Blood is the lifeline of the human body that brings oxygen and nutrients to all parts of the body. Blood also carries carbon dioxide and other waste materials from the organs to be removed from the body.
In an interview with the Sunday Observer, Dr. Trilicia Withanawasam, Consultant Transfusion Physician at the University Hospital of Kotelawala Defence University invites donors to participate in the benevolence of helping Covid-19 and other needy patients at this crucial juncture in the ongoing health crisis. She also is a senior lecturer at the Medical faculty of KDU. Dr.Withanawasam currently is the Head of the Department of Transfusion Medicine at the University Hospital-KDU.
Excerpts of the interview:
Q: What are the functions of the Blood Bank in a hospital setup?
A: The key role of the Blood Bank is to cater to any medical exigency such as medical, surgical, obstetric, paediatric, or other acute emergencies in a hospital. Transfusion-related services are mandatory functions in any hospital. Access to blood is a fundamental human right.
Almost every hospital, including base hospitals, possesses a Blood Bank. The cluster-based network in Sri Lanka is very strong, efficient, and effective to provide services by transfusion specialists to the whole country.
Apart from the medical officers, we have trained staff including nurses, laboratory technologists, and public health inspectors. The delivery of our service is 24 hours a day throughout the year and the service is committed to providing blood in emergencies such as accidents, post-partum hemorrhages, surgical blood losses, etc. Also, blood transfusions are lifesaving for patients with cancers, anemia like thalassemia, and organ transplantations.
Also, our functions include collecting blood from donors, preparing components, testing samples, matching with patients, and offering safe and quality assured blood components. Further service is extended to cater to other transfusion-related therapies as well as testing and therapeutic procedures for transplantation.
Q: What is blood donation in simple terms?
A: We follow the international standards followed by many countries to obtain blood from donors. We have donor selection criteria laid down by national blood donor selection guidelines to ensure the donor and recipient safety.
Blood donation is an altruistic solidarity act where a responsible person in society is trying to help someone else to save the life as a humanitarian obligation. On all occasions, donors are totally selfless and do not expect anything in return from society. It is a one hundred percentage voluntary service in Sri Lanka.
Q: What are the eligibility criteria of a blood donor and modes of blood collection?
A: The basic eligibility criteria are that the donor must be above 50 kg in weight, age between 18 years and 60 years, free from health issues, not under medications, and free from any type of risky behaviour such as drug addiction and unwarranted sexual activities.
According to the present guidelines, after 1 week of vaccination for Covid- 19, you are eligible to donate. Even after the Covid-19 infection, you can donate blood after 4 weeks of complete recovery.
The mobile collection is the main mode (Approximately 85%) of receiving blood. Naturally, the Sri Lankan society at large, with our guidance, organises blood donation campaigns all over the country. In addition, alternatively, many donors walk into hospital-based collection centres and donate blood frequently. With the pandemic situation, the in-house donation is vitally important as it assures donor safety in an organised, well-equipped environment.
Q: Can you explain the blood collection process to our readers?
A: It is an easy and simple process. The donor can walk into either a mobile blood campaign facility or any Blood Bank to offer blood. Usually, the whole process takes about 30 to 45 minutes. The donor initially goes through a brief counseling session with a medical officer on personal and medical information. Secondly, they go through a basic medical test on the pulse, blood pressure, hemoglobin levels, and then are directed to the bed. Normally, we collect 400 ml to 500 ml of blood (the accepted tolerable volume) from a donor, which will be replenished within 4 months. He/she can donate again after 4 months.
Q. What are blood components and what is blood component preparation?
A: 100% of collected blood is separated into components, namely red cells, white cells, platelets, and plasma. We manufacture three or four components from the collected blood depending on the collection system. A sample is screened for transfusions transmitted infections such as hepatitis B, C. HIV 1 and 2, Syphilis, and Malaria and test for blood group. Finally, tested blood components are ready for patients’ use. One donation can save three (3) lives. Plasma components are selected considering the patient and donor blood groups whilst red cell component needs compatibility to avoid mismatch transfusions.
There is a possibility of using plasma from Covid- 19 recovered patients (Convalescent Plasma-CP) as a treatment for infected patients; CP has been used in the past to treat similar viral infections.
Q: At this gruesome health crisis, what are the challenges the blood bank faces, and what are the steps taken to continue this important service uninterrupted?
A: We are currently fighting against the most dangerous communicable disease in recent history. As I told you before, a major collection of blood comes from mobile campaigns. With the strict health guidelines and regulations, people are justifiably kept away from gatherings.
The requirement of blood components has not changed. Hence, we are now compelled to encourage individuals to visit our blood banks that are protected against the Covid-19 virus with many extra precautions.
Alternatively, we have to encourage small groups of five to ten donors and provide them the maximum health security. We request provincial and village level frontline health officers to permit small-group blood donation campaigns under their supervision whenever possible.
Also, donors can log on to www.nbts.health and reserve a convenient time at the closest centre. Even during travel restrictions, donors can come to blood centres by using the message they receive. Appointments to UH KDU can be made through 071 021 9600/ 011 204 4555 (Ext 4440).
At this point, I would like to appeal to those who are tirelessly organising donor campaigns to reach people and motivate them to go to hospitals in their respective areas and donate blood as they have done previously.
Q: What are the services and facilities available to patients in University Hospital KDU (UH KDU) and services relevant to the blood bank?
A: KDU hospital is the dedicated medical and surgical hospital for the General Sir John Kotelawala Defence University. As everyone knows, the KDU is one of the best-managed Universities in the country and so is the KDU Hospital. UH-KDU has 814 beds, 36 bed ICU facilities, and 20 operating theatres. All the departments are with state-of-the-art facilities in all medical disciplines. It’s a State-owned hospital and a national asset. With the assistance of the Ministry of Health, UH KDU also has established a separate unit for Covid-19 patients with ICU beds.
The Department of Transfusion Medicine has facilities for blood donation, component preparation, and testing, and therapeutic procedures for patients. Soon we will have a dedicated unit solely for transfusion-dependent patients.
We have one of the most modern facilities in the country with high-tech precision equipment and dedicated qualified and trained staff. Our blood collection centre is completely separated with a dedicated entrance to the donors with a very large waiting area. We follow all the health guidelines on Covid-19 to the letter to ensure 100% safety for walking-in donors. All our collection is added to the national pool.
Q: Transfusion medicine is a specialised subject matter that usually escapes public attention. What are the extended services a specialist in the field of Transfusion Medicine offers to the clinical services to function in the hospital?
A: Blood transfusion is a complex and complicated process in any medical or surgical emergency. Selection and matching of the blood of a patient and a donor is an intricate process.
Transfusion specialist bears the responsibility of whole transfusion process as well as therapeutic procedures like plasma exchanges. Though transfusion is lifesaving it carries risks; if specialists involve in decision-making patient outcomes can be improved. Further transfusion specialists play a key role in donor-recipient matching in transplantation.
Q: Any final message, comments, or acknowledgments?
A: First and foremost let me emphatically point out that the requirement of blood is as important as the need for oxygen. Therefore, I appeal to all stakeholders in our society to take part in any capacity in this kindly, humanitarian, and charitable activity of blood donations.
I must first thank our donors, the unsung heroes, particularly, regular donors who are scattered around the country who keep donating blood no matter what the situation is.
Also, I must appreciate the role of the Vice-Chancellor of Kotelawala Defence University Major General (retd) Milinda Pieris who is taking a huge personal interest in related matters.
I must especially thank my dedicated team and hospital administration. Finally, I thank the National Blood Transfusion Service for their unconditional support.