Blood has become a critical tool in saving lives across the world today, due to a rise in emergency situations calling for blood supplies on a daily basis. Hence a steady and ready supply of quality blood products will always be needed, more so in Sri Lanka where there has been a sharp rise in accidents and diseases requiring transfusions.
Having a steady stockpile of blood to meet this rising demand is thus the need of the hour. Following World Blood donation Day last week, The Sunday Observer spoke to the Director of the National Blood Transfusion Services ( NBTS) Dr. Lakshman Edirisinghe to get more insights into how blood donations are carried out and the precautions taken to ensure that the donated blood is safe
Excerpts
Q: Just recently on June 14, the world observed Blood Donation Day. Why is this day so significant in the context of Sri Lanka?
A: June 14, 2023 was an important day for the National Blood Bank of Sri Lanka because we achieved 100 percent voluntary blood donations on this day. This represents a significant milestone in our blood collecting campaign as from the total blood collected in Sri Lanka yearly, 85 percent of it is collected in mobile blood donation campaigns organised by roughly 5,000 mobile blood donation camp organisers from various walks of life using their time and money to perform this voluntary service for their fellow citizens.. So, on each year on June 14, we felicitate these mobile donation camp organisers and donors, for their valuable contribution thereby motivating them to continue their valuable service.
Q: The slogan for 2023 World Blood Donor Day is “Give blood; give plasma, share life, Share often.”How relevant is this in the Sri Lanka context?
A. The aim of NBTS is to encourage donors to donate blood and to donate regularly. Regular donors are important as it ensures safe blood, as they already know the selection process, get themselves medically assessed regularly and are thus more suitable.
As regular donors donate every 4 months of the year it eases the blood stock management of the country with regard to forecasts and predictions on blood collections. Apheresis donors and rare blood group donors being regular donors are important as well because we have a limited number of these individuals. Locally or internationally the aim is to donate blood regularly and it fits well with our system as most of the blood collected is via mobile blood donation campaigns.
Q: Who are those who need blood most in our country?
 Dr. Lakshman Edirisinghe
Director - NBTS
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A. According to our statistics last year, in Sri Lanka, the largest requirement has been to medical wards for patients suffering from anemia, secondly surgical patients such as patients after road traffic accidents, cardio pulmonary surgeries, and other routine surgeries. Thirdly it is transfusions related to obstetrics and gynaecological issues including pregnancy and related complications. Patients with diseases such as Thalassemia (specially in children), cancers involving the blood, bone marrow failures, kidney failure patients also require regular blood transfusions to maintain quality of life.
Q: What is the ideal age for donating blood and why is it considered the ideal age group?
A. The ideal age is 18 years to 60 years. We have considered many factors when choosing this age range. Morbidity factors related to age, health condition of related age groups, ability to give consent to enter the voluntary donor program, blood volume that can be withdrawn, are some of the factors that we have considered when deciding this guideline.
Q: How much blood can a person give in a single donation?
A. A person can donate a standard volume of 450ml once every 4 months. However, the eligibility to donate depends on the age, weight and health status. Age should be 18 to 55 years for first time donors, if you are a regular donor the upper age limit is raised till 60 years. The weight has to be above 50kgs.
Q: Do blood donations require hospital settings?
A. No. It is a simple procedure, without any health hazards and hospital conditions are not required. More than 85 percent of our routine collections are done through mobile blood donations campaigns.
But ensuring the safety of the donor and the collected blood is what is required. Ideally, we encourage all would-be donors to come to hospital blood banks for their donation, which ensures the safety of the donor. But since the vast majority of blood is taken in mobile blood donation campaigns held within the community, we take the utmost care and precautions to make sure that the donor and the blood collected is handled safely and securely.
Q: Where are blood donations usually done?
A. Blood donations require a permanent building, water, electricity, and a clean environment to ensure the safety and quality of the blood. Hence they cannot be done in a makeshift building.
Q: Are they done under medical supervision?
A. Yes, absolutely. All donations, including donations done in mobile blood donations campaigns are done with the supervision of a NBTS trained, qualified medical officer.
Q: Are all blood donations voluntary?
A. Yes. All donations taken from the national blood transfusion service are 100 percent voluntary.
Q: Are preliminary investigations required before you donate your blood? If so, what are they ?
A. No preliminary investigations are required before donating blood. But we may request particular investigations to be done if we suspect some underlying disease condition that must be ruled out prior to donation. However, we do check the hemoglobin prior to donation to see whether it is in the acceptable range. Further testing for Transfusion Transmissible Infections are done after donation.
