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1. Donation made easy — a step-by-step guide of what happens at one of our clinics
2. Tips for donation
3. Donation criteria
4. How we ensure a safe blood supply
5. Statistics
6. Literature

Donation made easy — a step-by-step guide of what happens at one of our clinics

The complete donation process, from reporting at reception to enjoying a drink afterwards, can take between 30 and 45 minutes, depending on the size of the clinic and the number of donors. The actual donation will take approximately 10 minutes.

• When you arrive

  All donors report at the reception desk where new donors give their name and details and regular donors' names are checked on the WPBTS database using their donor card that contains their blood type and details.

• The blood iron test

  A blood iron test is performed to check the level of haemoglobin in the donor's blood.

• The questionnaire

  Every time a donor donates, they are required to complete the confidential questionnaire as accurately and honestly as possible to ensure that there is no risk of potentially transmitting any infection through transfusion. This questionnaire asks very personal questions, but it is in the best interests of the donor and recipient to ensure that everything about the donor's health and lifestyle is in order.

  New donors are assisted by the nursing sister who goes through questions with them and answers any queries.

• Donation

  Once the questionnaire is completed and found to be in order the donor is referred to a chair and the sister hands the completed questionnaire to reception where the bags and test tubes are labelled and issued for the donation.
  The clinic attendant takes the bags and specimen tubes to the donor, identifies the donor in the chair, checks the labels and bags and then sets them up for the donation: cleans the donor's arm, checks blood pressure and pulse.

• Bleeding commences

  The donation process takes about 10 minutes and approximately 475ml blood is taken.

• Taking a break after donation

  The donor is ushered to the tea area where they can take a seat and enjoy a biscuit and something to drink before leaving the clinic.

  The unit of blood is taken to a separate area (or room) where the blood and tubes are correlated with documents before it is packed in a secure, sealed container.
  All donations from a specific clinic are transported by drivers assigned for this purpose to the WPBTS laboratories in Pinelands, where information is correlated again before being tested and processed.

  It is important to note that the final decision for acceptance/deferral of donors at a clinic rests with the medical sister on duty.

Tips for donation

• Eat all your regular meals and drink plenty of fluids on the day of your donation.
• Have a snack at least four hours before you donate, but do not eat a big meal shortly before it.
• Avoid taking aspirin or similar anti-inflammatory medication in the 72 hours prior to your donation. (Aspirin inhibits the function of blood platelets. If you have taken aspirin within this period, your blood platelet component cannot be transfused to a patient.)
• Drink at least four non-alcoholic beverages in the four to five hours after you've given blood, particularly in summer.
• If you feel dizzy, lie down or sit with your head on your knees.
• Keep the dressing on your arm dry and in place for five hours after donation.
• If your arm begins to bleed, raise it up in the air and apply pressure on the site until bleeding stops.
• Do not do heavy exercise or lifting on the day of donation.
• Reduce the extent of regular exercise or sporting activity for a few days after donation.
• If you are worried about bruising or pain in the arm where the needle was inserted, please contact the WPBTS and ask to speak to a doctor or nursing sister.
• In the unlikely event that you feel faint, be sure to lie down on your back with your legs elevated. This usually resolves any feeling of light-headedness and should prevent fainting.

Donation Criteria

Regular donors have proven to be the safest source of blood and provide 85% of the Western Province Blood Transfusion Service's supply.

Donors are recruited on a voluntary basis and accepted only if they comply with stringent selection criteria.

The safety and health of donors are as important as that of recipients and every care is taken to remind them of the importance of healthy lifestyle choices and honesty about their medical history.

Each donor is required to read information about blood safety and fill in a detailed questionnaire about their health and lifestyle every time they donate.

Prospective donors should be:

• Between 17 and 65 years of age
• Weigh more than 50 kilograms
• Live a safe and healthy lifestyle

It does happen from time to time that donors are deferred from donation, either temporarily or permanently. There are a number of reasons for deferral, but they are all aimed at ensuring the well-being of donors and the safe supply of blood for recipients.

Some of the most common reasons for deferral are:

• Colds and flu (during the winter)
• Donors who've displayed "at-risk" behaviour (body piercings, drugs, sexual lifestyle)
• Infections and medication
• Low haemoglobin (iron) levels
• Underweight

• If you have not had a light meal three or four hours before you give blood.
• After major surgery donors should defer from donating for six months.
• If you are due for an operation within six weeks.
• If you have had jaundice or hepatitis.
• Pregnant or nursing mothers should not give blood until six months after the baby's birth or three months after the baby is weaned.
• If you have had cancer, heart disease, epilepsy, or a bleeding disorder.
• If there is any possibility that you may have been exposed to the HIV/AIDS virus you should not register as a donor.

If you are a competitive sportsman or involved in a "hazardous" occupation; taking medication or in any doubt about your health, please speak to the sister on duty at the donation clinic or phone the WPBTS to speak to the medical officer or head sister about your ability to donate.

Please also see Changes in Donor Deferral Periods, a press release about revised deferral periods issued in October 2006.

How the Western Province Blood Transfusion Service ensures a safe blood supply

Please note that we host a specific site for clinicians at www.wpbtsmedical.org.za

Providing safe blood is a responsibility that the Western Province Blood Transfusion Service (WPBTS) takes very seriously and commitment to safeguard the blood supply rests on multiple layers of protection to ensure that the risk of transfusion-transmitted infection is kept to as low a level as possible.

