blood donation
As blood is called the voluntary surrender a certain amount of blood . The blood is then examined, processed and used for medical , scientific and pharmaceutical purposes. The amount withdrawn is usually half a liter.
Types of blood donation
- The most common blood donation is whole blood donation , in which around 500 ml of blood are taken from a vein , usually in the crook of the elbow. The donated blood is preserved (preserved), examined and then, if appropriate, separated into various blood products . These are stored in a blood bank .
- A special form of whole blood donation is autologous blood donation . Blood is given up to four times in a period of two to six weeks before an operation, which is then used to compensate for any blood loss during (or after) the operation. Since it is your own blood, it is optimally tolerated.
- In addition to taking whole blood, it is also possible to only use individual blood components - such as B. erythrocytes (red blood cells), thrombocytes (blood platelets), blood plasma (see plasma donation ) or even stem cells - can be obtained from the blood. The blood components that are not required are returned to the body. The apheresis procedure ( plasmapheresis , stem cell apheresis ) is sometimes used for this.
The donation time, which depends on various factors, is 20–240 minutes, while a whole blood donation only takes about five to ten minutes.
Involved
Donor
basic requirements
Anyone who is at least 18 years old is allowed to donate blood, provided there are no health concerns and if the person has a minimum Hb value .
While donations are only allowed up to the age of 75 in Switzerland, the upper age limit has been lifted in Austria since June 2008. In Germany, there has also been no fixed upper limit for repeat donors since May 2009, but from the age of 72, a decision is made individually on the suitability for blood donation based on the state of health. The upper limit for first-time donors has been increased to 68 years. For the age limits according to the 2017 total amendment to the haemotherapy guidelines, see section Germany .
In Austria, Germany and Switzerland, a minimum body weight of 50 kg applies to all donors.
Frequency of donation
A rest period of three months is usually recommended between two blood donations. In Germany and Austria, according to the hemotherapy guidelines and the Blood Safety Act, the minimum interval between two whole blood donations is 56 days (eight weeks). Women are only allowed to donate four times a year and men a total of six times. In Switzerland, women are allowed to donate three times and men four times a year at an interval of at least twelve weeks (in the canton of Bern a minimum of 76 days applies).
Grounds for exclusion
Depending on the risk situation, a distinction is made between permanent and temporary reasons for exclusion. For example, the following are problematic:
- Due to the increased risk of transmission of diseases such as HIV or hepatitis C :
- Tattoos and piercings within the last four months
- promiscuity
- Intravenous drug addiction such as B. Heroin
- Due to the regional accumulation of certain diseases:
- Stay in the tropics within the last six months ( tropical diseases ).
- Stayed in Great Britain between 1980 and 1996 for more than six months, or someone who had one or more operations and / or transfusions in the United Kingdom of Great Britain / Northern Ireland after January 1, 1980. These measures are intended to rule out a theoretically possible transmission of Creutzfeldt-Jakob disease through transfusions.
- There are also changing temporary restrictions when traveling abroad, for example in areas polluted by the Asian tiger mosquito .
Donors who are temporarily ill or are on sick leave, who are taking certain medications, who belong to groups with certain (potential) health problems, who have temporary iron deficiency or who have false alarms ("false alarms") when testing the blood for pathogens are also temporarily deferred . gave so-called false positives .
In Germany, since August 7, 2017, men who have sex with men have been excluded from donating blood if they have had sex within the last twelve months. Six of the 28 EU countries only look at the risk behavior of the donor and treat men who have sex with men in the same way as men who have sex with women. These countries are Bulgaria, Italy, Latvia, Poland, Portugal and Spain.
Regardless of any risk behavior, men who have sex with men are excluded from donating blood in Austria and Switzerland. This practice of blood donation services is criticized in particular by interest groups of homosexuals, but also from an academic perspective, as it is perceived as discriminatory. This practice is also increasingly coming under fire outside of the German-speaking countries and has been abolished in some countries. For example, in Great Britain and Belgium, on the condition that the donor has not had sexual intercourse in the past twelve months.
