov/genomics/training/perspectives/other/hfe.htm|access-date=2008-06-03|publisher=CDC Office of Public Health Genomics |archive-url = https://web.archive.org/web/20080308024528/http://www.cdc.gov/genomics/training/perspectives/other/hfe.htm |archive-date = 2008-03-08}} [30] => [31] => The donor's race or ethnic background is sometimes important since certain [[human blood group systems|blood types]], especially rare ones, are more common in certain ethnic groups.{{cite news|url=https://query.nytimes.com/gst/fullpage.html?res=9C0CEEDC123DF930A25752C0A966958260|title=Donors' Races to Be Sought To Identify Rare Blood Types|work=The New York Times|access-date=2008-06-01|first=Richard|last=Severo|date=1990-01-13|url-status=live|archive-url=https://web.archive.org/web/20090303124002/http://query.nytimes.com/gst/fullpage.html?res=9C0CEEDC123DF930A25752C0A966958260|archive-date=2009-03-03}} Historically, in the United States donors were segregated or excluded on race, religion, or ethnicity, but this is no longer a standard practice.{{cite web|url=https://www.pbs.org/wnet/redgold/innovators/bio_drew.html|title=Red Gold, Innovators and Pioneers|publisher=Public Broadcasting Service (United States)|access-date=2008-06-01|url-status=live|archive-url=https://web.archive.org/web/20080517052129/http://www.pbs.org/wnet/redgold/innovators/bio_drew.html|archive-date=2008-05-17}}{{cite web|url=https://ncse.com/blog/2015/08/how-science-students-helped-end-segregated-blood-banks-0016561|title=How Science Students Helped End Segregated Blood Banks|publisher=National Center For Science Education (United States)|access-date=2017-11-05|url-status=live|archive-url=https://web.archive.org/web/20171107022856/https://ncse.com/blog/2015/08/how-science-students-helped-end-segregated-blood-banks-0016561|archive-date=2017-11-07|date=2015-08-05}} [32] => [33] => ===Recipient safety=== [34] => [[File:Map_of_blood_donation_policies_for_men_who_have_sex_with_men.svg|thumb|right|200px|[[Blood donation restrictions on men who have sex with men|Blood donation policies for men who have sex with men]] [35] => {{legend|#9F9| – Men who have sex with men may donate blood; '''No deferral'''}} [36] => {{legend|#FFB| – Men who have sex with men may donate blood; '''Temporary deferral'''}} [37] => {{legend|#F99| – Men who have sex with men may not donate blood; '''Permanent deferral'''}} [38] => {{legend|#C0C0C0| – No Data}} ]] [39] => [40] => [[File:Map_of_blood_donation_policies_for_female_sex_partners_of_men_who_have_sex_with_men.svg|thumb|right|200px|[[Blood donation restrictions on men who have sex with men|Blood donation policies for female sex partners of men who have sex with men]] [41] => {{legend|#9F9| – Female sex partners of men who have sex with men may donate blood; '''No deferral'''}} [42] => {{legend|#FFB| – Female sex partners of men who have sex with men may donate blood; '''Temporary deferral'''}} [43] => {{legend|#F99| – Female sex partners of men who have sex with men may not donate blood; '''Permanent deferral'''}} [44] => {{legend|#C0C0C0| – No Data}}]] [45] => [46] => Donors are screened for health risks that could make the donation unsafe for the recipient. Some of these restrictions are controversial, such as [[Blood donation restrictions on men who have sex with men|restricting donations from men who have sex with men]] (MSM) because of the risk of transmitting [[HIV]].{{cite news|url=https://www.nytimes.com/2007/05/24/washington/24blood.html|title=Drug Agency Reaffirms Ban on Gay Men Giving Blood|work=[[The New York Times]]|access-date=2009-03-26|date=2007-05-24|url-status=live|archive-url=https://web.archive.org/web/20130524225849/http://www.nytimes.com/2007/05/24/washington/24blood.html?_r=2&oref=slogin|archive-date=2013-05-24}} In 2011, the UK (excluding Northern Ireland) reduced its blanket ban on MSM donors to a narrower restriction which only prevents MSM from donating blood if they have had sex with other men within the past year.{{cite web|url=http://www.nat.org.uk/News-and-Media/Press-Releases/2011/September/Blood%20donation.aspx|title=HIV charities welcome the lifting of lifetime ban on gay men donating blood|publisher=National Aids Trust|date=2011-09-08|access-date=2014-01-31|url-status=dead|archive-url=https://web.archive.org/web/20140202104749/http://www.nat.org.uk/News-and-Media/Press-Releases/2011/September/Blood%20donation.aspx|archive-date=2014-02-02}} A similar change was made in the US in late 2015 by the [[Food and Drug Administration]] (FDA).{{cite web|url=https://www.fda.gov/BiologicsBloodVaccines/BloodBloodProducts/QuestionsaboutBlood/ucm108186.htm|title=Revised Recommendations for Reducing the Risk of Human Immunodeficiency Virus Transmission by Blood and Blood Products – Questions and Answers|publisher=US Food and Drug Administration|access-date=2016-03-30|url-status=live|archive-url=https://web.archive.org/web/20160330080857/https://www.fda.gov/BiologicsBloodVaccines/BloodBloodProducts/QuestionsaboutBlood/ucm108186.htm|archive-date=2016-03-30}} In 2017, the UK and US further reduced their restrictions to three months.{{cite web|url=https://www.blood.co.uk/news-and-campaigns/news-and-statements/blood-donation-rules-have-changed/|title=The rules on blood donation in England change on 28th November|publisher=[[NHS Blood and Transplant]]|date=2017-11-28|access-date=2019-10-21|url-status=live|archive-url=https://web.archive.org/web/20191015113108/https://www.blood.co.uk/news-and-campaigns/news-and-statements/blood-donation-rules-have-changed/|archive-date=2019-10-15}} In 2023, the FDA announced new policies easing restrictions on gay and bisexual men donating blood.{{Cite web |date=2023-08-07 |title=FDA policy allowing more gay and bisexual men to donate blood goes into effect |url=https://www.nbcnews.com/nbc-out/out-news/fda-policy-allowing-gay-bisexual-men-donate-blood-goes-effect-rcna98234 |access-date=2023-08-15 |website=NBC News |language=en}} These updated guidelines stipulate that men in monogamous relationships with other men, or who have not recently had sex, can donate. Individuals who report having sex with people who are HIV positive or have had sex with a new partner who has engaged in anal sex are still barred from blood donation. [[Autologous blood donation|Autologous]] donors are not always screened for recipient safety problems since the donor is the only person who will receive the blood.{{cite journal |vauthors=Heim MU, Mempel W |title=[The need for thorough infection screening in donors of autologous blood] |language=de |journal=Beitr Infusionsther |volume=28 |pages=313–316 |year=1991 |pmid=1725645 }} Since the donated blood may be given to pregnant women or women of child-bearing age, donors taking [[teratogenic]] (birth defect-causing) medications are deferred. These medications include [[acitretin]], [[etretinate]], [[isotretinoin]], [[finasteride]], and [[dutasteride]].{{cite web|url=https://www.fda.gov/cder/consumerinfo/druginfo/avodart.htm|title=Avodart consumer information|publisher=US Food and Drug Administration|access-date=2008-06-01 |archive-url = http://webarchive.loc.gov/all/20090509052758/http%3A//www%2Efda%2Egov/cder/consumerinfo/druginfo/avodart%2Ehtm |archive-date = May 9, 2009 }} [47] => [48] => Donors are examined for signs and symptoms of diseases that can be transmitted in a blood transfusion, such as [[HIV]], [[malaria]], and [[viral hepatitis]]. Screening may include questions about risk factors for various diseases, such as travel to countries at risk for malaria or [[variant Creutzfeldt–Jakob disease]] (vCJD). These questions vary from country to country. For example, while blood centers in [[Héma-Québec|Québec]] and the rest of [[Canada]], [[Poland]], and many other places defer donors who lived in the United Kingdom for risk of vCJD,{{cite web | title=Donor Qualification criteria | publisher=Héma-Québec, Canada |url=http://www.hema-quebec.qc.ca/anglais/dondesang/qualifidonneurs.htm | access-date=2006-12-17 |archive-url = https://web.archive.org/web/20061108025138/http://www.hema-quebec.qc.ca/anglais/dondesang/qualifidonneurs.htm |archive-date = 2006-11-08}}{{cite web|title=Permanent exclusion criteria / Dyskwalifikacja stała |url=http://www.rckik-warszawa.com.pl/dlakrwio_ds.html |publisher=RCKiK Warszawa |language=pl |access-date=2010-03-03 |url-status=dead |archive-url=https://web.archive.org/web/20090830053230/http://www.rckik-warszawa.com.pl/dlakrwio_ds.html |archive-date=August 30, 2009 }} donors in the United Kingdom are only restricted for vCJD risk if they have had a blood transfusion in the United Kingdom.{{Cite web|url=http://transfusionguidelines.org.uk/Index.aspx?Publication=RB&Section=25&pageid=546|title=Guidelines for UK Blood Services|access-date=2008-06-01|publisher=UK Blood and Tissue Services|url-status=live|archive-url=https://web.archive.org/web/20080515023549/http://www.transfusionguidelines.org.uk/index.aspx?Publication=RB|archive-date=2008-05-15}} [49] => [50] => ===Donor safety=== [51] => The donor is also examined and asked specific questions about their medical history to make sure that donating blood is not hazardous to their health. The donor's [[hematocrit]] or [[hemoglobin]] level is tested to make sure that the loss of blood will not make them [[anemic]], and this check is the most common reason that a donor is ineligible.{{cite journal |author=Gómez-Simón A |title=Evaluation of four rapid methods for hemoglobin screening of whole blood donors in mobile collection settings |journal=Transfus. Apher. Sci. |volume=36 |issue=3 |pages=235–242 |date=Jun 2007 |pmid=17556020 |doi=10.1016/j.transci.2007.01.010 |author2=Navarro-Núñez L |author3=Pérez-Ceballos E |display-authors=3 |last4=Lozano |first4=M |last5=Candela |first5=M |last6=Cascales |first6=A |last7=Martinez |first7=C |last8=Corral |first8=J |last9=Vicente |first9=V}} Accepted hemoglobin levels for blood donations, by the American Red Cross, is 12.5g/dL (for females) and 13.0g/dL (for males) to 20.0g/dL, anyone with a higher or lower hemoglobin level cannot donate.