PIMS severely short of voluntary blood donors

Islamabad : Voluntary blood donations in the Pakistan Institute of Medical Sciences (PIMS), the capital city’s premier government hospital, have fallen short of need.

According to the relevant officials, the PIMS Blood Bank needs around 125 donations every day to meet the patients’ transfusion needs but as there is a severe shortage of voluntary blood donors, the families are convinced to provide donors from within to ensure the supply of blood from the bank to their patients on ‘replacement basis’.

However, there is a problem. Not only is collecting blood from family members or friends, especially when they are undergoing a stressful situation of caring for their indisposed patients, ‘not very ethical’ but the family donors are not considered to be the most suitable as well. According to the World Health Organisation, the ‘family replacement donors’ are not the safest donors as they can conceal certain facts rendering them ineligible for blood donation.

In such situations, an element of coercion is also involved as their patients are unlikely to get blood transfusion if blood donors are not provided by the families. In addition, the family donors are invariably first and one-time donors.

The best and safest category of blood donors is the regular voluntary blood donors, who give blood of their free will and without any reward or benefit to save or improve the lives of anonymous patients. Such blood donors are considered to be the safest donors by the WHO. The officials say in developed countries with advanced healthcare and blood transfusion systems, things depend on a small pool of 1-3 per cent national population of regular voluntary blood donors, who give blood three to four times a year.

These regular blood donors go through the three tier process of suitability evaluation after which their donated blood is utilised for transfusion to the patients. The first step of evaluation of a blood donor consists of clearing a list of small questions designed to determine the presence of any risk factors in the blood donor, which may render his or her blood harmful for the transfusion recipient.

These questions also determine the possibility of any harm to the donor’s health. The second step of evaluation of the blood donor comprises a brief physical examination which includes recording the donor’s weight, pulse, blood pressure, temperature, haemoglobin estimation etc. to check the fitness of the donor to donate blood.

After these two steps are carried out, the blood collection procedure is performed.

The third step i.e. serological screening of the blood for the presence of certain transfusion transmissible infections like HIV, hepatitis B and C virus and malaria and syphilis is performed after blood collection.

If the donated blood is free of infections, only then the donated blood is used to saving the lives of patients.

In any proper blood bank, at least three different blood components are prepared from one unit of donated blood; red cell concentrates, fresh frozen plasma and platelet concentrates. In other words, from one act of blood donation, the lives of three different patients can be saved. As for the PIMS Blood Bank, the donated blood is processed into three blood components and the blood screening is performed on modern equipment using very sensitive assays.

Insisting that the workforce is well trained and experienced and the hospital’s blood bank has a donor friendly environment, head of the PIMS Blood Transfusion Services Prof Hasan Abbas Zaheer told ‘The News’ that the blood safety standards could be further improved if the blood donors belonged to the safest category i.e. regular voluntary non-remunerated ones.

According to him, it has been observed that in times of natural or man-made calamities large segment of the population throng to the blood banks to donate blood and save the lives of those in need. On such occasions, it often becomes difficult to manage the huge workload. However, these acts of sporadic altruism clearly demonstrate that the spirit of voluntary blood donation exists in the society but in the absence of a structured system the potential remains untapped.

Prof Hasan said though the PIMS Blood Bank organised mobile blood camps in collaboration with university or college based blood donor organisations, such moves was a very labour intensive activity and was not a very sustainable option in resource constraint settings. In any case, the camp if managed according to the recommended guidelines and practicing safety standards can at best yield 50-60 donations a day.

On the other hand, the daily need of a tertiary care hospital blood bank is between 100-150 blood donations. In the opinion of the PIMS Blood Bank head, blood camps are not the ideal solution.

“We have to have a situation where we have adequate number of walk-in blood donors in our blood banks every day. And these voluntary donors need to be taken good care of and a donor friendly experience ensured to motivate them to repeat their noble act regularly in addition to serving as a source of inspiration for other potential donor,” he said.