This group of people is still excluded (as of April 2012), for example in the USA, Canada, Denmark, Finland, France, Greece, Hungary, Ireland, Luxembourg, Malta, the Netherlands, Norway and Slovenia. In contrast, New Zealand, Great Britain, Australia, Sweden and South Africa postpone donations for one to ten years after their last sexual contact with men. Since 2000, Spain has been deferring potential donors six months after having sex with a new partner, regardless of the combination of the sexes. A similar regulation has been in place in Italy since 2001 with a four-month reserve. In Estonia, Latvia and the Czech Republic there is also no permanent exclusion after sex between men. The joint working group made up of representatives of the “Blood Working Group according to § 24 TFG” and the standing working group “Guidelines for Haemotherapy according to §§ 12a and 18 TFG” of the Scientific Advisory Board of the German Medical Association “Exclusion from blood donation of persons with sexual risk behavior” comes to the recommendation in 2013 instead of the to introduce a one-year deferral of donors after high-risk behavior (sex between men, sex work) in the event of permanent exclusion.
Confidential self-control
Each donor must state in confidence whether his blood can be administered to patients or whether it should be excluded from administration to patients, e.g. B. by ticking a piece of paper or attaching a barcode sticker. Even if he excluded his blood before the donation, blood will still be drawn from him. This is to ensure that people who go together in groups (e.g. boy scouts ) to donate blood do not have to reveal their affiliation to a risk group to their comrades.
This procedure is designed to provide the best possible protection for recipients of blood donations. A dilemma between the recipient's need for security, which is also dependent on the honesty of the donor, and the donor's need for confidentiality is to be avoided.
Share of donors in the population
The German Red Cross says in its donation campaign:
“In total, only 3% of the population donate blood at the moment. That is not enough to adequately care for 100% of patients in Germany. We need around 6% of the population as regular permanent donors if the supply of blood preparations is to be adequately secured in the long term. "
The proportion of blood donors fluctuates strongly from region to region, despite the fundamentally high level of interest served by popular science magazines. In Bavaria, for example, according to the annual report of the Bavarian Red Cross 2017, the willingness to donate is significantly higher in rural areas than in metropolitan areas and shows its extremes in the Haßberge district in Lower Franconia with 12.75% and in Nuremberg , Dachau and Munich with around one percent.
receiver
In the case of a transfusion , the recipient is usually given blood components (rarely whole blood ), which mix with the remaining blood. To avoid clumping of the blood ( transfusion incident ), the recipient i. d. Usually only blood of the own blood group is transfused. If necessary, however, red cell concentrates from a donor with blood group 0− ( universal donor ) can be transfused to each recipient . In an emergency, people with blood group AB + can receive red cell concentrates from any donor (universal recipient).
Blood donation organizations (in Germany and Austria)
Blood donation services
In larger cities there are private and municipal blood donation services organized by the clinics . Many clinics have a blood bank where plasma or partial blood can be donated for a fee . This blood is collected to cover our own hospital needs.
Red Cross
In Austria and Germany , a large part of the blood donation service is organized by the Austrian Red Cross and the German Red Cross , respectively . According to the findings of the higher federal authority for the supervision of the blood donation system in Germany ( Paul Ehrlich Institute , § 27 Abs. 1 Transfusionsgesetz), the blood donation services of the German Red Cross provide more than 70% of the whole blood donations. The Austrian Red Cross accounts for 95% of the blood application.
Whole blood donations are generally free of charge. In Germany, the Red Cross conducts around 130 donation appointments every day with mobile teams (i.e. around 15,000 whole blood donations), both in cities and in rural regions. In addition, blood donations are also carried out in companies, public institutions, etc. In cooperation with the blood donation service of the German Armed Forces, blood donation campaigns are carried out by the German Red Cross in institutions of the German Armed Forces. In addition, the blood donation services also have buses to enable blood donation appointments, for example in the context of events. In addition to the opportunity to donate blood at the blood donation service, there are also permanent facilities in exposed locations.
The six blood donation services of the DRK are non-profit limited companies .
| DRK Blood Donation Service (BSD) | Regional associations |
|---|---|
| Northeast | Berlin, Brandenburg, Hamburg, Saxony and Schleswig-Holstein |
| Mecklenburg-Western Pomerania | Mecklenburg-Western Pomerania |
| NSTOB | Lower Saxony, Saxony-Anhalt, Thuringia, Oldenburg and Bremen |
| west | North Rhine, Westphalia-Lippe, Rhineland-Palatinate and Saarland |
| Baden-Württemberg - Hesse | Baden , Baden-Württemberg and Hesse |
| BSD of the Bavarian Red Cross | Bavaria |
You can also donate your own blood at many Red Cross blood donation services.
