Blood transfusion is lifesaving. So is donating blood

Of the 60.14 million people living in South Africa, only 432 000 of them — 

less than 1% — are blood donors. In stark contrast, a blood transfusion takes place every 48 seconds and a minimum of 810 000 units of blood are required annually to meet demand. One unit of blood can save a minimum of three lives, but only lasts 42 days after donation. 

Blood transfusion is lifesaving. It goes without saying that blood donation is too.

The effect of the Covid-19 pandemic on hospitals has stretched blood supplies in the country and blood stocks are critically low. Although donors have been extremely generous during this time, there has been low donor turnout at South African National Blood Services (SANBS) mobile blood drives and donor centres because of restricted mobility during lockdown, among other challenges.

As we head into the festive season, it is inevitable there will be an increase in the demand for blood. We have extended our donor centre operating hours to give donors more time to make their donations. 

The ready availability of blood components is integral to implementing the medical and surgical treatment of acute and chronic diseases and critical for use when required in medical emergencies to increase patient safety.

The World Health Organisation (WHO) defines patient safety as a health care discipline that emerged with the evolving complexity in health care systems and the resulting rise of patient harm in health care facilities. It aims to prevent and reduce risks, errors and harm that occur to patients during the provision of health care. A cornerstone of the discipline is continuous improvement based on learning from errors and adverse events.

Sub-Saharan Africa has one of the highest incidences of postpartum haemorrhage and maternal death in the world. In South Africa, there is a misconception that most of the donated blood goes to accident victims, but the biggest percentage of blood stock goes to women experiencing obstetric complications. According to Statistics South Africa, the infant mortality rate for 2021 is estimated at 24.1 per 1 000 live births. Getting blood timeously to mothers in distress is critical. 

With 185 sites countrywide, SANBS’s infrastructure is extensive, particularly in the urban areas but it is difficult to get blood to hospitals in deeply rural areas.

In response to this challenge, our innovative partnership with Quantum-Systems for the use of the TRON Unmanned Aerial Vehicle (UAV) — a highly specialised drone used to transport blood from blood banks to hospitals in remote areas at a speed of between 160km to 180km an hour. The TRON, like a helicopter, is capable of vertical take-off and landing and can carry up to four units of blood a flight, keeping them at optimal temperatures and increasing the ability for patient safety across the country.

Patient safety is at the heart of blood transfusion — both the safety of blood products and the safety during the clinical transfusion process. 

Transfusion carries the risk of various adverse events including errors, transfusion reactions and transmission of infections, therefore patient and donor safety is critical to the work we do. 

According to the WHO, each year, 134 million adverse events occur in hospitals in low- and middle-income countries because of unsafe care, resulting in 2.6 million deaths.

The SANBS adheres to the WHO Clinical Transfusion Process and Patient Safety which encompasses a series of interconnected steps including the prescription and ordering of blood products; patient identification; collection and labelling of patient blood samples; pre-transfusion compatibility procedures and issuance of blood; collection and transportation of blood units within the hospital; handling of blood units in the clinical area; blood administration; monitoring of patients; and management of adverse transfusion events.

Through our various divisions, we continuously strive to mitigate risk factors affecting blood supply, from medical to legal and ethical. We optimise medical and surgical patient outcomes by advocating appropriate and safe blood utilisation through Patient Blood Management, which focuses on managing haematological threats for surgical patients which include anaemia, haemorrhage and transfusion.

The complete blood value chain’s focus is on improving a patient’s health and survival — from donation to transfusion.

Continuous innovation ensures our blood supply remains among the safest in the world, employing sensitive and rigorous world class testing technology and collection protocols.

Our focus on innovative information technology is key for us in improving collection, planning, tracking and inventory management — functions that are crucial to the sustainable supply of safe blood and by-products. We invest in the latest technology, which allows us to achieve the level of excellence and service provided by leading global blood transfusion services.

Our recently launched 7500m² state-of-the-art laboratory in Mount Edgecombe, KwaZulu-Natal houses our centralised area where molecular-based processes are optimised and developed. We believe we are well on our way to being an internationally recognised research unit known for innovation and collaboration. In terms of sustainability, the facility contributes to our vision of greening the SANBS in line with the United Nations sustainable development goals.

The SANBS’s training, education and advisory services focus on supporting the blood ecosystem through training of healthcare professionals, development of educational materials and designing digital platforms that provide external stakeholders access to training material. In response to Covid-19 restrictions, the division initiated a programme to put routers in blood banks to provide virtual training to doctors and nurses during lockdown.

Our quality assurance department ensures that all blood, blood components processed, and activities carried out by the SANBS meet required specifications and comply with the required standards. This is achieved through a system by which products are tested while they are being manufactured, and at the end of processing. 

The molecular research and development section provides support to the specialised laboratory services department, by researching and developing current technologies and keeping abreast of new advances in technology. A major part of molecular research and development is the evaluation of new reagents/techniques and platforms including next generation sequencing suitable for the South African environment. 

The country’s health system is burdened by the weight of diabetes, cancer and cardiovascular conditions, violence-related injury and communicable diseases such as HIV and Covid-19. The management of many of these diseases includes the use of blood and blood products, while future management will also involve novel cellular therapy. 

Our purpose is to save lives and enhance human healthcare. As we navigate the road to the future of blood transfusion, we continue to appeal to members of the public to donate blood and help the realisation of the third UN sustainable development goal, which seeks to ensure health and well-being for all.

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Petro-Lize Wessels
Dr Petro-Lize Wessels is the lead consultant of patient blood management at the South African National Blood Services

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