{{Cite web|title=Iron Information for All Blood Donors|url=https://www.redcrossblood.org/donate-blood/blood-donation-process/before-during-after/iron-blood-donation/iron-informationforallblooddonors.html|access-date=2020-10-20|website=www.redcrossblood.org|language=en|archive-date=2020-10-16|archive-url=https://web.archive.org/web/20201016185542/https://www.redcrossblood.org/donate-blood/blood-donation-process/before-during-after/iron-blood-donation/iron-informationforallblooddonors.html|url-status=live}} [[Pulse]], [[blood pressure]], and [[body temperature]] are also evaluated. Elderly donors are sometimes also deferred on age alone because of health concerns.{{cite journal |vauthors=Goldman M, Fournier E, Cameron-Choi K, Steed T |title=Effect of changing the age criteria for blood donors |journal=Vox Sang. |volume=92 |issue=4 |pages=368–372 |date=May 2007 |pmid=17456161 |doi=10.1111/j.1423-0410.2007.00897.x |s2cid=36493554 }} In addition to age, weight and height are important factors when considering the eligibility for donors. For example, the American Red Cross requires a donor to be {{convert|110|lb|kg}} or more for whole blood and platelet donation and at least {{convert|130|lb|kg}} (males) and at least {{convert|150|lb|kg}} (females) for power red donations (double red [[erythrocytapheresis]]).{{Cite web|title=Eligibility Requirements|url=https://www.redcrossblood.org/donate-blood/how-to-donate/eligibility-requirements.html|access-date=2020-10-20|website=www.redcrossblood.org|language=en|archive-date=2020-10-16|archive-url=https://web.archive.org/web/20201016185850/https://www.redcrossblood.org/donate-blood/how-to-donate/eligibility-requirements.html|url-status=live}} The safety of donating blood during pregnancy has not been studied thoroughly, and pregnant women are usually deferred until six weeks after the pregnancy.{{cite web|url=http://www.bloodbankofalaska.org/donating/faq.html|title=Donating – Frequently Asked Questions|access-date=2008-06-01|publisher=Blood Bank of Alaska|url-status=dead|archive-url=https://web.archive.org/web/20080606001946/http://www.bloodbankofalaska.org/donating/faq.html|archive-date=2008-06-06}} [52] => [53] => === Blood testing === [54] => [[File:Blood Donor Health Screening Report.png|thumb|right|350px|A patient's health screening report given after a blood donation]] [55] => The donor's [[blood type]] must be determined if the blood will be used for transfusions. The collecting agency usually identifies whether the blood is type [[ABO blood group system|A, B, AB, or O]] and the donor's [[Rh blood group system|Rh (D) type]] and will screen for [[antibodies]] to less common antigens. More testing, including a [[crossmatch]], is usually done before a transfusion. Type O negative is often cited as the "universal donor"{{cite web|url=http://www.webmd.com/a-to-z-guides/blood-type-test|title=Blood Type Test|publisher=WebMD.com|access-date=2008-06-01|url-status=live|archive-url=https://web.archive.org/web/20080529053700/http://www.webmd.com/a-to-z-guides/blood-type-test|archive-date=2008-05-29}} but this only refers to [[red blood cells|red cell]] and whole blood transfusions. For [[blood plasma|plasma]] and platelet transfusions the system is reversed: AB positive is the universal platelet donor type while both AB positive and AB negative are universal plasma donor types.{{cite web|url=http://donatebloodnow.org/apheresis/docs/Plasma_Fact%20Sheet.pdf|title=Plasma fact sheet|publisher=American Red Cross|url-status=dead|archive-url=https://web.archive.org/web/20090326155535/http://donatebloodnow.org/apheresis/docs/Plasma_Fact%20Sheet.pdf|archive-date=2009-03-26}}{{Cite web | url=https://www.scbb.org/donateblood/donor-information/right-type-right-time.html | title=Right Type, Right Time | access-date=2018-07-22 | archive-date=2018-07-22 | archive-url=https://web.archive.org/web/20180722184739/https://www.scbb.org/donateblood/donor-information/right-type-right-time.html | url-status=live }} [56] => [57] => Most blood is tested for diseases, including some [[sexually transmitted disease|STDs]].{{cite journal |author=Bhattacharya P |title=Significant increase in HBV, HCV, HIV, and syphilis infections among blood donors in West Bengal, Eastern India 2004–2005: exploratory screening reveals high frequency of occult HBV infection |journal=World J. Gastroenterol. |volume=13 |issue=27 |pages=3730–3733 |date=Jul 2007 |pmid=17659734 |pmc=4250646 |doi=10.3748/wjg.v13.i27.3730 |author2=Chandra PK |author3=Datta S |display-authors=3 |last4=Banerjee |first4=A |last5=Chakraborty |first5=S |last6=Rajendran |first6=K |last7=Basu |first7=SK |last8=Bhattacharya |first8=SK |last9=Chakravarty |first9=R |doi-access=free }} The tests used are [[sensitivity (tests)|high-sensitivity screening tests]] and no actual diagnosis is made. Some of the test results are later found to be false positives using more [[specificity (tests)|specific testing]].{{cite web|url=http://www.aabb.org/Content/About_Blood/Facts_About_Blood_and_Blood_Banking/fabloodtesting.htm|title=Testing of Donor Blood for infectious disease|publisher=[[AABB]]|access-date=2008-06-25|url-status=dead|archive-url=https://web.archive.org/web/20080509055313/http://www.aabb.org/Content/About_Blood/Facts_About_Blood_and_Blood_Banking/fabloodtesting.htm|archive-date=2008-05-09}} [[Sensitivity (tests)|False negatives]] are rare, but donors are discouraged from using blood donation for the purpose of anonymous STD [[screening (medicine)|screening]] because a false negative could mean a contaminated unit. The blood is usually discarded if these tests are positive, but there are some exceptions, such as [[autologous blood donation|autologous donations]]. The donor is generally notified of the test result.{{cite journal |author1=R. Miller |author2=P.E. Hewitt |author3=R. Warwick |author4=M.C. Moore |author5=B. Vincent |title=Review of counselling in a transfusion service: the London (UK) experience |journal=Vox Sang |volume=74 |issue=3 |pages=133–139 |year=1998 |pmid=9595639 |doi=10.1046/j.1423-0410.1998.7430133.x|s2cid=24514380 |doi-access= }} [58] => [59] => Donated blood is tested by many methods, but the core tests recommended by the World Health Organization are these four:{{Cite web |title=Blood safety and availability |url=https://www.who.int/news-room/fact-sheets/detail/blood-safety-and-availability |access-date=2022-10-28 |website=www.who.int |language=en |archive-date=2020-04-24 |archive-url=https://web.archive.org/web/20200424022540/https://www.who.int/news-room/fact-sheets/detail/blood-safety-and-availability |url-status=live }} [60] => * [[Hepatitis B]] surface antigen [61] => * Antibody to [[hepatitis C]] [62] => * Antibody to [[HIV]], usually [[Subtypes of HIV|subtypes 1 and 2]] [63] => * Serologic test for [[syphilis]] [64] => [65] => The WHO reported in 2006 that 56 out of 124 countries surveyed did not use these basic tests on all blood donations. [66] => [67] => A variety of other tests for [[transfusion transmitted infection]]s are often used based on local requirements. Additional testing is expensive, and in some cases the tests are not implemented because of the cost.{{cite web|url=http://www.advisorybodies.doh.gov.uk/acmsbtt/msbtsum280605.pdf|title=Advisory Committee on MSBTO, 28 June 2005|access-date=2008-06-01|url-status=dead|archive-url=https://web.archive.org/web/20080528073208/http://www.advisorybodies.doh.gov.uk/acmsbtt/msbtsum280605.pdf|archive-date=28 May 2008}} These additional tests include other infectious diseases such as [[West Nile fever]]{{cite web | title=Precautionary West Nile virus blood sample testing| publisher=Héma-Québec, Canada | url=http://www.hema-quebec.qc.ca/anglais/centredepresse/coms2005/20050808.htm | access-date=2006-12-17 |archive-url = https://web.archive.org/web/20070913200134/http://www.hema-quebec.qc.ca/anglais/centredepresse/coms2005/20050808.htm |archive-date = 2007-09-13}} and [[babesiosis]].{{Cite press release|title=FDA approves first tests to screen for tickborne parasite in whole blood and plasma to protect the U.S. blood supply|date=6 March 2018|publisher=FDA|url=https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm599782.htm|quote=While babesiosis is both preventable and treatable, until today, there was no way to screen for infections amongst blood donors|access-date=6 March 2018|url-status=live|archive-url=https://web.archive.org/web/20180307040445/https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm599782.htm|archive-date=7 March 2018}} Sometimes multiple tests are used for a single disease to cover the limitations of each test. For example, the [[Diagnosis of HIV/AIDS#Antibody tests|HIV antibody test]] will not detect a recently infected donor, so some blood banks use a [[p24 antigen]] or [[Nucleic acid test|HIV nucleic acid]] test in addition to the basic antibody test to detect infected donors. [[Cytomegalovirus]] is a special case in donor testing in that many donors will test positive for it.{{cite web|url=http://www.aabb.org/Documents/About_Blood/Circulars_of_Information/coi0702.pdf |title=Circular of Information for use of Blood and Blood Products |publisher=[[AABB]], [[American Red Cross|ARC]], [[America's Blood Centers]] |url-status=dead |archive-url=https://web.archive.org/web/20091007071259/http://www.aabb.org/Documents/About_Blood/Circulars_of_Information/coi0702.pdf |archive-date=2009-10-07 }} The virus is not a hazard to a healthy recipient, but it can harm infants{{cite web |url=http://www.cps.ca/english/statements/fn/fn02-02.htm#What%20type%20of%20RBCs%20should%20be%20used |title=Red blood cell transfusions in newborn infants: Revised guidelines |publisher=Canadian Paediatric Society (CPS) |access-date=2007-02-02 |url-status=dead |archive-url=https://web.archive.org/web/20070203095445/http://www.cps.ca/english/statements/FN/fn02-02.htm#What%20type%20of%20RBCs%20should%20be%20used |archive-date=2007-02-03 }} and other recipients with weak immune systems. [68] => [69] => ==Obtaining the blood== [70] => [[File:Blood donation at Fleet Week USA.jpg|thumb|A [[United States Navy|US Navy]] sailor donating blood]] [71] => [[File:Blood donation needle.jpg|thumb|300px|A donor's arm at various stages of donation. The two photographs on the left show a blood pressure cuff being used as a tourniquet.]] [72] => There are two main methods of obtaining blood from a donor. The most frequent is to simply take the blood from a vein as [[whole blood]]. This blood is typically separated into parts, usually [[red blood cell]]s and [[blood plasma|plasma]], since most recipients need only a specific component for transfusions.