In Germany, the German Red Cross awards blood donors repeatedly with the blood donor badge of honor at certain intervals . A corresponding award in Austria is the medal for services to blood donation of the Austrian Red Cross .
- New blood donation card from the German Red Cross
At the beginning of 2012, the German Red Cross began to introduce a new blood donation card with the aim of simplifying and standardizing blood donation within the various DRK blood donation services. In particular, the new donor card enables problem-free donations to other than the issuing DRK blood donation service (for example on vacation or while traveling).
The new ID card has an RFID chip that can be read by the DRK blood donation services and on which the following donor data is stored:
- Surname
- First name
- Name at birth (if different from the name)
- Date of birth
- prefixed title
- name suffix
- Home address (street, house number, zip code, city)
- Donor number of the issuing blood donation service
- Blood group with rhesus factor
In the case of donations to other than the issuing DRK blood donation service, the following data is also stored on the ID:
- the donor number at the regional DRK blood service (s) where the donation was made
- the number and date of the last blood donation (s) made there
- a total of all blood donations made so far
However, there is no obligation for donors to have their blood donation card with them when donating.
- Variants of DRK blood donation cards from the Blood Donation Service East in bronze and the Blood Donation Service Baden-Württemberg and Hesse in silver and gold as an award for high numbers of donations
25 to 49 blood donations (bronze)
50 to 99 blood donations (silver)
100 or more blood donations (gold)
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State-municipal and university blood donation services (StKB)
75 state-municipal and university blood donation services, including 31 university institutions, are integrated both locally and organizationally in public hospitals. An essential core of the StKB is a strictly demand-oriented production of blood and blood products combined with a rational, demand-oriented therapy with blood components in the sense of optimal patient care.
The efficiency of clinic-integrated blood donation services depends crucially on a registered base of reliable long-term blood donors who have declared their willingness to be contacted by telephone if necessary and to be available to donate in the shortest possible time. The donors are typed with regard to all relevant antigens (rare blood group characteristics, HLA, thrombocytes) and are available practically at all times, a fact that is of decisive importance in emergencies, disasters or other bottlenecks. The essential core of the organizational structure of the clinic-integrated blood donation facilities (StKB) is the direct coupling of the manufacture of blood and blood products with patient-related needs-based care: manufacture, pre-transfusion diagnostics and transfusion medical advice for clinicians are carried out by the same specialist staff in 24-hour service operations. In addition to rational, needs-based hemotherapy with blood products in the sense of optimal patient care, this also includes the possibility of flexible response to emergencies and bottlenecks, the prevention of foreseeable bottlenecks and the minimization of the expiry rate of blood reserves, which in many hospitals without their own blood donation facility can sometimes be as high as 20 Achieve% and more.
Every year the clinic-integrated state-communal blood donation services (StKB) take approx. 1,400,000 blood donations from over 450,000 blood donors, of which 950,000 whole blood donations, 300,000 plasma donations (using machine apheresis) and 150,000 thrombocyte donations (using machine apheresis). Approx. 2,500,000 blood components are produced from this and made available as 950,000 red cell concentrates, 345,000 platelet concentrates and 150,000 liters of fresh frozen plasma for therapeutic use in patients. The clinic-integrated state-communal blood donation services have supplied 220,000 liters of source plasma for the pharmaceutical production of special preparations.
Another important focus of the clinic-integrated transfusion medicine facilities are regular transfusion medicine-haemostaseological consultation activities, the implementation of autologous blood donations, extracorporeal photopheresis, therapeutic hematheresis, such as leukapheresis, plasmapheresis or thrombocytheresis, as well as the extraction of peripheral blood stem cells for stem cell transplantation in hematological diseases. In accordance with its origins, transfusion medicine has close connections with a number of clinical specialist disciplines, so that tasks can be tackled together and many clinical questions can also be solved by a well-functioning, also hemostaseological, consultation activity, if the specialist disciplines see each other as supplements and through mutual suggestions, deepen the traditional and good cooperation that already exists in many places.
