For the first time ever, June 14 of this year has been designated by the World Health Organization (WHO) as the first World Blood Donor Day. Globally, regular, voluntary, non-remunerated donors are being acknowledged and honored. This type of blood donor is considered the best type according to the WHO as they ensure sufficient, effective and safe influx of blood to much needing patients. Till our present day, there is no substitute for blood, making it imperative to organize such an event annually in order to encourage and bring to focus how precious these donors are.

The National Blood Transfusion Centre [NBTC] in Egypt divides donors into 4 main categories namely:

Paid /professional donor: considered as the worst type of donor as they are usually a high risk for transfusion transmissible diseases e.g. AIDS. This donor is paid for giving blood.

Family/replacement donor: these are donors that donate blood only to a family member or in replacement of a blood unit issued to a family member.

Voluntary non-remunerated donor: here the donor gives his blood of his own free will with the sole intention of helping a patient. He expects no reward for his service.

Obliged donors: this donor is compelled to give blood in return for a certain service. For example, to acquire an ID card or drivers' license.

The following table shows different percentages of donors in both developed and under-developed countries.

Most donors believe that a single unit of blood will be valuable only to a single patient. This is not the case. With the advancement of medicine and technology, we are now able to process blood. A single blood unit can be separated into three or four components and each component can be given to a different patient according to his/her medical condition.

The main components of blood are:

Packed red blood cells [PRBCs]: used mainly for correcting both hereditary and non-hereditary types of anemia.

Plasma: an important component of blood that replaces the lost proteins and coagulation factors in patients.

Platelets: this component helps to prevent bleeding tendency and its lack leads to spontaneous hemorrhage.

Whole blood: is rarely used now with advances in transfusion medicine. However, it can be used in cases of severe hemorrhage in order to maintain the blood volume.

Invariably, blood or its components are needed by all age groups including intra uterine neonates. Intra-uterine transfusion is indicated in cases of baby/mother mismatched blood groups.

There are patients who cannot survive without blood and need blood [or its components] to exist. These are transfusion dependent patients. For the most part, they have a hereditary disease that causes the lack or dysfunction of blood or its components. A famous example is thalassemia, which is a chronic form of anemia. It is most common in the Mediterranean region.

Major surgeries such as open heart and transplantation surgeries can never be performed without blood. An average of 4-5 units of blood is needed for each operation.

Cancer patients taking chemotherapy must be regularly transfused with most of the components of blood, specifically platelets.

Organ failure, e.g. liver and kidney failure, also requires regular transfusion.

Providing blood in emergencies such as in road accidents and maternal hemorrhages can be life saving.

We are all aware of whole blood donations where a donor is bled into a plastic bag. This is the most common type of donation worldwide. After collection, the blood unit is later processed into its components.

With the advancement of technology, aphaeresis machines have been developed. These machines are able to extract a certain component of blood in large volumes. Twelve units of platelets can be retrieved from a single donor using this machine. Transfusion-dependent patients are the most to benefit from this type of donation. These patients are less liable to form antibodies against platelets when infused with large volumes from a single donor in a single sitting. This substantially increases the numbers of effective transfusions the patient can receive during his life.

The discovery of AIDS in the 1980s has caused a revolution in screening tests in blood banks. Very sensitive techniques and equipment have been developed in order to detect the minimal amount of infection present.

Infectious agents transmitted through blood can be viruses such as HIV, hepatitis C virus (HCV), cytomegalovirus; parasites such as malaria and leishmania; and bacteria such as Treponema pallidum (the causative organism of syphilis). All these infective agents made it mandatory to develop screening tests, especially as some of them result in incurable diseases that may eventually lead to death.

In Egypt, for example, blood is tested for four main parameters, namely, HIV, HCV, hepatitis B virus (HBV) and syphilis. These parameters are the minimum as recommended by the WHO. Extra parameters may be tested according to the prevalence of diseases in a certain country as well as its economical status.

But despite such thorough measures and sensitive techniques, detection of infection may be missed, particularly during early stages of the disease; what is known as the incubation period of infection. This explains why some blood units may transmit AIDS, for example, even though the screening tests proved negative to the disease.

Donor selection assists to some extent in overcoming the problem of missed infections. Here, we try to choose a donor with minimal risk TTIs. This is achieved by allowing the donor to answer some very vital questions about his medical history. With such questions, the donor could be either temporarily deferred as in cases of influenza or a common cold attack, or permanently deferred as in cases of hepatitis B or C infection. Donor selection is very crucial in transfusion medicine. Nowadays, donation doctors call for auto deferral. The donor is given a brochure with some medical information to allow him the confidentiality as well as opportunity to defer himself.

Giving blood, although a short and simple process, has been a source of apprehension for many of us. I recall the first time I gave blood and how terrified I was of the needle. Alhamdulillah, the process went without a hitch and I survived! I am now enlisted on the regular blood donor list of aphaeresis.