{{cn|date=July 2023}} [73] => [74] => The amount of blood donated in one session – generally called a 'unit' – is defined by the WHO as 450 millilitres.{{cite web | url = https://www.who.int/news-room/questions-and-answers/item/blood-products-why-should-i-donate-blood | title = Why Should I Donate Blood | date = 2022-06-06 | website = WHO | access-date = 2023-02-18 | archive-date = 2023-02-18 | archive-url = https://web.archive.org/web/20230218101325/https://www.who.int/news-room/questions-and-answers/item/blood-products-why-should-i-donate-blood | url-status = live }} Some countries like Canada follow this standard,{{cite news | url = https://www.reference.com/science-technology/much-one-unit-blood-c72a3d11219cd49c | title = How Much Is One Unit of Blood? | date = 2020-04-11 | website = reference.com | publisher = Ask Media Group LLC | access-date = 2023-02-18 }} but others have set their own rules, and sometimes there is variation even among different agencies within a country. For example, whole blood donations in the United States are in the 460–500 ml range,{{cite web|url=http://www.mayoclinic.com/health/blood-donation/GA00039|title=Blood donation: What to expect|publisher=Mayo Clinic|access-date=2008-12-03|url-status=live|archive-url=https://web.archive.org/web/20081204105051/http://www.mayoclinic.com/health/blood-donation/GA00039|archive-date=2008-12-04}}{{cite web | url = https://www.oneblood.org/media/blog/how-much-blood-is-taken-when-you-donate.stml | title = How Much Blood Is Taken When You Donate? | last = Eberts | first = Dan | date = 2021-08-17 | website = OneBlood | access-date = 2023-02-18 | archive-date = 2023-02-18 | archive-url = https://web.archive.org/web/20230218101325/https://www.oneblood.org/media/blog/how-much-blood-is-taken-when-you-donate.stml | url-status = live }} while those in the EU must be in the 400-500 ml range.{{cite report | date = 2004-03-22 | title = Commission Directive 2004/33/EC | url = https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32004L0033&from=EN | publisher = Official Journal of the European Union | page = 14 | access-date = 2023-02-18 }} Other countries have smaller units – India uses 350 ml,{{cite web | url = http://nbtc.naco.gov.in/page/donationprocess/ | title = Donation Process | website = National AIDS Control Organisation | publisher = National Blood Transfusion Council | access-date = 2023-02-18 | archive-date = 2023-02-18 | archive-url = https://web.archive.org/web/20230218162930/http://nbtc.naco.gov.in/page/donationprocess/ | url-status = live }} Singapore 350 or 450 ml,{{cite web | url = https://www.hsa.gov.sg/blood-donation/blood-facts-and-figures | title = Blood facts and figures | website = Government of Singapore | date = 31 October 2018 | publisher = Health Sciences Authority | access-date = 2023-02-18 | archive-date = 2023-02-18 | archive-url = https://web.archive.org/web/20230218101331/https://www.hsa.gov.sg/blood-donation/blood-facts-and-figures | url-status = live }} and Japan 200 or 400 ml.{{cite report | date = 2017 | title = 献血者血液検査結果の集計 / Hematologic and Biochemical Values in Blood Donors | url = https://www.jrc.or.jp/donation/pdf/summary2017.pdf | publisher = Japanese Red Cross Society | page = 5 | access-date = 2023-02-18 }} Historically, donors in the [[People's Republic of China]] would donate only 200 ml, though larger 300 and 400 ml donations have become more common, particularly in northern China and for heavier donors.{{cite journal|title=Who donates blood at five ethnically and geographically diverse blood centers in China in 2008|author=Jingxing Wang|journal=Transfusion|volume=50|date=December 2010|doi=10.1111/j.1537-2995.2010.02722.x|author2=Nan Guo (corresponding)|display-authors=2|last3=Guo|first3=Xiaoming|last4=Li|first4=Julin|last5=Wen|first5=Guo-Xing|last6=Yang|first6=Tonghan|last7=Yun|first7=Zhongqiao|last8=Huang|first8=Yi|last9=Schreiber|first9=George B.|issue=12|pages=2686–2694|pmid=20553435|s2cid=205723043}} In any case, an additional 5-10 ml of blood may be collected separately for testing. [75] => [76] => The other method is to draw blood from the donor, separate it using a [[centrifuge]] or a filter, store the desired part, and return the rest to the donor. This process is called [[apheresis]], and it is often done with a machine specifically designed for this purpose. This process is especially common for [[plasmapheresis|plasma]], [[plateletpheresis|platelets]], and [[erythrocytapheresis|red blood cells]].{{cite journal| author=Waxman DA| title=Volunteer donor apheresis. | journal=Ther Apher | year= 2002 | volume= 6 | issue= 1 | pages= 77–81 | pmid=11886580 | doi=10.1046/j.1526-0968.2002.00395.x | pmc= | url=https://pubmed.ncbi.nlm.nih.gov/11886580 }} [77] => [78] => For direct transfusions a vein can be used but the blood may be taken from an [[artery]] instead.{{cite journal |vauthors=Sagi E, Eyal F, Armon Y, Arad I, Robinson M |title=Exchange transfusion in newborns via a peripheral artery and vein |journal=Eur. J. Pediatr. |volume=137 |issue=3 |pages=283–284 |date=Nov 1981 |pmid=7318840 |doi= 10.1007/BF00443258|s2cid=23219586 }} In this case, the blood is not stored, but is pumped directly from the donor into the recipient. This was an early method for blood transfusion and is rarely used in modern practice.{{cite web [79] => |url = https://www.pbs.org/wnet/redgold/basics/bloodonhoof.html [80] => |title = Blood on the Hoof [81] => |publisher = Public Broadcasting Service [82] => |access-date = 2008-06-25 [83] => |url-status = live [84] => |archive-url = https://web.archive.org/web/20080604035952/http://www.pbs.org/wnet/redgold/basics/bloodonhoof.html [85] => |archive-date = 2008-06-04 [86] => }} It was phased out during [[World War II]] because of problems with [[logistics]], and doctors returning from treating wounded soldiers set up banks for stored blood when they returned to civilian life.{{cite web|url=http://www.isbt-web.org/files/tt/TT63.pdf|title=ISBT Quarterly Newsletter, June 2006, "A History of Fresh Blood", p. 15|access-date=2008-07-31|publisher=[[International Society of Blood Transfusion]] (ISBT/SITS)|url-status=dead|archive-url=https://web.archive.org/web/20080803020034/http://www.isbt-web.org/files/tt/TT63.pdf|archive-date=2008-08-03}} [87] => [88] => ===Site preparation and drawing blood=== [89] => [[File:Blood draw 16 second.webm|thumb|right|Insertion of a butterfly needle into a vein to begin the blood draw process]] [90] => The blood is drawn from a large arm [[superficial vein|vein close to the skin]], usually the [[median cubital vein]] on the inside of the elbow. The skin over the blood vessel is cleaned with an [[antiseptic]] such as [[iodine]] or [[chlorhexidine]]{{cite journal |vauthors=Lee CK, Ho PL, Chan NK, Mak A, Hong J, Lin CK |title=Impact of donor arm skin disinfection on the bacterial contamination rate of platelet concentrates |journal=Vox Sang. |volume=83 |issue=3 |pages=204–208 |date=Oct 2002 |pmid=12366760 |doi=10.1046/j.1423-0410.2002.00219.x |s2cid=19946631 }} to prevent skin bacteria from contaminating the collected blood and also to prevent infections where the needle pierced the donor's skin.{{cite book |author=M. L. Turgeon|title=Clinical Hematology: Theory and Procedures |url= https://books.google.com/books?id=v2iyQBKx00kC&q=phlebotomy+complications&pg=PA30 |access-date=2008-06-21 |edition= fourth |year= 2004 |publisher= Lippincott Williams & Wilkins |isbn= 978-0-7817-5007-3 |page= 30}} [91] => [92] => A largeOne major manufacturer of collection sets uses a 16 [[Hypodermic needle#Gauge|gauge]] (1.651 mm) size {{cite web|url=http://www.genesisbps.com/PDF/blood_bags_terumo.pdf|title=Blood banking laboratory supplies|publisher=Genesis BPS|access-date=2008-06-01|url-status=dead|archive-url=https://web.archive.org/web/20080625001730/http://www.genesisbps.com/PDF/blood_bags_terumo.pdf|archive-date=2008-06-25}} [[hypodermic needle|needle]] (16 to 17 [[Hypodermic needle#Gauge|gauge]]) is used to minimize [[shearing (physics)|shearing]] forces that may physically [[hemolysis|damage]] red blood cells as they flow through the needle.{{cite web|url= http://www.bd.com/vacutainer/pdfs/techtalk/TechTalk_Jan2004_VS7167.pdf|title= What is Hemolysis?|access-date= 2008-06-01|publisher= [[Becton-Dickinson]]|url-status= live|archive-url= https://web.archive.org/web/20080625001730/http://www.bd.com/vacutainer/pdfs/techtalk/TechTalk_Jan2004_VS7167.pdf|archive-date= 2008-06-25}} A [[tourniquet]] is sometimes wrapped around the upper arm to increase the [[Blood pressure#Venous pressure|pressure of the blood in the arm veins]] and speed up the process. The donor may also be prompted to hold an object and squeeze it repeatedly to [[skeletal-muscle pump|increase the blood flow]] through the vein.{{citation needed|date=November 2021}} [93] => [94] => [[File:Blood Donation 12-07-06 2.JPG|thumb|left|A mechanical tray agitates the bag to mix the blood with anticoagulants and prevent clotting.]] [95] => [96] => ===Whole blood=== [97] => {{Further|Whole blood}} [98] => The most common method is collecting the blood from the donor's vein into a container. The amount of blood drawn varies from 200 millilitres to 550 millilitres depending on the country, but 450 millilitres is typical. The blood is usually stored in a flexible plastic bag that also contains [[sodium citrate]], [[phosphate]], [[dextrose]], and [[adenine]]. This combination keeps the blood from clotting and preserves it during storage up to 42 days.