The Service operates according to international standards as set out by the World Health Organisation, complies strictly with the government of South Africa's Human Tissue Act (Act 65 of 1983) and is accredited by the South African National Accreditation Service (SANAS no MO 198). The Service has ISO 17025 as well as the SANAS Blood Transfusion accreditation, and on its own accord complies with the requirements of ISO 9000.

Ensuring the safety of our recipients

Committed voluntary donors
The maintenance of a committed voluntary donor base has proven to be the safest source for blood.

Donor education
Prospective donors are educated through presentations and literature about donation at new donor clinics.
Education focuses on health and lifestyle requirements for the donation of safe blood and donor safety.

Pre-donation screening
Donors are confidentially questioned and counselled by clinic personnel at each clinic. Combined with a physical examination, this prevents those individuals at risk of HIV, Hepatitis or other infections from donating.

Medical screening looks out for:

• Medication
• Past illness and operations
• History of TB
• Malaria illness or recent exposure
• Recent illness or infection
• History of jaundice
• Early symptoms of HIV
• Previous blood transfusions

Confidential exclusion of donors whose behaviour falls within the high-risk guidelines are based on:

• Multiple sexual partners
• Recent history of venereal disease
• Sex for money
• Sexual partner known to be unfaithful
• Body piercing and tattoos

A confidential exclusion hotline gives donors the opportunity to withdraw donations if they have donated but feel there may have been some risk.

Ensuring the safety of our donors

The Western Province Blood Transfusion Service's most valuable assets are its donors.

Donor selection
WPBTS's first concern is to ensure that donating blood will not harm our donors. Donors are carefully questioned about their health and lifestyle to determine whether they are able to donate.

Donation and HIV infection
New and sterile equipment is used for each donation and is destroyed after use so there is no risk of contracting HIV, hepatitis B or C by donating blood.

Donation side effects
Donors must be able to withstand the rapid withdrawal if approximately 10% of their blood without compromising the cardiovascular system.

If a donor is in good health and has eaten shortly before donation, they should not experience any side effects.

Testing
South Africa is currently the only country in the world that tests every donor's contribution at each donation for HIV 1 and 2 antibodies; HIV subtype O; syphilis and hepatitis B and C.

The WPBTS utilises Nucleic Acid Testing (NAT) which uses DNA technology that effectively narrows the detection period of HIV infection to between five and 11 days.

All results must be negative for a unit of blood to be labelled and released. Blood that tests positive for any of the indicators are quarantined, removed and incinerated. Confirmatory tests are performed to ensure true positive results.

Donors with confirmed results are contacted confidentially, and referred for medical follow-up or counselling in the case of HIV infection.

Records of donors' details and results are kept indefinitely to assist in look-back procedures.

The HIV seroprevalence rate of our selected donors is 0.067%, which is significantly less than that of the general population in the Western Cape Province.

Sterilisation of blood products
Many plasma-derived products are subjected to approved sterilisation procedures. Factor VIII, Factor IX, Immunoglobulins, stabilised serum, albumin, and some Fresh Frozen Plasma units are virally inactivated.

The WPBTS Look-Back procedure
This programme examines the recipients of negative tested units from a repeat donor who, on a subsequent donation is found to be positive for either HIV antigen or antibody or hepatitis B.

The recipient's doctor is notified and asked to inform and test the recipient to ensure that the donor did not infect the patient while in the window period for infection.

In many cases it is possible to pinpoint when the infection took place due to the information received from the donor when counselled.

If a transfusion-transmitted HIV infection is identified the Service is legally required to trace these recipients and to notify the health authorities.

The reverse occurs when the Service is periodically asked to review the status of donors whose non-reactive units were given to a medical or surgical patient in the past and where the patient has later been diagnosed with HIV/AIDS.

Testing of blood began in 1985 and to date there have been only four documented cases of HIV infection as a result of transfusion in the area served by WPBTS.

During this period we have transfused in excess of 11 million blood products.

Alternative options for recipients
There are alternatives to receiving blood from the general donor supply.

Autologous donation
Donors can donate a number of units for their own use to be used during surgery.

Designated donation
Compatible family members and friends can donate for the donor.

Intra-operative collection
Blood lost during surgery is saved and transfused back to the donor.

Safety versus risk in blood transfusion
Although the WPBTS takes every precaution to prevent infection, it is important to understand that there are unavoidable risks as there is with every other procedure, operation, or medication.

The final decision with regard to blood transfusion rests with the physician and it is accepted that the benefits must outweigh the risks at all times.
Most major operations, childbirth or anaesthesia carry mortality rates which are 10 — 100 times greater than acquiring AIDS through transfusion

The relative mortality risks of certain procedures are illustrated below

A zero-risk blood supply is not achievable but neither is a zero-risk sport or a zero-risk operation.

To access and print our brochure about blood safety, click on the link below

Blood Safety PDF format (600KB).

Statistics

Literature

The Western Province Blood Transfusion Service has a range of brochures that deal with all aspects of blood donation and transfusion. To access any of them, please click on the links below. They are in PDF format.

Blood Safety (600KB).
Blood Donation front (860KB), back (900KB)
Autologous Donation (1 MB)
Platelet Donation (770KB)