Ethan Riley
Blood banks perform a variety of tests on donated blood to ensure its safety for transfusion. These tests include screening for infectious diseases, such as HIV, hepatitis, and cytomegalovirus (CMV), as well as testing for blood type and red cell antibodies. First-time donors are typically tested for the human T-cell lymphotropic virus (HTLV), and additional tests may be performed based on the donor's travel history or other risk factors. Blood banks also test donors' vital signs, including blood pressure, haemoglobin levels, and pulse, to ensure they are healthy enough to donate. These comprehensive testing protocols help minimise the risk of transmitting infections through blood transfusions, making the process safer for both donors and recipients.
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Blood type
Blood typing is a method to determine a person's blood type. Blood types include A, B, AB, and O. Blood typing is important for safe blood donation and transfusion, as it helps identify compatible blood types.
The standard method for blood typing involves two steps: forward typing and reverse typing. In forward typing, blood cells are mixed with antibodies against type A and B blood. If the blood cells react and stick together (agglutination), it indicates the presence of the corresponding antigen. For example, if agglutination occurs with anti-B antibodies, the blood type is determined to be A. Reverse typing is a cross-check that mixes the serum with known type A and type B blood cells to confirm the results.
At-home blood typing kits are available, typically requiring a finger prick to collect a blood sample on a special card. The blood is then observed for clumping or spreading, which is matched to a guide to determine the blood type. Alternatively, blood typing can be performed by a phlebotomist at a doctor's office, clinic, or hospital, where blood is drawn and sent for testing.
Knowing one's blood type can provide useful information about health and potential treatments. Additionally, it is essential for blood transfusion compatibility, as a mismatch between blood types can result in a severe immune response.
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Red cell antibodies
Red blood cells (RBCs) carry numerous protein and carbohydrate antigens on their surface. There are over 600 antigens, which are separated into 30 blood group systems. The presence or absence of these antigens in an individual determines their blood type. The main antigens found on red blood cells are A, B, and Rh Factor (also called D antigen).
Red blood cell antibody screening is a test used to identify the minor antibodies (non-ABO) in a person's serum or plasma. These antibodies can cause hemolytic transfusion reactions. Antibody screening is routinely used in conjunction with typing and crossmatch before the administration of blood products, especially RBCs, to avoid transfusion reactions and to prevent notably decreased survival of transfused RBCs.
The primary reason an individual may have RBC antibodies circulating in their blood is because they have been exposed, through blood transfusion or pregnancy, to RBCs other than their own (foreign RBCs). These antibodies can cause harm if the individual is transfused with red blood cells that the antibodies may target, or if a pregnant woman has antibodies that target the red cells of her developing baby.
During pregnancy, the test can show whether a woman has RBC antibodies that could attack the red blood cells of her fetus, causing a very serious type of fetal anemia. RBC antibodies that may cause problems in pregnancy include Rh and Kell antibodies.
Antibody screening is a critical step in transfusion medicine and prenatal care to prevent alloimmune complications by detecting antibodies against red cell antigens before transfusion or during pregnancy.
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Infections
Blood banks test for infectious diseases to ensure donated blood is safe for transfusion. The tests aim to identify any infections in the donor's blood that could be transmitted to the recipient. Here are some common infections that blood banks screen for:
Hepatitis:
- Hepatitis B virus (HBV) is commonly screened for using markers such as the Hepatitis B Surface Antigen (HBsAg) and Hepatitis B Core Antibody (anti-HBc).
- Hepatitis C virus (HCV) screening is also important, especially in countries where HCV is prevalent.
Human Immunodeficiency Virus (HIV):
Screening for HIV-1 and HIV-2 antigens and antibodies is crucial to prevent transmission through blood transfusions.
Zika Virus:
The Zika virus is a mosquito-borne infection that has been monitored and addressed by blood banks, especially in regions where it is more prevalent.
Parasitic Infections:
Chagas disease, caused by the parasite Trypanosoma cruzi, is screened for in blood donations, especially in Latin America where it is endemic.
Bacterial Contamination:
Bacterial contamination, particularly in platelet transfusions, is the most common infectious risk. It occurs in approximately 1 in 2,000 to 2,500 platelet transfusions.
Other Infections:
West Nile Virus, malaria, human cytomegalovirus (CMV), and prion diseases are also screened for, depending on local epidemiological evidence and the risk to specific recipient groups.
It's important to note that blood banks employ a range of screening assays and tests to detect these infections, and they continuously update their procedures to address emerging infectious diseases. The specific tests and markers used may vary based on regional guidelines and the availability of assays.
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Blood pressure
A blood pressure test measures how hard your blood is pushing against the walls of your arteries at two key moments: when your heart is pumping out blood and when it is at rest. This is why there are two numbers that make up your blood pressure reading. The first and higher number is the systolic blood pressure, which measures the pressure inside your arteries when your heart beats. The second and lower number is the diastolic blood pressure, which measures the pressure inside your artery when your heart rests between beats.
A blood pressure test can be carried out manually or with an automatic device. In a manual test, a healthcare provider will use a fabric cuff and a gauge that shows your blood pressure numbers. As the cuff inflates, you will feel it tighten around your arm, blocking the blood flow in that part of your arm for a short time. The provider will then open a valve on the cuff to slowly release air. As the pressure falls, a measurement is taken when the sound of blood pulsing is first heard (systolic pressure). As the air continues to be released, the blood pulsing sound will start to go away. When it completely stops, another measurement is taken (diastolic pressure). This test only takes about one minute to complete.
Automatic devices are similar to manual devices but do not require the use of a stethoscope or a gauge. Instead, the provider will check the device's digital read-out screen to see your blood pressure numbers.
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Haemoglobin levels
Haemoglobin (Hb) is an iron-rich protein found in red blood cells. It is responsible for carrying oxygen from the lungs to the rest of the body. A haemoglobin test is a blood test that measures the amount of haemoglobin in the blood. This test is often used to check for anaemia, a condition in which the body does not produce enough healthy red blood cells, resulting in a lack of oxygen in the body. Anaemia can cause symptoms such as tiredness, fatigue, weakness, dizziness, and shortness of breath.
It is important to note that abnormal haemoglobin levels do not always indicate a medical condition requiring treatment. However, if you have concerns about your haemoglobin levels, it is advisable to consult a healthcare professional. They will consider your symptoms, medical history, and the results of other blood tests to provide a comprehensive diagnosis.
To perform a haemoglobin test, a small blood sample is typically collected from a vein in the arm using a needle. This procedure is generally safe and carries minimal risks. The test can be used to monitor the treatment of anaemia or other health conditions that may impact haemoglobin levels.
Additionally, maintaining optimal haemoglobin levels can be supported by a healthy diet. Consuming foods rich in iron, such as vegetables, and vitamin C, found in fresh fruits and vegetables, can enhance iron absorption and improve haemoglobin levels. However, it is important to avoid drinking tea with or close to mealtimes as it may reduce iron absorption.
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Frequently asked questions
Blood banks test donors' blood for a variety of things, including:
- Blood type
- Haemoglobin levels
- Blood pressure
- Pulse
- Red cell antibodies
- Infectious diseases
The blood bank tests for a variety of infectious diseases, including:
- HIV
- HBV
- HCV
- HTLV
- Syphilis
- CMV
- Malaria
- Chagas disease
If you test positive for an infectious disease, the blood bank will notify you as soon as possible and provide you with counselling and support. The donation will be destroyed, and you may be contacted as part of a "lookback" process to identify and test anyone who may have received your blood.