{{cite journal |vauthors=Akerblom O, Kreuger A |title=Studies on citrate-phosphate-dextrose (CPD) blood supplemented with adenine |journal=Vox Sang. |volume=29 |issue=2 |pages=90–100 |year=1975 |pmid=238338 |doi= 10.1111/j.1423-0410.1975.tb00484.x|s2cid=9785373}}{{cite journal |last1=Sugita |first1=Yoshiki |last2=Simon |first2=Ernest R. |date=1965 |title=The Mechanism of Action of Adenine in Red Cell Preservation* |journal=Journal of Clinical Investigation |volume=44 |issue=4 |pages=629–642 |issn=0021-9738 |pmid=14278179 |pmc=292538 |doi=10.1172/JCI105176}}{{cite journal |last1=Simon |first1=Ernest R. |last2=Chapman |first2=Robert G. |last3=Finch |first3=Clement A. |date=1962 |title=Adenine in red cell preservation |journal=Journal of Clinical Investigation |volume=41 |issue=2 |pages=351–359 |issn=0021-9738 |pmid=14039291 |pmc=289233 |doi=10.1172/JCI104489}} Other chemicals are sometimes added during [[whole blood#Processing|processing]]. [99] => [100] => The plasma from whole blood can be used to make [[blood plasma#Fresh frozen plasma and other transfused plasmas|plasma for transfusions]] or it can also be processed into other medications using a process called [[blood fractionation|fractionation]]. This was a development of the [[blood plasma#Dried plasma|dried plasma]] used to treat the wounded during World War II and variants on the process are still used to make a variety of other medications.{{cite web|url=http://history.amedd.army.mil/booksdocs/wwii/blood/chapter7.htm|title=Plasma Equipment and Packaging, and Transfusion Equipment|publisher=Office of Medical History ([[OTSG]])|access-date=2008-06-19|url-status=live|archive-url=https://web.archive.org/web/20170609105142/http://history.amedd.army.mil/booksdocs/wwii/blood/chapter7.htm|archive-date=2017-06-09}}{{cite web|url=http://www.sanquin.nl/Sanquin-eng/sqn_From_blood_to_medicine.nsf/All/Plasma-Fractionation---Medicines-Derived-From-Plasma.html|title=Medicines derived from human plasma|publisher=Sanquin Blood Supply Foundation|access-date=2008-06-01|url-status=dead|archive-url=https://web.archive.org/web/20090101223605/http://www.sanquin.nl/Sanquin-eng/sqn_From_blood_to_medicine.nsf/All/Plasma-Fractionation---Medicines-Derived-From-Plasma.html|archive-date=2009-01-01}} [101] => [102] => ===Apheresis=== [103] => {{Main|Apheresis|Erythrocytapheresis|Plasmapheresis|Plateletpheresis}} [104] => [[File:Platelets collected by using apheresis.jpg|thumb|right|Platelets collected by using [[apheresis]] at an [[American Red Cross]] donation center]] [105] => Apheresis is a blood donation method where the blood is passed through an apparatus that separates out one particular constituent and returns the remainder to the donor. Usually the component returned is the red blood cells, the portion of the blood that takes the longest to replace. Using this method an individual can donate [[plasmapheresis|plasma]] or [[Plateletpheresis|platelets]] much more frequently than they can safely donate whole blood.[http://www.blood.co.uk/pages/b8apher.html Component Donation] {{webarchive|url=https://web.archive.org/web/20091011201240/http://www.blood.co.uk/pages/b8apher.html |date=2009-10-11 }} UK National Blood Service. Retrieved 2009-10-26 These can be combined, with a donor giving both plasma and platelets in the same donation.{{citation needed|date=December 2021}} [106] => [107] => [[Platelets]] can also be separated from whole blood, but they must be pooled from multiple donations. From three to ten units of whole blood are required for a [[therapeutic dose]].{{cite web|url=http://www.scbcinfo.org/publications/bulletin_v2_n2.htm|title=Indications for Platelet Transfusion Therapy|publisher=Southeastern Community Blood Center|access-date=2008-06-10|url-status=live|archive-url=https://web.archive.org/web/20080512120421/http://www.scbcinfo.org/publications/bulletin_v2_n2.htm|archive-date=2008-05-12}} Plateletpheresis provides at least one full dose from each donation.{{citation needed|date=November 2021}} [108] => [109] => During a platelet donation, the blood is drawn from the patient and the platelets are separated from the other blood components. The remainder of the blood, red blood cells, plasma, and white blood cells are returned to the patient. This process is completed several times for a period of up to two hours to collect a single donation.{{cite web |url=https://www.redcrossblood.org/donate-blood/how-to-donate/types-of-blood-donations/platelet-donation.html |title=Platelet Donation |publisher=The American National Red Cross |url-status=live |archive-url=https://web.archive.org/web/20190329193614/https://www.redcrossblood.org/donate-blood/how-to-donate/types-of-blood-donations/platelet-donation.html |archive-date=2019-03-29 |access-date=2019-05-16 }} [110] => [111] => [[Plasmapheresis]] is frequently used to collect [[source plasma]] that is used for manufacturing into medications much like the plasma from whole blood. Plasma collected at the same time as plateletpheresis is sometimes called ''concurrent plasma''. [112] => [113] => Apheresis is also used to collect more red blood cells than usual in a single donation (commonly known as "[[Erythrocytapheresis|double reds]]") and to [[leukapheresis|collect white blood cells]] for transfusion.{{cite web|url = http://www.unitedbloodservices.org/automation.html|title = Double Up to Save Lives|publisher = [[United Blood Services]]|access-date=2007-02-23 |archive-url = https://web.archive.org/web/20061230200404/http://www.unitedbloodservices.org/automation.html |archive-date = 2006-12-30}}{{cite web| url = http://www.my-redcross.org/index.cfm/p/Double-Red-Cell| title = Double the Difference| publisher = [[American Red Cross]] (Greater Chesapeake and Potomac)| access-date=2007-02-23 |archive-url = https://web.archive.org/web/20070513184529/http://www.my-redcross.org/index.cfm/p/Double-Red-Cell |archive-date = 2007-05-13}} [114] => [[File:Blood Donation 12-07-06 1.JPG|thumb|A relatively large needle is used for blood donations.]] [115] => [116] => ==Recovery and time between donations== [117] => [118] => Donors are usually kept at the donation site for 10–15 minutes after donating since most adverse reactions take place during or immediately after the donation.{{cite journal |vauthors=Eder AF, Hillyer CD, Dy BA, Notari EP, Benjamin RJ |title=Adverse reactions to allogeneic whole blood donation by 16- and 17-year-olds |journal=JAMA |volume=299 |issue=19 |pages=2279–2286 |date=May 2008 |pmid=18492969 |doi=10.1001/jama.299.19.2279 |doi-access= }} Blood centers typically provide light refreshments, such as orange juice and cookies, or a lunch allowance to help the donor recover.{{cite web|url=http://siba2.unile.it/ese/issues/288/660/RelazDonazSanguigne_p6.pdf|archive-url=https://web.archive.org/web/20080803020034/http://siba2.unile.it/ese/issues/288/660/RelazDonazSanguigne_p6.pdf|url-status=dead|archive-date=2008-08-03|title=Report on the promotion by Member States of voluntary unpaid blood donation|publisher=Commission of the European Communities|access-date=2008-06-26}} The needle site is covered with a [[bandage#Compression bandage|bandage]] and the donor is directed to keep the bandage on for several hours. In hot climates, donors are advised to avoid [[dehydration]] (strenuous exercise and games, alcohol) until a few hours after donation.{{citation needed|date=November 2021}} [119] => [120] => Donated plasma is replaced after 2–3 days.{{cite web|url=http://www.cbccts.org/donating/automated.htm|title=Donating Apheresis and Plasma|publisher=Community Blood Center|access-date=2008-06-11|url-status=live|archive-url=https://web.archive.org/web/20080704182910/http://www.cbccts.org/donating/automated.htm|archive-date=2008-07-04}} Red blood cells are replaced by bone marrow into the circulatory system at a slower rate, on average 36 days in healthy adult males. In one study, the range was 20 to 59 days for recovery.{{cite journal |vauthors=Pottgiesser T, Specker W, Umhau M, Dickhuth HH, Roecker K, Schumacher YO |title=Recovery of hemoglobin mass after blood donation |journal=Transfusion |volume=48 |issue=7 |pages=1390–1397 |date=2008 |pmid=18466177 |doi=10.1111/j.1537-2995.2008.01719.x |s2cid=21814989 }} These replacement rates are the basis of how frequently a donor can donate blood.{{citation needed|date=November 2021}} [121] => [122] => [[Plasmapheresis]] and [[plateletpheresis]] donors can donate much more frequently because they do not lose significant amounts of red cells. The exact rate of how often a donor can donate differs from country to country. For example, plasmapheresis donors in the United States are allowed to donate large volumes twice a week and could nominally donate 83 litres (about 22 gallons) in a year, whereas the same donor in Japan may only donate every other week and could only donate about 16 litres (about 4 gallons) in a year.{{cite web|url=https://www.fda.gov/ohrms/dockets/ac/03/transcripts/4014T2.htm|title=Blood Products Advisory Committee, 12 December 2003|website=[[Food and Drug Administration]]|access-date=2008-06-01|url-status=live|archive-url=https://web.archive.org/web/20081108142506/https://www.fda.gov/ohrms/dockets/ac/03/transcripts/4014T2.htm|archive-date=8 November 2008}} [123] => [124] => [[Iron supplement]]ation decreases the rates of donor deferral due to low hemoglobin, both at the first donation visit and at subsequent donations. Iron-supplemented donors have higher hemoglobin and iron stores. On the other hand, iron supplementation frequently causes [[diarrhea]], [[constipation]] and [[epigastric]] abdominal discomfort. The long-term effects of iron supplementation without measurement of iron stores are unknown.