Blood donation service of the Bundeswehr
The blood donation service of the German Armed Forces is Department XXII of the German Armed Forces Central Hospital in Koblenz in the Rheinkaserne property. Erected in 1962, it is on the move within a radius of approx. 200 km around Koblenz on the premises of the Bundeswehr and carries out blood donation appointments there. In addition, there is a stationary hematheresis for the extraction of 2 red blood cell concentrates per donation in the premises of the BSDBw. The primary task is to supply the deployment and field hospitals of the Bundeswehr's foreign missions . The Bundeswehr hospitals are supplied with second priority . All other canned goods are given to clinics and transfusion practices for a fee as part of the national blood supply. The armed forces blood donation service awards soldiers and civil employees who have donated blood voluntarily and free of charge with a blood donation badge and a certificate.
Independent Blood Donation Services (VUBD)
The blood donation system in Germany rests on three pillars. In addition to the five major blood donation services of the DRK and the state-communal blood donation services (StKB), there are also independent, private blood donation services in the Federal Republic. These are in the Association of Independent Blood Donation Services e. V. (VUBD) organized. With around 1.2 million donations in 2014 and 35 blood and plasma donation centers in Germany, the Leipzig blood donation service Haema is the largest among the independents.
Hospitals
Hospitals have also been organizing their own blood donation services since the 1930s (for example under the surgeon Paul Clairmont in Zurich or Ernst Unger in Berlin). They already have the necessary laboratory equipment, need blood donations themselves and can sell more to the pharmaceutical industry.
Pharmaceutical company
Some pharmaceutical companies also offer blood donation services that use the blood for pharmaceutical purposes. Because although today many drugs can be produced synthetically, this is forbidden for some active ingredients. One main reason is the chirality of some drugs. These can appear in nature in two forms (left-handed or right-handed). But only one form is effective in humans. In the best case, the other form is ineffective, in the worst case this other form is toxic. Since synthetic processes produce both forms in equal parts and these are chemically difficult to separate, natural occurrences must be used for these substances, e.g. B. blood or plasma donations. Organ donations are not included.
GDR district institute for blood donation and transfusion
In the 1980s, the GDR also sold blood that had been extorted from prisoners for foreign currency to the Bavarian Red Cross. The blood was sold to the Swiss branch of Ortho Diagnostic Systems through the central export office at the GDR Ministry of Health. The city of Karlsruhe and the Duisburg blood donation center were also customers for the erythrocytes and plasma. The historian Tobias Wunschik examined this in his study published in 2014 entitled “Prison for the Class Enemy. Prisoner Work in the GDR, East-West Trade and State Security (1970–1989) ”. The GDR had part of the exported plasma processed into human albumin in the West, in order to then re-import it. According to the medical historian Rainer Erices , in August 1985 the GDR delivered 41 blood products infected with HIV to the West, which were discovered in Switzerland at the time. At that time, HIV testing was not yet standard.
The GDR tried to keep blood sales secret from other donations to the West. GDR citizens donating blood did not know that their donations were being sold to the West for foreign currency.
procedure
Blood collection
It is important for the donor to have sufficient fluid intake before and after the donation: Around 1.5 liters of fluid should have been drunk during the day before the blood donation. You should also have eaten a little something in the last two to three hours. The last meal shouldn't have been longer. However, the day before the donation you should avoid eating high-fat foods if possible.
Before the donation, the donor is examined for health. In some cases, a questionnaire that provides information about your last health status, such as operations or medication intake, has to be completed. Stays in areas presenting certain health risks must be indicated. There are also questions about sexual behavior and imprisonment. Blood pressure and pulse rate are examined, the temperature in the ear is measured, and questions are asked about complaints and illnesses. Before each donation, the hemoglobin (HB) value is tested by taking a drop of blood from the fingertip or the earlobe. This value provides information about the ability of the blood to transport oxygen and its level is decisive for admission to blood donation: men must have a minimum value of 13.5 g / dl, women a minimum value of 12.5 g / dl To be approved by a donor doctor. The HB value is determined using an electronically measuring HB photometer . If the iron value is too low, the donor will be refused for his own safety and, if necessary, advised on how the low HB value can be brought to a higher level by the next blood donation date. In this context, iron supplements are often recommended, which must be taken for a few weeks.
