To give blood to save others — not only about soldiers
A rundown on donation by State Duma deputy, doctor Boris Mendelevich
Donation is voluntarily giving a part of blood, its components, other tissues or organs for treatment. Blood donation is more widespread and simpler. Donors’ blood is always necessary: for patients with haemophilia, cancer, those who got injured in serious road accidents and catastrophes, people after invasive surgery. In a word, there are enough cases when it is vital. According to statistics, one in three residents of Earth have needed blood transfusion at least once. Here is another column of Boris Mendelevich about the social institution of donation and its development.
Donation and laws
According to the WHO, the national blood stock in 62 countries a hundred per cent or almost a hundred per cent consists of voluntary blood donation that is no paid. Such donors don’t receive money for giving blood.
By the way, according to our country’s laws (No. 160 of Federal Law), human organs and tissues can’t be an object of sale and purchase, and such an act is a reason for criminal persecution. As a rule, organisers in different parts of the world usually give donors souvenirs and provide some snacks as incentive.
In Russia, in accordance with Article 186 of the Labour Code of Russia, a donor may not work on the day he donates blood or its components and does a medical check-up regardless of the form of ownership with the average wage for these days. If according to an agreement with the management the donor anyway goes to work after giving blood, he may choose another day off. Such a choice is permitted only if the work doesn’t include harmful and hazardous working conditions. And the blood service, in turn, provides the donor with free meal or compensation for lunch.
Who can become a donor?
In Russia, the number of donors increases every year and now totals around 2 million people. It turns out that 14-15 in 1,000 people are donors. But, according to the WHO, to meet blood demand, the amount should double, since 1,5 million people on the globe need transfusion every day.
In general, anybody above 18 who weighs more than 50 kg and doesn’t have temporary or permanent contraindications can become a donor. The temporary bans include tattooing, piercing or acupuncture (120 calendar days), tonsillitis, the flu, viral respiratory infections (30 calendar days after recovery), pregnancy and breastfeeding (a year after giving birth, 90 days after stopping breastfeeding), vaccines, alcohol intake (48 hours).
Permanent bans: infectious diseases, malignant tumour, diseases of the central nervous system, diseases of the blood system, haematopoietic organs and some disorders engaging immunity, mental disorders and behavioural disorders in the acute phase and (or) posing threat to the patient and people around, etc. It is considered that men can give blood five times a year, women can — four times.
Myths about donation
One can contract infectious diseases during donation.
Any donation is a medical procedure that is carried out in compliance with strict rules, including sanitary rules: all donation venues in Russia are provided with disposable, sterile equipment, personal systems. Health workers open disposable syringes and needles only in presence of the donor. You can make sure of this yourself. They are disposed of after being used.
No point in donating widespread blood type.
Here is casuistry. The prevalence means both a big number of donors and a big number of recipients, people who need this blood type. So even if you have the most widespread blood type and you want to share it, go to a donation venue without hesitation.
I do not give blood now, but if needed, I will up and donate blood several times.
It isn’t that simple. The shortest period between donations is 60 days, that’s to say, blood can be given once in two months, but there are restrictions too: four times a year for women and five times for men. In case blood components are donated, the interval between donations reduces to 14 days for plasma and platelet but no more than 20 plasma donations and no more than 10 platelet donations.
It is harmful to give blood
No. The organism recovers plasma after donation in some 10 days and whole blood in a month. It is thought that the organism of permanent donors is more resistant to bleeding due to regular donations.
I have decided to give blood. Where to go?
Firstly, it is necessary to find you the state of your health and learn if there aren’t contraindications. Secondly, find the closest blood transfusion centre and ask when you should come.
It is recommended to have light breakfast before you give blood, for instance, porridge cooked in water and a cup of tea with sugar. Then take your passport and go through necessary procedures.
Whole blood donation on average takes 10-15 minutes, plasma does 40 minutes, platelet collection — around 90 minutes. It is recommended to sit for 10-15 minutes after the procedure to recover, not to take off the bandage for 3-4 hours and avoid physical exercise on this day.
Organ donation: problems and prospects
Besides blood donation, there is organ and bone marrow donation. To become a bone marrow donor, people aged 18-45 without chronic diseases should do a blood typing test and join the register of bone marrow donors. Then the blood is examined and added to the general database. I will note that now Russia doesn’t have a general database for donors. Every bank, for instance, that of Rusfond, counts its donors itself. In cases when a patient needs a donor, his HLA genotype is compared with the data of potential donors who are in the registry. According to statistics, the probability of becoming a real donor doesn’t surpass 1%. So if there is a chance of saving a person’s life, the suitable donor is invited and withdrawn bone marrow. The procedure is painless and quite invasive, so one should get ready for unpleasant feelings. Open data suggests that more than 5,000 Russians annually need bone marrow transplantation.
As for the donation of organs, there are a lot of questions here. So according to Article 8 of Law On Transplantation of Human Organs and (or) Tissues, a corpse may not be removed organs and (or) tissues if the health establishment was informed that when this person was alive or his close relatives or a legal representative expressed their disagreement about having his organs and (or) tissues removed after death for a recipient’s transplantation. At the same time, in some cases when a recipient needs a specific organ and in the absence of a written refusal of the donor, it is decided to remove the organ.
However, the donor’s relatives learn about this soon and claim that when he was alive he was against donation. And according to law On Burial and Funeral Affairs, they have the right to this. In the end, the recipient doesn’t receive a chance to live, while doctors turn out to be captives of a legal collision.
- I think it is necessary to improve the existing law by adding a section about donation service, particularly, by specifying what exactly should be considered as voluntary consent to donation. For instance, it can be a legal namesake document.
- Secondly, it is necessary to understand who should store this consent and where, that’s to say, to whom the health establishment should turn in case it has a potential donor. For instance, in some countries, it is a health insurance company.
- Thirdly, it is important to create documents regulating health workers’ activity and raise ethical issues.
- Fourthly, it is necessary to scrupulously study the existing norms and understand why they don’t work. I think we should start here.
- Generally speaking, we should understand that donation as well as everything in medicine is about saving people’s lives. And it is important for the Ministry of Health, patients and the doctor’s community to pull together and work to make this idea popular. Because donor’s good will in the end turn into saved lives, and we should talk about it.