{{cite journal |vauthors=Smith GA, Fisher SA, Doree C, Di Angelantonio E, Roberts DJ |title=Oral or parenteral iron supplementation to reduce deferral, iron deficiency and/or anaemia in blood donors |journal=Cochrane Database Syst Rev |volume=7 |issue= 7|page=CD009532 |year=2014 |pmid=24990381 |doi=10.1002/14651858.CD009532.pub2|s2cid=205200473 |pmc=11019466 }} [125] => [126] => ==Complications== [127] => Donors are screened for health problems that would put them at risk for serious complications from donating. First-time donors, teenagers, and women are at a higher risk of a reaction.{{cite journal |author1=A.F. Eder |author2=C.D. Hillyer |author3=B.A. Dy |author4=E.P. Notari |author5=R.J. Benjamin |title=Adverse reactions to allogeneic whole blood donation by 16- and 17-year-olds |journal=JAMA |volume=299 |issue=19 |pages=2279–2286 |date=May 2008 |pmid=18492969 |doi=10.1001/jama.299.19.2279 |doi-access= }}{{cite journal |vauthors=Yuan S, Gornbein J, Smeltzer B, Ziman AF, Lu Q, Goldfinger D |title=Risk factors for acute, moderate to severe donor reactions associated with multicomponent apheresis collections |journal=Transfusion |volume=48 |issue=6 |pages=1213–1219 |date=Jun 2008 |pmid=18346014 |doi=10.1111/j.1537-2995.2008.01674.x |s2cid=403463 }} [128] => One study showed that 2% of donors had an adverse reaction to donation.{{cite web|url=http://www.redcross.or.th/extra/blood_seminar_50/files/211_1525-1536.pdf|archive-url=https://web.archive.org/web/20080625001733/http://www.redcross.or.th/extra/blood_seminar_50/files/211_1525-1536.pdf|url-status=dead|archive-date=2008-06-25|title=Adverse Effect of Blood Donation, Siriraj Experience|publisher=American Red Cross|access-date=2008-06-01}} Most of these reactions are minor. A study of 194,000 donations found only one donor with long-term complications.{{cite journal |author1=B. Newman |author2=S. Graves | title = A study of 178 consecutive vasovagal syncopal reactions from the perspective of safety | journal = Transfusion | volume = 41 | issue = 12 | pages = 1475–1479 | year = 2001 | pmid = 11778059 | doi = 10.1046/j.1537-2995.2001.41121475.x|s2cid=23789257 }} In the United States, a blood bank is required to report any death that might possibly be linked to a blood donation. An analysis of all reports from October 2008 to September 2009 evaluated six events and found that five of the deaths were clearly unrelated to donation, and in the remaining case they found no evidence that the donation was the cause of death.{{cite web|url=https://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/ReportaProblem/TransfusionDonationFatalities/ucm204763.htm#post|title=Fatalities Reported to FDA|publisher=US Food and Drug Administration|access-date=2010-12-20|url-status=live|archive-url=https://web.archive.org/web/20110102002237/https://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/ReportaProblem/TransfusionDonationFatalities/ucm204763.htm#post|archive-date=2011-01-02}} [129] => [130] => [[File:Blood donation bruising.jpg|thumb|right|Bruising three days after donation]] [131] => [[Hypovolemia|Hypovolemic]] reactions can occur because of a rapid change in [[blood pressure]]. [[Fainting]] is generally the worst problem encountered.{{cite journal |vauthors=Wiltbank TB, Giordano GF, Kamel H, Tomasulo P, Custer B |title=Faint and prefaint reactions in whole-blood donors: an analysis of predonation measurements and their predictive value |journal=Transfusion |volume= 48|issue= 9|pages= 1799–1808|date=May 2008 |pmid=18482188 |doi=10.1111/j.1537-2995.2008.01745.x |s2cid=157599 }} [132] => [133] => The process has similar risks to other forms of [[phlebotomy]]. [[Hematoma|Bruising]] of the arm from the needle insertion is the most common concern. One study found that less than 1% of donors had this problem.{{cite journal |author=Ranasinghe E, Harrison JF |title=Bruising following blood donation, its management and the response and subsequent return rates of affected donors |journal=Transfus Med |volume=10 |issue=2 |pages=113–116 |date=Jun 2000 |pmid=10849380 |doi=10.1046/j.1365-3148.2000.00240.x |s2cid=46557010 }} A number of less common complications of blood donation are known to occur. These include arterial puncture, delayed bleeding, nerve irritation, nerve injury, tendon injury, thrombophlebitis, and allergic reactions.{{cite journal |author=Working Group on Complications Related to Blood Donation JF |title=Standard for Surveillance of Complications Related to Blood D Donation |journal=European Haemovigilance Network |page=11 |year=2008 |url=http://www.isbt-web.org/members_only/files/society/StandardSurveillanceDOCO.pdf |url-status=dead |archive-url=https://web.archive.org/web/20100215092521/http://www.isbt-web.org/members_only/files/society/StandardSurveillanceDOCO.pdf |archive-date=2010-02-15 }} [134] => [135] => [136] => Donors sometimes have adverse reactions to the [[sodium citrate]] used in [[apheresis]] collection procedures to keep the blood from clotting. Since the anticoagulant is returned to the donor along with blood components that are not being collected, it can bind the [[calcium]] in the donor's blood and cause [[hypocalcemia]].{{cite journal |vauthors=Bolan CD, Greer SE, Cecco SA, Oblitas JM, Rehak NN, Leitman SF |title=Comprehensive analysis of citrate effects during plateletpheresis in normal donors |journal=Transfusion |volume=41 |issue=9 |pages=1165–1171 |date=Sep 2001 |pmid=11552076 |doi=10.1046/j.1537-2995.2001.41091165.x |s2cid=22220301 |url=https://zenodo.org/record/1236510 |access-date=2019-07-05 |archive-date=2020-07-27 |archive-url=https://web.archive.org/web/20200727011534/https://zenodo.org/record/1236510 |url-status=live }} These reactions tend to cause tingling in the lips, but may cause convulsions, seizure, hypertension, or more serious problems.{{cite journal |author1=Sorensen, BS |author2=Johnsen, SP |author3=Jorgensen, J. |title= Complications related to blood donation: A population-based study |journal= Vox Sanguinis |date= Feb 2008 |volume= 94 |issue= 2 |pages= 132–137|doi= 10.1111/j.1423-0410.2007.01000.x |pmid= 18028259|s2cid=35763171 }} Donors are sometimes given calcium supplements during the donation to prevent these side effects.{{cite web|url=http://www.redcross.org/services/biomed/0,1082,0_543_,00.html|title=Jerome H. Holland Laboratory for the Biomedical Sciences Volunteer Research Blood Program (RBP)|publisher=American Red Cross|access-date=2008-06-01|url-status=dead|archive-url=https://web.archive.org/web/20080315230152/http://www.redcross.org/services/biomed/0,1082,0_543_,00.html|archive-date=2008-03-15}} [137] => [138] => In apheresis procedures, the [[red blood cell]]s are returned. If this is done manually and the donor receives the blood from a different donor, a [[transfusion reaction]] can take place. Manual apheresis is extremely rare in the developed world because of this risk and automated procedures are as safe as whole blood donations.{{cite journal |author=Wiltbank TB, Giordano GF |title=The safety profile of automated collections: an analysis of more than 1 million collections |journal=Transfusion |volume=47 |issue=6 |pages=1002–1005 |date=Jun 2007 |pmid=17524089 |doi=10.1111/j.1537-2995.2007.01224.x |last2=Giordano |first2=Gerald F. |s2cid=19739978}} [139] => [140] => The final risk to blood donors is from equipment that has not been properly [[sterilization (microbiology)|sterilized]].''Global AIDS Crisis: A Reference Handbook'', Richard G. Marlink, Alison G. Kotin, p. 16 [https://books.google.com/books?id=aGfvQxiWLxAC], ABC-CLIO In most cases, the equipment that comes in direct contact with blood is discarded after use.{{cite web|url=http://www.ibts.ie/generic.cfm?mID=2&sID=9|title=Blood Donor Information Leaflet|publisher=Irish Blood Transfusion Service|access-date=2008-06-01|url-status=dead|archive-url=https://web.archive.org/web/20071119034136/http://www.ibts.ie/generic.cfm?mID=2&sID=9|archive-date=2007-11-19}} Re-used equipment was a significant problem in [[China]] in the 1990s, and up to 250,000 blood plasma donors may have been exposed to HIV from shared equipment.{{cite web|url=http://www.usembassy-china.org.cn/sandt/webaids5.htm|title=Keeping China's blood supply free of HIV|publisher=US Embassy, Beijing|access-date=2008-06-01|url-status=dead|archive-url=https://web.archive.org/web/20080907143947/http://www.usembassy-china.org.cn/sandt/webaids5.htm|archive-date=2008-09-07}}{{cite journal |author=Cohen J |title=HIV/AIDS in China. An unsafe practice turned blood donors into victims |journal=Science |volume=304 |issue=5676 |pages=1438–1439 |date=Jun 2004 |pmid=15178781 |doi=10.1126/science.304.5676.1438 |s2cid=45756186 }}{{cite web | url = https://www.theguardian.com/world/2019/sep/26/contaminated-blood-whistleblower-dies-in-us | title = Contaminated blood whistleblower dies in US | first = Mattha | last = Busby | date = 26 September 2019 | access-date = 26 September 2019 | work = [[The Guardian]] | archive-date = 26 September 2019 | archive-url = https://web.archive.org/web/20190926145307/https://www.theguardian.com/world/2019/sep/26/contaminated-blood-whistleblower-dies-in-us | url-status = live }} [141] => [142] => ==Storage, supply and demand== [143] => [[File:Blood Research- Saving Lives (8384) (9759061442).jpg|thumb|Whole blood is often separated, using a centrifuge, into components for storage and transportation.]] [144] => [145] => ===Storage and blood shelf life=== [146] => {{main|Blood bank}} [147] => [148] => The collected blood is usually stored in a blood bank as separate components, and some of these have short shelf lives. There are no storage methods to keep platelets for extended periods of time, though some were being studied as of 2008.{{cite journal|title=In Vitro Evaluation of Buffy Coat Derived Platelet Concentrates in SSP+ Platelet Storage Medium|last1=Beard|first1=M.|last2=Garwood|first2=M.|last3=Cookson|first3=P.|last4=Bashir|first4=S.|last5=Hancock|first5=V.|last6=Pergande|first6=C.|last7=Smith|first7=K.|last8=Turner|first8=C.