If the donor is approved to donate after the medical check-ups, the blood collection set is prepared first. It is made entirely of disposable material. For this reason, it is not possible to become infected with HIV or hepatitis when donating blood. The dispenser sits on a couch in the supine position and the needle is inserted into the elbow of the right or left arm, depending on your needs and vein suitability. First some blood samples are filled separately for examinations and the whole blood is collected in a collection bag. This type of blood donation usually takes between five and ten minutes.
After the blood donation, the body must first adjust to the loss of blood, so a rest phase of around ten minutes should be observed. Depending on the number of donors, this happens on the removal bed or on specially provided relaxation beds. After the donation, the blood donation service often offers a small snack, usually consisting of sandwiches, fruit, water, cola and coffee. Adequate hydration after donation is particularly important. The volume deficit (in contrast to the concentration of blood cells) is compensated by the fluid within a few hours.
The collected blood is tested for the most important pathogens , such as HIV (using an RT-PCR test ), hepatitis B , hepatitis C and syphilis . From October 2019, tests for hepatitis E will be mandatory in Germany , a virus that is usually only dangerous for immunocompromised patients and with which around 16% of the German population has been infected at one point in their life. Despite this examination, there is no absolute certainty that pathogen-free blood products will be found , because many pathogens can only be detected in the blood after a latency period. However, the risk of becoming infected with HIV through a blood transfusion is extremely low (<1: 4,300,000), thanks to the latest test options and NAT , which can be used to detect the genetic material of the virus in the early stages of an infection.
Regeneration of the donated blood
The blood loss due to a blood donation is compensated for after the collection in the following order:
- Circulatory regulation within 20 minutes
- Fluid balance within 24 hours
- Plasma protein replacement within two days
- Replacement of blood cells within two weeks
- Compensation for iron loss within eight weeks, longer for women.
Health risks in donating blood
Due to the disposable cutlery used, there is no significant risk of infection from the blood donation itself.
Only about ten percent of the existing blood cells are removed, which does not represent any relevant blood loss. A healthy body can easily compensate for this loss of blood, especially since the suitability for donation is determined based on the hemoglobin value before the donation . Exceptions, however, can create dangerous complications. During the donation, doctors monitor the donor and can cancel the donation in the event of a problem, for example if a shock sets in .
Due to the loss of fluid, there is an acute risk of circulatory problems during and immediately after the donation. Therefore, the donation is sufficiently extended in time by limiting the blood flow and after the donation a rest phase is inserted to allow the inflow of cell water into the bloodstream, which leads to a balance of the pressure conditions and prevents hypotension. Complete regeneration of the fluid loss usually takes one to two hours. As a precaution, you should protect your body for a few days after the donation, as it also has to build up the missing blood cells.
A bruise at the puncture site is comparatively common . In rare cases, nerve irritation occurs. Although the risk is low that a nerve injury will result in trauma to the medial cutaneous nerve during a blood donation , the donor must also be informed about this rare risk. If the information is not provided, the blood donation service faces claims for damages. It is controversial whether the donor is covered by the statutory accident insurance for damage to health that he suffers as a result of the blood donation and that go beyond the usual injuries (e.g. wound infections) . Both jurisprudence and literature disagree on this. Accidents on the way to and from the blood donation are insured without any problems.
Further processing of the blood donation
In the early days of transfusion medicine, the donated blood was transferred from hospitals to patients as so-called whole blood . Nowadays, several blood products are usually made from a donation in order to give the patient only those blood components that he specifically needs. On the one hand, this reduces the risk of side effects and intolerances such as B. febrile transfusion reactions are greatly reduced, and on the other hand, optimal conditions for durability and effectiveness can be achieved by separating the blood into its components.
Since 2009, the blood reserves have been provided with the Eurocode ( Eurocode IBLS, Eurocode International Blood Labeling System ) throughout Europe and are thus clearly identifiable.
As soon as the blood is donated, the blood is directed into a closed system of bags containing an anticoagulant and a nutrient solution for the cells . The bag system is designed in such a way that the individual blood components can be transferred into separate, firmly connected bags without the system having to be opened. This avoids reactions with the air and contamination with pathogens or dust particles.
