What is blood transfusion?
Sunday, July 19, 2020
Transfusions are used for various medical conditions to replace lost components of the blood. /Net photo

The National Centre for Blood Transfusion (NCBT) normally conducts regular campaigns sensitising people to respond to the noble cause of saving lives.

Blood is defined as a body fluid in humans and other animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells. In vertebrates, it is composed of blood cells suspended in blood plasma.

According to medics, there are four basic components that comprise human blood: plasma, red blood cells, white blood cells and platelets.

The components of blood

•Red Blood Cells

Red blood cells represent 40% to 45% of your blood volume. They are generated from your bone marrow at a rate of four to five billion per hour. They have a lifecycle of about 120 days in the body.

•Platelets

Platelets are an amazing part of your blood. Platelets are the smallest of our blood cells and literally look like small plates in their non-active form. Platelets control bleeding. Wherever a wound occurs, the blood vessel will send out a signal. Platelets receive that signal and travel to the area and transform into their "active” formation, growing long tentacles to make contact with the vessel and form clusters to plug the wound until it heals.

•Plasma

Plasma is the liquid portion of your blood. Plasma is yellowish in colour and is made up mostly of water, but it also contains proteins, sugars, hormones and salts. It transports water and nutrients to your body’s tissues.

•White Blood Cells

Although white blood cells (leukocytes) only account for about 1% of your blood, they are very important. White blood cells are essential for good health and protection against illness and disease. Like red blood cells, they are constantly being generated from your bone marrow. They flow through the bloodstream and attack foreign bodies, like viruses and bacteria. They can even leave the bloodstream to extend the fight into tissue.

White blood cells are found in the plasma, which is the liquid part of the blood that makes up around 55 per cent of the entire blood.

Understanding blood transfusion

Dr Swaibu Gatare, Division Manager of the National Centre for Blood Transfusion (NCBT) at Rwanda Biomedical Center, says generally when it comes to blood transfusion from the entire blood, they get out different components.

He says what is normally done is to fraction out those different components.

The blood components, he says, include the platelets, plasma, red cells and cryoprecipitate and that all these are kept separately.

"Each of the components is administered to the patient given the different illnesses or conditions they are having at the moment,” he says.

For example, if someone is suffering from malaria, the plasmodium attacks the cells, meaning that these particular cells are the ones that are going to be destroyed, therefore; the patient will need the red cells.

Still regarding malaria, he says the plasmodium attacks platelets, meaning that along the course of the illness, the patient might end up needing platelets.

In another scenario, Gatare says is if a person is bleeding profusely after an accident, and that sometimes there could be massive haemorrhage, it is required to give all the four components to save a life.

He says the case can as well be applied in post mortem haemorrhage, which happens when one bleeds massively after giving birth.

Procedures

When it comes to donating blood, there are different eligibility standards for this.

Dr Christopher Gashaija, in charge of training and research at NCBT, says first of all, one needs to be 18 (consent age) and above.

But again, he says, they don’t go above 60 years, noting that as one ages, their bodies become weaker. Also, one should weigh above 50 kg.

"In the last 48 hours to donation time, one shouldn’t have taken aspirin because it inhibits aggregation of the platelets,” says Gashaija.

He adds that people with some chronic diseases like asthma, hypertension and diabetes are not advised to donate.

For women, he says, one must have come out of her menstrual period at least 7 days before.

"One shouldn’t be pregnant and even after giving birth, waiting for 12 months is ideal before being allowed to donate blood,” he notes.

Gatare says it is important to allow medics to conduct the minimum medical examinations that are required before qualifying to donate blood.

"The donor should be able to consent to medics by signing that they are willing to not only donate blood, but also their blood can be transfused to another person,” he says.

What to put into consideration

Although blood transfusion is not risk-free, there are rare cases of side effects on both donor and receiver, and most of the time they are manageable.

The donor, Gatare says, could develop some reactions.

He explains that after one has donated blood, there is plaster that is put on venepuncture side and some donors can get allergic reactions due to that.

Venepuncture is the process of obtaining intravenous access for the purpose of venous blood sampling or intravenous therapy.

There could also be nerve lesions; the injection used can damage the nerve.

Gatare says scrubbing well to clean the venepuncture site is important as, if not done, could result in infection into the bloodstream.

He further notes that it’s always recommended that before donating, one should be given a bottle of water to balance the hemodynamic equilibrium of the body to avoid nausea and vomiting.

If this is not done, Gashaija says it can lead to vasovagal reaction, that is, nausea and vomiting, because of the quantity of the blood they have given.

To date, NCBT has been able to serve hospitals across the country to the tune of over 90 per cent. Last year, the demand for blood from hospitals was 100, 245 while NCBT managed to supply 91,960 which according to Gashaija gives the hospital the satisfaction percentage of 90 per cent.

Among 91,960 blood units issued to the hospitals, 25,356 were done by the drones.

Last year, there were 68,851 donations made across the country.

Meanwhile, there are up to 552 mobile collection sites that have been created all over the country, depending on where someone is located; they can visit any site for blood donation.

Although the turn up is good so far, Gatera says there is need for more people to show up and continue donating blood to save lives.