|last9=Wiltshire|first9=M.|last10=Thomas|first10=S.|last11=Cardigan|first11=R.|journal=Transfusion Medicine |year=2006|volume=16|page=26|doi=10.1111/j.1365-3148.2006.00694_4.x|s2cid=72452243}} The longest shelf life used for platelets is seven days.{{cite web|url=http://transfusionguidelines.org.uk/index.asp?Publication=HTM&Section=9&pageid=1106|title=Transfusion Handbook, summary information for Platelets|publisher=National Blood Transfusion Committee|access-date=2008-06-02|url-status=live|archive-url=https://web.archive.org/web/20080804171854/http://www.transfusionguidelines.org.uk/index.asp?Publication=HTM&Section=9&pageid=1106|archive-date=2008-08-04}} [149] => [150] => Red blood cells (RBC), the most frequently used component, have a shelf life of 35–42 days at refrigerated temperatures.{{cite journal |vauthors=Lockwood WB, Hudgens RW, Szymanski IO, Teno RA, Gray AD |title=Effects of rejuvenation and frozen storage on 42-day-old AS-3 RBCs |journal=Transfusion |volume=43 |issue=11 |pages=1527–1532 |date=Nov 2003 |pmid=14617310 |doi=10.1046/j.1537-2995.2003.00551.x |s2cid=22694513 |doi-access=free }}{{cite web|url=http://transfusionguidelines.org.uk/Index.aspx?Publication=HTM&Section=9&pageid=1105|title=Transfusion handbook, Summary information for Red Blood Cells|access-date=2008-06-02|publisher=National Blood Transfusion Committee|url-status=live|archive-url=https://web.archive.org/web/20080804173034/http://www.transfusionguidelines.org.uk/Index.aspx?Publication=HTM&Section=9&pageid=1105|archive-date=2008-08-04}} For (relatively rare) long-term storage applications, this can be extended by freezing the blood with a mixture of [[glycerol]], but this process is expensive and requires an extremely cold freezer for storage. Plasma can be stored frozen for an extended period of time and is typically given an expiration date of one year and maintaining a supply is less of a problem.{{cite web|url=http://agmed.sante.gouv.fr/ang/pdf/glffpl.pdf|title=Transfusion of Fresh Frozen Plasma, products, indications|publisher=Agence française de sécurité sanitaire des produits de santé|access-date=2008-06-02|url-status=dead|archive-url=https://web.archive.org/web/20080625001730/http://agmed.sante.gouv.fr/ang/pdf/glffpl.pdf|archive-date=2008-06-25}} [151] => [152] => ===Demand for blood=== [153] => The American Red Cross states that in the United States, someone needs blood every two seconds, and someone needs platelets every thirty seconds.{{Cite web|title=American Red Cross Issues Emergency Need for Blood Donors|url=https://www.redcross.org/about-us/news-and-events/press-release/2019/american-red-cross-issues-emergency-need-for-blood-donors.html|access-date=2020-12-12|website=www.redcross.org|language=en|archive-date=2020-08-15|archive-url=https://web.archive.org/web/20200815134827/https://www.redcross.org/about-us/news-and-events/press-release/2019/american-red-cross-issues-emergency-need-for-blood-donors.html|url-status=live}} There is not a consistent demand for each blood type. One type of blood being in stock does not guarantee that another type is. Blood banks may have some units in stock but lack others, ultimately causing the patients that need units for specific blood types to have delayed or canceled procedures.{{Cite journal|last1=Glynn|first1=Simone A.|last2=Williams|first2=Alan E.|last3=Nass|first3=Catharie C.|last4=Bethel|first4=James|last5=Kessler|first5=Debra|last6=Scott|first6=Edward P.|last7=Fridey|first7=Joy|last8=Kleinman|first8=Steven H.|last9=Schreiber|first9=George B.|last10=Retrovirus Epidemiology Donor Study|date=January 2003|title=Attitudes toward blood donation incentives in the United States: implications for donor recruitment|url=http://doi.wiley.com/10.1046/j.1537-2995.2003.00252.x|journal=Transfusion|language=en|volume=43|issue=1|pages=7–16|doi=10.1046/j.1537-2995.2003.00252.x|pmid=12519425|s2cid=25995392}} Additionally, every year there is an increase of around 5-7% for transfusions without an increase of donors to balance it as well as a growing population of elderly people that will need more transfusions in the future without a predicted increase in donations{{Cite journal|last=McCarthy|first=Leo J.|date=May 2007|title=How do I manage a blood shortage in a transfusion service?|url=http://dx.doi.org/10.1111/j.1537-2995.2007.01187.x|journal=Transfusion|volume=47|issue=5|pages=760–762|doi=10.1111/j.1537-2995.2007.01187.x|pmid=17465938|s2cid=32044726|issn=0041-1132}} to reflect those growing numbers. This was supported in 1998 where blood donations to the Red Cross increased to 8%, totaling 500,000 units but hospitals' need for donations increased by 11%.{{cite journal |last=Hensley |first=Scott |date=October 25, 1999 |title=Blood Shortages Become More Common |url=https://www.modernhealthcare.com/article/19991025/PREMIUM/910250315/blood-shortages-become-more-common |journal=Modern Healthcare |volume=29 |page=34 |access-date=April 15, 2021 |archive-date=April 15, 2021 |archive-url=https://web.archive.org/web/20210415234744/https://www.modernhealthcare.com/article/19991025/PREMIUM/910250315/blood-shortages-become-more-common |url-status=live }} [154] => [155] => Blood donations tend to always be high in demand with numerous accounts repeatedly stating periodic shortages over the decades.{{Cite journal|last=Sass|first=Reuben G.|date=June 2013|title=Toward a More Stable Blood Supply: Charitable Incentives, Donation Rates, and the Experience of September 11|url=http://dx.doi.org/10.1080/15265161.2013.781703|journal=The American Journal of Bioethics|volume=13|issue=6|pages=38–45|doi=10.1080/15265161.2013.781703|pmid=23641850|s2cid=29044770|issn=1526-5161}} However, this trend is disrupted during national disasters. The trend demonstrates that people are donating the most during catastrophes when, arguably, donations are not as needed compared to periods without disasters. From 1988 to 2013, it has been reported that during every national disaster, there was a surplus of donations; a surplus that consisted of over 100 units.{{Cite journal|last=Schmidt|first=Paul J.|date=2002-02-21|title=Blood and Disaster – Supply and Demand|url=http://dx.doi.org/10.1056/nejm200202213460813|journal=New England Journal of Medicine|volume=346|issue=8|pages=617–620|doi=10.1056/nejm200202213460813|pmid=11856803|issn=0028-4793}} One of the most notable examples of this pattern was the September 11th attacks. A study observed that compared to the four weeks before September 11, there was an estimated increase of 18,700 donations from first-time donors for the first week after the attack: 4,000 was the average of donations from first-time donors before the attack which increased to about 22,700 donations; while repeat donors increased their donations by 10,000 per week: initially, donations were estimated to be around 16,400 which increased to 26,400 donations after September 11.{{Cite journal|last1=Glynn|first1=Simone A.|last2=Busch|first2=Michael P.|last3=Schreiber|first3=George B.|last4=Murphy|first4=Edward L.|last5=Wright|first5=David J.|last6=Tu|first6=Yongling|last7=Kleinman|first7=Steven H.|last8=for the NHLBI REDS Study Group|date=2003-05-07|title=Effect of a National Disaster on Blood Supply and Safety: The September 11 Experience|journal=JAMA|language=en|volume=289|issue=17|pages=2246–2253|doi=10.1001/jama.289.17.2246|pmid=12734136|issn=0098-7484|doi-access=|s2cid=22399331 }} Therefore, in the first week after the attack on 9/11, there was an overall estimated 28,700 increase in donations compared to the average weekly donations made four weeks prior to the attack. Increases in donations were observed in all blood donation centers, beginning on the day of the attack. While blood donations were above average after the first few weeks following 9/11, the number of donations fell from an estimated 49,000 donations in the first week to 26,000–28,000 donations between the second and fourth weeks after 9/11. Despite the substantial increase of donors, the rate that first-time donors would become repeat donors were the same before and after the attack. [156] => [157] => The limited storage time means that it is difficult to have a stockpile of blood to prepare for a disaster. The subject was discussed at length after the [[September 11 attacks]] in the United States, and the consensus was that collecting during a disaster was impractical and that efforts should be focused on maintaining an adequate supply at all times.{{cite web|url=http://www.gao.gov/new.items/d021095t.pdf|title=Maintaining an Adequate Blood Supply Is Key to Emergency Preparedness|publisher=[[Government Accountability Office]]|access-date=2008-06-01|url-status=dead|archive-url=https://web.archive.org/web/20131224105302/http://www.gao.gov/new.items/d021095t.pdf|archive-date=2013-12-24}} Blood centers in the U.S. often have difficulty maintaining even a three-day supply for routine transfusion demands.{{cite web|url=http://members.americasblood.org/plsql/ecat/supply_monitor_pkg.web_report|title=Current status of America's Blood Centers blood supply|publisher=America's Blood Centers|url-status=dead|archive-url=https://web.archive.org/web/20090201061335/http://members.americasblood.org/plsql/ecat/supply_monitor_pkg.web_report|archive-date=2009-02-01}} [158] => [159] => ===Donation levels=== [160] => The [[World Health Organization]] (WHO) recognizes World Blood Donor Day on 14 June each year to promote blood donation. This is the birthday of [[Karl Landsteiner]], the scientist who discovered the [[ABO blood group system]].{{cite web|url=http://www.wbdd.org/index.php?id=24|title=World Blood Donor Day|publisher=World Health Organization|access-date=2008-06-01|url-status=live|archive-url=https://web.archive.org/web/20080915165850/http://www.wbdd.org/index.php?id=24|archive-date=2008-09-15}} The theme of the 2012 World Blood Donor Day campaign, "Every blood donor is a hero" focuses on the idea that everyone can become a hero by giving blood. Based on data reported by 180 countries between 2011 and 2013, the WHO estimated that approximately 112.5 million units of blood were being collected annually.