4 Questions to ask before taking blood from a blood bank

Blood donations have saved millions of lives across the world. From trauma patients, to accident victims, pregnant mothers, anemic newborns, patients with blood disorders, and many more. However, blood transfusion is a delicate practice as any error will lead to serious complications. In Nigeria where patient’s relatives are some times involved in sourcing blood for transfusion, here are 4 important questions to ask at the blood bank.

1. The ABO and Rhesus type of blood. Blood transfusion has a rule of compatibility that must be followed to prevent blood transfusion complications. ABO and Rhesus D blood groups are the most important consideration for blood transfusion. There are 4 blood types based on the ABO grouping: A, B, O, and AB. It is named thus based on the antigens on the cells and antibodies in the plasma. The rhesus group has two types: Rhesus D positive and Rhesus D Negative blood types. Each of these blood types combine to give 8 blood groups: A+, A-, B+, B-, O+, O-, AB+, and AB-.

• A group cells have antigen A on their red cells and antibody B in the plasma.
• B group cells have antigen B on their red cells and antibody A in the plasma.
• AB group have both antigens on the cells and no antibody in the plasma.
• O group have no antigens on the cells but both antibodies (A and B), including anti A,B in the plasma.

The Rules

For blood transfusion, the major concerns are the antigens on the surface of the red blood cells of the donor and the antibodies in the plasma of the blood recipient. Hence the following rules are followed:

• O group blood can be given to everyone because there are no antigens on their blood cells that can participate in an immune reaction against any of the ABO blood antibody of the recipient. This is however dependent on the fact that the donor does not have high titer antibodies or hemolysins. They can, however, only receive blood from O group.
• The AB blood group can only be given to AB group because they have both antigens on their cells. However, they can receive blood from everyone because they do not have any antibody in the plasma that can mount an immune response against the donors blood cells.
• A group can receive A and O blood types
• B group can receive B and O blood types.
• Rhesus D positive individuals can receive both positive and negative rhesus D blood of compatible ABO group.
• Rhesus D negative individuals can only be transfused with rhesus D negative blood. Individuals who are rhesus D negative must not be transfused with rhesus D positive blood no matter the ABO compatibility except in life threatening conditions which should be followed up with anti D immunoglobulin administration especially for women of reproductive age.
• Plasma is donated specifically by AB blood type individuals because they do not have any ABO antibodies in their plasma.

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2. The compatibility test for other antigens. Apart from the ABO and rhesus typing of blood. There are other minor blood antigens that may result in blood transfusion complications hence proper compatibility testing that combines the donor’s blood cells and recipients plasma studied under various conditions must be done and done accurately.
3. The method used for testing for infectious diseases. Infectious diseases can be transmitted through blood transfusion. Therefore, blood donors are screened for infectious diseases such as HIV, hepatitis B and C, syphilis, malaria, etc. The method of screening is very important because some of the viral diseases have long incubation time. Screening methods approved by National Blood Transfusion Services (NBTS) are those that can detect the presence of the disease causing viral material when they are very very small in the body system. Such methods include ELISA and Nucleic acid tests. Rapid test methods are no longer approved.
4. The date of collection and expiration of the blood product. Blood for transfusion has to be viable enough to perform the function for which it is being transfused. Whole blood in a blood bag is viable for only 35days after donation. Expired blood should not be given to any patient to avoid complications.

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