Q: How safe are these voluntary donations is a question uppermost in the minds of recipients. So, tell us what are the tests that are done prior to using the blood , to ensure it is safe.?
A. Blood donated by Sri Lankan donors is collected under sterile conditions, by NBTS trained and qualified staff members. Donors must individually fill a declaration form where the donors are questioned regarding various details and other personal behaviour and habits. Following which they are counselled and requestioned by a NBTS trained medical officer with regard to the information they have given. Donors are also given education material regarding high-risk behaviour that they must avoid and refrain from, if they are planning to be blood donors. After going through this extensive selection process and after the donor donates the blood, it goes through another extensive compulsory testing procedure where it is tested for Transfusion Transmissible Infections, which are HIV, Hepatitis B and C, Syphilis and Malaria. Only blood that goes through this testing procedure are allowed to be released to and transfused to patient’s islandwide. The NBTS complies with all of these requirements.
Q: How long will it take for a person who has donated his blood to recover?
A. The fluid lost is recovered within 24hours, red blood cell recovery takes 21 days, it takes 3 months to replenish the iron that we lose when a person donates blood. In some countries a donor is eligible for donation every 3 months. In Sri Lanka we have considered the donor’s safety further and have added another extra month (4 months in total) in order for the donor to completely recover and be eligible for the next donation.
Q: So how often can a healthy person donate blood?
A. He or she can donate every 4 months.
Q: Can children under 12 years of age donate blood? If not, why not?
A. The standard blood volume collected at each donation is 450 ml, and should not exceed more than 13 percent of the total adult blood volume. Since a child’s blood volume is less than an adult, if we are to collect 450ml from a child, it will exceed this 13 percent limit.
As a prerequisite the donor has to be 18 years or more to give consent.
Q: What are the obstacles that prevent voluntary donations across the country? Eg, cultural barriers and myths.
A. We have managed to achieve this 100 percent total voluntary blood donations because of the fact that there are no cultural barriers. For example, Buddhists donate frequently as part of their religious practice, Catholics and Muslims are also encouraged to donate blood by their clergy, and Hindus also donate as part of their traditional festivities.
Q: Apart from benefits to the recipient, what are the medical and psychological benefits of blood donations to the donor?
A. Research has shown that the risk of ischemic heart disease and stroke is significantly less for individuals who donate frequently. The mental satisfaction of donating blood is another benefit.
Q: How many lives can a single dose of blood save?
A. Four
Q: Blood is a precious resource that must be carefully managed. How do you ensure that each donor’s gift provides the greatest benefit to patients without wasting any blood?
A. We take a donation from a 100 percent totally voluntary donor after a thorough counselling session, examination followed by investigations such as haemoglobin estimation and a thorough TTI screening method. After the blood goes through these screening tests and after we have ensured it is safe to use, we prepare components from it.
Which are Red Cell Concentrates, Plasma, Platelets and White Blood cells (Buffy Coat). To further prevent the wastage of blood and to make sure it is used properly we have the following procedures.
Blood components collected earliest will be issued first. (First In First Out Method)
The entire NBTS is a centrally coordinated system and we have a dedicated Stock Management Team who daily reviews the existing blood stocks of all blood banks and coordinates the distribution of close expiry products to where it will be needed.
Q: Which authority is responsible for the overall management of blood donations island wide? What role does it play?
A. The national blood transfusion service (NBTS) analyses the requirement of Blood islandwide and decides on the collection. All the policies, instructions, guidelines, operating procedures are developed by the NBTS.
The investigations and quality assessment are all regulated by the NBTS.
Q: What is the goal of the National Blood Transfusion Service in the future?
A. To be the leader and best service provider in transfusion medicine in the Southeast Asian region. We have decided to improve other sectors such as to increase in-house donations and to decrease discards so that we further improve the quality of our services and to obtain GMP status. We are also working towards being an international training centre to provide training opportunities for individuals in the Asian region.
We are also working towards improving quality standards and introducing the External Quality Assurance Services to the South Asian region.
Q: Is there a definite date for achieving your goal?
A. Yes. By 2025
Q: What is your message to all would be donors?
A. “Give blood, give plasma, share life, share often”.
Q: If someone wants more information on blood donations is there a contact number they can reach?
A. Please call the following numbers and the required information can be obtained from our Nursing Officers and Public Health Inspectors. 0112369 931-35