{{Cite web|url=https://www.who.int/en/news-room/fact-sheets/detail/blood-safety-and-availability|title=Blood safety and availability|publisher=World Health Organization|access-date=2019-01-11|archive-date=2018-04-18|archive-url=https://web.archive.org/web/20180418141600/http://www.who.int/mediacentre/factsheets/fs279/en/|url-status=live}} [161] => [162] => In the United States it is estimated that 111 million citizens are eligible blood donors,{{cite journal |vauthors=Riley W, Schwei M, McCullough J |title=The United States' potential blood donor pool: estimating the prevalence of donor-exclusion factors on the pool of potential donors |journal=Transfusion |volume=47 |issue=7 |pages=1180–1188 |date=July 2007 |pmid=17581152 |doi=10.1111/j.1537-2995.2007.01252.x |s2cid=20867091 |url=https://www.hhs.gov/ash/bloodsafety/presentations/riley0807.pdf |access-date=2013-01-04 |url-status=dead |archive-url=https://web.archive.org/web/20120927212126/http://www.hhs.gov/ash/bloodsafety/presentations/riley0807.pdf |archive-date=2012-09-27 }} or 37% of the population.{{cite web | url = http://www.americasblood.org/about-blood/facts-figures.aspx | title = Facts About Blood | publisher = America's Blood Centers | access-date = 2013-01-04 | url-status = live | archive-url = https://web.archive.org/web/20131108144957/http://www.americasblood.org/about-blood/facts-figures.aspx | archive-date = 2013-11-08 }} However less than 10% of the 37% eligible blood donors donate annually. In the UK the [[National Health Service|NHS]] reports blood donation levels at "only 4%"{{cite web | url = http://www.blood.co.uk/giving-blood/ | publisher = NHS Blood & Transfustion | title = Give Blood | access-date = 2012-01-04 | quote = Blood is something we all expect to be there for us when we need it, yet only 4% of us give blood. | url-status = live | archive-url = https://web.archive.org/web/20111230103449/http://www.blood.co.uk/giving%2Dblood/ | archive-date = 2011-12-30 }} while in Canada the rate is 3.5%.{{cite web|url=http://www.bloodservices.ca/centreapps/internet/uw_v502_mainengine.nsf/page/E_Future-donors?OpenDocument|title=Canadian Blood Services|url-status=live|archive-url=https://web.archive.org/web/20130523231402/http://www.bloodservices.ca/centreapps/internet/uw_v502_mainengine.nsf/page/E_Future-donors?OpenDocument|archive-date=2013-05-23}} [163] => [164] => ==Donator's incentive and deterrence== [165] => Multiple studies have shown that the main reason people donate is due to prosocial motivators (e.g., altruism, selflessness, charity), general awareness regarding the demand for blood, increased confidence in oneself, helping a personal friend/relative, and social pressure.{{Cite journal|last1=Edwards|first1=Patrick W.|last2=Zeichner|first2=Amos|date=January 1985|title=Blood donor development: Effects of personality, motivational and situational variables|url=http://dx.doi.org/10.1016/0191-8869(85)90085-6|journal=Personality and Individual Differences|volume=6|issue=6|pages=743–751|doi=10.1016/0191-8869(85)90085-6|issn=0191-8869}}{{Cite journal |last1=Muthivhi |first1=Tshilidzi |last2=Olmsted |first2=M. |last3=Park |first3=H. |last4=Sha |first4=Mandy |date=August 2015 |title=Motivators and deterrents to blood donation among Black South Africans: a qualitative analysis of focus group data |journal=Transfusion Medicine |language=en |volume=25 |issue=4 |pages=249–258 |doi=10.1111/tme.12218 |issn=0958-7578 |pmc=4583344 |pmid=26104809}} On the other hand, lack of blood donations can occur due to fear, lack of faith in the medical professionals, inconvenience, and the lack of consideration for donating,Drake AW. "Public Attitudes and Decision Processes With Regard to Blood Donation: Final Report and Executive Summary". Cambridge, Mass: MIT; 1978:1–189. or perceived racial discrimination. Pathologist Leo McCarthy states that blood shortages routinely occur in the United States between July 4 and Labor day and between Christmas and New Year. [166] => [167] => === Donor health benefits === [168] => In patients prone to [[iron overload]], blood donation prevents the accumulation of toxic quantities.{{cite journal |vauthors=Fields AC, Grindon AJ |title=Hemochromatosis, iron, and blood donation: a short review |journal=Immunohematology |volume=15 |issue=3 |pages=108–112 |year=2020 |doi=10.21307/immunohematology-2019-628 |pmid=15373512 |s2cid=23137986 |doi-access=free }} Donating blood may reduce the risk of heart disease for men, but the link has not been firmly established and may be from [[selection bias]] because donors are screened for health problems.{{cite journal |vauthors=Tuomainen TP, Salonen R, Nyyssönen K, Salonen JT |title=Cohort study of relation between donating blood and risk of myocardial infarction in 2682 men in eastern Finland |journal=BMJ |volume=314 |issue=7083 |pages=793–794 |date=Mar 1997 |pmid=9080998 |pmc=2126176 |doi= 10.1136/bmj.314.7083.793 }}{{cite journal |author1=Atsma, F. |author2=de Vegt, F.|title= The healthy donor effect: a matter of selection bias and confounding|journal=Transfusion|volume=51|pages=1883–1885|date=Sep 2011|issue=9|pmid=21790637|doi= 10.1111/j.1537-2995.2011.03270.x|s2cid=30195641}} [169] => [170] => Research published in 2012 demonstrated that in patients with [[metabolic syndrome]], repeated blood donation is effective in reducing [[blood pressure]], [[Blood sugar|blood glucose]], [[Glycated hemoglobin|HbA1c]], low-density lipoprotein/high-density lipoprotein ratio, and [[heart rate]].{{cite journal|last=Manco|first=Melania|author2=Fernandez-Real, Josè|title=Back to past leeches: repeated phlebotomies and cardiovascular risk|journal=BMC Medicine|date=1 January 2012|volume=10|issue=1|page=53|doi=10.1186/1741-7015-10-53|pmid=22647488|pmc=3409018 |doi-access=free }} {{open access}} [171] => [172] => A study published in JAMA Network Open tracked [[Per- and polyfluoroalkyl substances|PFAS]] levels in a clinical trial and showed that regular blood or plasma donations resulted in a significant reduction in PFAS levels for the participants.{{cite web |last1=Matei |first1=Adrienne |title=Here's another reason to donate blood: it reduces 'forever chemicals' in your body |url=https://www.theguardian.com/commentisfree/2022/may/12/heres-another-reason-to-donate-blood-it-reduces-forever-chemicals-in-your-body |website=The Guardian |date=12 May 2022 |publisher=Guardian News & Media Limited |access-date=24 May 2022 |archive-date=24 May 2022 |archive-url=https://web.archive.org/web/20220524043813/https://www.theguardian.com/commentisfree/2022/may/12/heres-another-reason-to-donate-blood-it-reduces-forever-chemicals-in-your-body |url-status=live }} [173] => [174] => ===Donor compensation=== [175] => [[File:UK Blood Donor Awards.jpg|thumb|right|[[United Kingdom|UK]] awards for 50, 25 and 100 donations]] [176] => [[File:Singapore Red Cross National Blood Programme Ruby Award.jpg|thumb|right|Ruby award from the [[Singapore Red Cross]] for 75 voluntary donations]] [177] => [[File:Monumento a los Donantes de Sangre en Ávila.JPG|thumb|Monument to blood donors in [[Ávila, Spain]] ]] [178] => The World Health Organization set a goal in 1997 for all blood donations to come from unpaid volunteer donors, but as of 2006, only 49 of 124 countries surveyed had established this as a standard. Some countries, such as [[Tanzania]], have made great strides in moving towards this standard, with 20 percent of donors in 2005 being unpaid volunteers and 80 percent in 2007, but 68 of 124 countries surveyed by WHO had made little or no progress. Most [[plasmapheresis]] donors in the [[United States]] are still paid for their donations.{{cite web|url=http://www.gao.gov/archive/1998/he98205.pdf|title=Blood Plasma Safety|publisher=[[GAO]]|access-date=2008-06-01|url-status=dead|archive-url=https://web.archive.org/web/20080625001728/http://www.gao.gov/archive/1998/he98205.pdf|archive-date=2008-06-25}} Donors are now paid between $25 and $50 per donation.{{Cite web|title=Donate Blood For Money|url=http://www.ineedmoneyasap.com/2014/02/donate-blood-for-money/|url-status=live|archive-url=https://web.archive.org/web/20141218163125/http://www.ineedmoneyasap.com/2014/02/donate-blood-for-money/|archive-date=2014-12-18}} In some countries, for example [[Brazil]] and the [[United Kingdom]], it is illegal to receive any compensation, monetary or otherwise, for the donation of blood or other human tissues.L. Fusco "From Latin America to Asia, Rising Above Difficulties, Achieving New Heights" ''AABB News''. April 1998: p. 30 [179] => [180] => Regular donors are often given some sort of non-monetary recognition. Time off from work is a common benefit.{{cite web|url=http://www.labor.state.ny.us/workerprotection/laborstandards/PDFs/Blood%20guidelinesFINAL.pdf|title=Guidelines for Implementation of Employee Blood Donation Leave|publisher=New York State Department of Labor|access-date=2008-06-01|url-status=dead|archive-url=https://web.archive.org/web/20080625001730/http://www.labor.state.ny.us/workerprotection/laborstandards/PDFs/Blood%20guidelinesFINAL.pdf|archive-date=2008-06-25}} For example, in [[Italy]], blood donors receive the donation day as a paid holiday from work.{{cite web|url=http://www.camera.it/parlam/leggi/05219l.htm|title=Legge 21 ottobre 2005, n. 219 (Law 21 October 2005, n. 219)|publisher=Italian Parliament|access-date=2009-09-04|url-status=live|archive-url=https://web.archive.org/web/20090427112804/http://www.camera.it/parlam/leggi/05219l.htm|archive-date=27 April 2009}} In 2023, Poland introduced legislation that secured two days off work for employed persons when they donate - the donation day and the subsequent next day.