3: Providing safe blood
- Unpaid volunteers, donating regularly, are key to the provision of safe and sufficient blood for transfusion.
- 17 to 65 year olds can enrol as first-time blood donors and there is no upper age limit for regular donors (subject to an annual health check).
- To ensure the safety of the donor and recipient, a medical questionnaire covering health, lifestyle, travel history, medical history and medication is completed before each donation.
- The minimum mandatory infection screen on all donations is for hepatitis B and C, HIV, HTLV and syphilis, and extra tests are performed as required.
- The risk of transmission of prion diseases such as variant Creutzfeldt–Jakob disease (vCJD) is reduced by excluding at-risk donors (including recipients of a blood transfusion or tissue/organ transplant since 1980), removing white cells from donations (leucodepletion), importing plasma derivatives from countries with a low risk of vCJD and providing imported, virus-inactivated fresh frozen plasma (FFP) for patients born on or after 1 January 1996.
- Donations are routinely ABO and RhD typed and screened for clinically important blood group antibodies.
- Modern transfusion practice is based on the use of blood components rather than whole blood donations.
- Plasma derivatives are licensed medicines and include albumin solutions, coagulation factor concentrates and immunoglobulins.
Blood transfusion in the UK is now very safe indeed and most serious adverse events originate in the hospital rather than the blood transfusion centre (see Chapter 5). However, ensuring a safe and effective blood supply remains essential. This requires a combination of high-quality donor recruitment and selection, infection screening, serological testing and blood component production (followed by rational clinical use). The four UK Blood Services – NHS Blood and Transplant, Northern Ireland Blood Transfusion Service, Scottish National Blood Transfusion Service and Welsh Blood Service – maintain common standards for blood donation, testing and blood products. The Joint UKBTS Professional Advisory Committee (JPAC) is responsible for producing the Guidelines for the Blood Transfusion Services in the UK, often known as the Red Book (http://www.transfusionguidelines.org.uk/). In 2011 the UK Blood Services issued 2.1 million units of red cells, 300 000 platelet doses, 288 000 units of fresh frozen plasma and 126 000 units of cryoprecipitate.