{{cite web | url=https://kpmg.com/pl/pl/blogs/home/posts/2023/08/dwa-dni-wolnego-od-pracy-dla-honorowego-dawcy-na-stale-w-przepisach-blog-prawny.html | title=Dwa dni wolnego od pracy dla honorowego dawcy na stałe w przepisach | date=11 August 2023 }} Blood centers will also sometimes add incentives such as assurances that donors would have priority during shortages, free T-shirts, first aid kits, windshield scrapers, pens, and similar trinkets. There are also incentives for the people who recruit potential donors, such as prize drawings for donors and rewards for organizers of successful drives.{{cite web|url=http://www.bloodct.org/announcements.php|title=Incentives program for blood donors and organizers|publisher=American Red Cross Connecticut Blood Services Region|access-date=2008-06-01 |archive-url = https://web.archive.org/web/20080602155009/http://www.bloodct.org/announcements.php |archive-date = 2008-06-02}} Recognition of dedicated donors is common. For example, the [[Singapore Red Cross Society]] presents awards for voluntary donors who have made a certain number of donations under the Blood Donor Recruitment Programme starting with a "bronze award" for 25 donations.{{Cite web|title=Red Cross Honour Roll|url=http://www.redcross.org.sg/articles/honour-roll|url-status=dead|archive-url=https://web.archive.org/web/20120928144221/http://www.redcross.org.sg/articles/honour-roll|archive-date=2012-09-28}} In Ireland the [[Irish Blood Transfusion Service]] awards a silver pin or pendant for 10 donations, a gold pin or pendant for 20 donations, a gold lapel pin for 50 donations while those reaching 100 donations attend a dinner ceremony where they are presented with a small porcelain statue depicting the logo of the IBTS (a pelican).{{cite web | url=https://www.independent.ie/regionals/kerryman/news/are-you-one-of-the-12m-27366158.html | title=Are you one of the 1.2m? | date=5 February 2004 | access-date=2023-04-11 | archive-date=2023-04-11 | archive-url=https://web.archive.org/web/20230411110835/https://www.independent.ie/regionals/kerryman/news/are-you-one-of-the-12m-27366158.html | url-status=live }} The government of [[Malaysia]] also offers free outpatient and hospitalization benefits for blood donors, for example, 4 months of free outpatient treatment and hospitalization benefits after every donation.{{cite web |url=https://pdn.gov.my/index.php?option=com_content&view=article&id=16&Itemid=227 |title=Keistimewaan Penderma Darah |access-date=2021-04-15 |trans-title=Blood Donor Privileges |archive-date=2021-04-15 |archive-url=https://web.archive.org/web/20210415234744/https://pdn.gov.my/index.php?option=com_content&view=article&id=16&Itemid=227 |url-status=live }} In Poland, after donating a specific amount of blood (18 litres for men and 15 for women), a person is gifted with the title of "Distinguished Honorary Blood Donor" as well as a medal. In addition, a popular privilege in larger Polish cities is the right to free use of public transport, but the conditions for obtaining a privilege may vary depending on the city. Also in Poland, [[Poznań]]'s theatre [[:pl:Teatr Nowy w Poznaniu|Teatr Nowy]] offers theatregoers standing discounts on theatre tickets.{{cite web | url=https://teatrnowy.pl/ceny-zasady-kupna-biletow/ | title=Ceny I Zasady Kupna Biletów }} During the [[COVID-19 pandemic]], many US blood centers advertised free COVID-19 antibody testing as an incentive to donate; however, these antibody tests were also useful for blood centers in determining which donors could be flagged for convalescent plasma donations.{{cite news |title=Donate blood, get antibody test |url=https://www.qchron.com/editions/north/donate-blood-get-antibody-test/article_5af44ceb-ebe3-5b56-8de8-9de2de6dd40e.html |access-date=26 March 2021 |publisher=Queens Chronicle |date=25 February 2021 |archive-url=https://web.archive.org/web/20210226102709/https://www.qchron.com/editions/north/donate-blood-get-antibody-test/article_5af44ceb-ebe3-5b56-8de8-9de2de6dd40e.html |archive-date=26 February 2021}}{{cite news |last1=Dunbar |first1=Erin |title=Blood drive in Huntsville offering free COVID-19 antibody test |url=https://whnt.com/news/blood-drive-in-huntsville-offering-free-covid-19-antibody-test/ |access-date=26 March 2021 |publisher=WHNT 19 |date=1 March 2021 |archive-url=https://web.archive.org/web/20210301231742/https://whnt.com/news/blood-drive-in-huntsville-offering-free-covid-19-antibody-test/ |archive-date=1 March 2021}}{{cite news |title=Red Cross calls on donors to refuel the blood supply |url=https://www.kpcnews.com/thestar/article_e85eeab9-331c-5fb2-a23d-82e12f004994.html |access-date=26 March 2021 |work=The Star |date=25 March 2021 |archive-url=https://web.archive.org/web/20210326202451/https://www.kpcnews.com/thestar/article_e85eeab9-331c-5fb2-a23d-82e12f004994.html |archive-date=26 March 2021}} [181] => [182] => Most allogeneic blood donors donate as an act of charity and do not expect to receive any direct benefit from the donation.{{cite journal |author=Steele WR |title=The role of altruistic behavior, empathetic concern, and social responsibility motivation in blood donation behavior |journal=Transfusion |volume=48 |issue=1 |pages=43–54 |date=Jan 2008 |pmid=17894795 |doi=10.1111/j.1537-2995.2007.01481.x |author2=Schreiber GB |author3=Guiltinan A |display-authors=3 |last4=Nass |first4=Catharie |last5=Glynn |first5=Simone A. |last6=Wright |first6=David J. |last7=Kessler |first7=Debra |last8=Schlumpf |first8=Karen S. |last9=Tu |first9=Yongling|s2cid=19252616 |doi-access=free }} The sociologist [[Richard Titmuss]], in his 1970 book ''The Gift Relationship: From Human Blood to Social Policy'', compared the merits of the commercial and non-commercial blood donation systems of the US and the UK, coming down in favor of the latter. The book became a bestseller in the US, resulting in legislation to regulate the private market in blood.{{cite web|url=http://www.ntpu.edu.tw/sw/titmuss2.htm|title=Richard Titmuss|publisher=National University of Taipei social work department|access-date=2010-11-07|url-status=dead|archive-url=https://web.archive.org/web/20110115040145/http://www.ntpu.edu.tw/sw/titmuss2.htm|archive-date=2011-01-15}} The book is still referenced in modern debates about turning blood into a commodity.{{cite web|url=http://www.australianreview.net/digest/2007/06/waldby.html|title=The logistics of altruism|author=Catherine Waldby, The University of Sydney|author-link1=Catherine Waldby|access-date=2010-11-07|url-status=live|archive-url=https://web.archive.org/web/20110121015814/http://www.australianreview.net/digest/2007/06/waldby.html|archive-date=2011-01-21}} The book was republished in 1997 and the same ideas and principles are applied to analogous donation programs, such as [[organ donation]] and [[sperm donation]].{{cite journal |url=http://www.cairn.info/article.php?ID_REVUE=RFS&ID_NUMPUBLIE=RFS_445&ID_ARTICLE=RFS_445_0147&FRM=N#no4 |title=Gifts of Blood and Organs: the Market and "Fictitious" Commodities |author=Philippe Steiner |journal=Revue Française de Sociologie |date=2003 |issue=5 |pages=147–162 |publisher=Revue française de sociologie 5/2003 (Volume 44), pp. 147–162 |doi=10.3917/rfs.445.0147 |access-date=2010-11-07 |url-status=live |archive-url=https://web.archive.org/web/20111204210409/http://www.cairn.info/article.php?ID_REVUE=RFS&ID_NUMPUBLIE=RFS_445&ID_ARTICLE=RFS_445_0147&FRM=N#no4 |archive-date=2011-12-04}} [183] => [184] => ==See also== [185] => * [[Blood bank#History]] (history of blood donation) [186] => * [[Blood donation restrictions on men who have sex with men]] [187] => * [[Blood substitute]] [188] => * [[James Harrison (blood donor)]] [189] => * [[List of blood donation agencies]] [190] => * [[World Blood Donor Day]] [191] => * [[Xenotransfusion]] [192] => {{clear}} [193] => [194] => ==References== [195] => {{Reflist}} [196] => [197] => ==Further reading== [198] => {{Commons category|Blood_donation|Blood donation}} [199] => * [https://web.archive.org/web/20090312073700/http://www.anemia.org/patients/blood-donation/index.php Deferred Donors: Anemia & Blood Donation] [200] => * [https://www.transfusionguidelines.org/ British guidelines for transfusion medicine] [201] => * {{cite journal |author=Harrison E |title=Blood cells for sale |journal=Sci. Am. |volume=297 |issue=5 |pages=108–109 |date=Nov 2007 |pmid=17990831 |doi= 10.1038/scientificamerican1107-108 |bibcode=2007SciAm.297e.108H |quote=(subtitle) There's more to blood banking than just bagging blood}} [202] => [203] => {{Transfusion medicine}} [204] => {{Authority control}} [205] => [206] => [[Category:Blood donation]] [207] => [[Category:Hematology]] [208] => [[Category:Transfusion medicine]] [] => )
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Blood donation

Blood donation is the process of voluntarily giving blood, either for storage in a blood bank or for immediate use by a patient. The donated blood is used for various medical purposes, including transfusions during surgeries, treatments for certain medical conditions, and emergencies.

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The donated blood is used for various medical purposes, including transfusions during surgeries, treatments for certain medical conditions, and emergencies. Blood donations can be made by eligible individuals who meet the criteria for donation, such as having a certain minimum age, weight, and not having certain health conditions. Donors may donate whole blood, which includes red and white blood cells, platelets, and plasma, or specific blood components based on the patient's needs. The process of blood donation involves screening the donor for eligibility, collecting the blood through a needle inserted into a vein, and storing or processing it for future use. Numerous organizations and blood banks facilitate blood donation efforts, with campaigns and awareness programs conducted to encourage people to donate blood regularly. The availability of safe and adequate blood supplies is crucial for the provision of healthcare services and meeting the needs of patients worldwide.

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