The next step takes place at a blood donation center. There, the blood donation is separated into its components by centrifugation : the cells and blood components are separated into layers due to their different densities. The erythrocytes (red blood cells) are found in the bottom layer, above the leukocytes (white blood cells), then the thrombocytes (blood platelets) and on top the cell-free blood plasma . The individual components are now in the corresponding bag areas and are then divided into an erythrocyte concentrate, a fresh plasma preparation and the intermediate layer ( buffy coat ), which contains the white blood cells and platelets, by pressing (controlled by a light sensor ) . The leukocytes are reduced by a factor of 1000 at different times using special filters, depending on the blood bag system used, in order to reduce the risk of immunization of the recipient.
The red cell concentrate can be stored at +4 ° C for 42 days. The fresh plasma is frozen and can be kept for over two years in this condition. In order to produce a platelet concentrate large enough for a transfusion, four suitable "buffy coat" preparations must be combined. The leukocytes are separated from the resulting preparation through a filter . The removal of the leukocytes increases the tolerance of the platelet concentrate, as these can cause side effects such as fever or the formation of antibodies . The platelet concentrate can be stored at +22 ° C for five days.
Laboratory examination after the blood donation
With reference to the DRK blood donation services, the German Red Cross states that after the blood donation, the blood is first examined according to:
- Hepatitis A, -B, -C and -E (virus-related liver inflammation) and parvovirus B19
- HIV infection ( HIV test )
- Syphilis (venereal disease)
- Antibodies that are directed against blood cells that are foreign to the body and that could cause dangerous incidents during blood transfusions ( blood grouping )
Use of blood reserves
Only after the laboratory test will the blood donated be used again. For the most part, this is not done to compensate for blood loss caused by an accident, but primarily as part of regularly planned operations, e.g. B. especially for cancer therapy, where chemotherapy leads to a temporary suppression of the body's own blood formation, so that the patient is completely dependent on blood reserves.
In Germany, 19% of the blood reserves are used for cancer. A smaller proportion of 12 percent of the blood reserves is required for accidents. Diseases (with the exception of cancer) require a 47 percent share of the blood. This 47 percent share is divided equally between the heart and the gastrointestinal area (16 percentage points each); 6 percent of the blood reserves are used for diseases of the liver and kidneys, 5 percent of the blood reserves for diseases of the blood including anemia and 4 percent for diseases of the bones and joints.
The use of blood reserves varies significantly regionally and internationally. In Germany, for example, significantly more blood products are used per inhabitant than in the Netherlands, Switzerland and Norway with a comparable level of health care. In the most recent studies, the Barmer Ersatzkasse recognizes a significant backlog in Germany in the area of patient blood management , i. H. of measures to avoid blood transfusions, especially the treatment of anemia in patients prior to surgery. According to the studies, around a third of the blood reserves could be dispensed with if blood reserves were used sparingly. By means of such measures, patient safety could also be significantly improved.
Income from the blood donation service
It is estimated that blood products generate around 500 million euros annually in Germany. For the blood donation services of non-profit organizations , voluntary donations are an important source of income. The non-profit organizations do not publish any business data. The private sector companies are subject to the statutory disclosure requirements.
The high specific expenditure for collection, testing, processing, storage and distribution must be taken into account. In addition, the short shelf life of fully canned food is a cost factor. After the permitted storage time has expired, the fully canned goods are fractionated , the fractions can be stored for longer.
Charges for the consumer
Conserved blood is mostly used in clinical use, including mainly red cell concentrates . The clinics pay the transfused blood reserves at the rates negotiated with the payers . In Switzerland, the cost-covering rate set by the Federal Office of Public Health in 2011 is 212.50 francs (approx. 198 euros) per 450 ml donation unit.
Charges for the donor
There is a demand from the European Council for unpaid, voluntary and purpose-free blood donation. Section 10 of the German Transfusion Act states:
"The donor can be granted an expense allowance, which should be based on the immediate effort depending on the type of donation."
Many providers, especially the state-municipal and private blood donation services as well as some universities, pay an expense allowance, which is based on the type and size of the donation. Depending on the provider, this is between 10 and 28 euros per whole blood donation. The delivery of platelets is compensated significantly higher.
Money-free expense allowance
Most donors are rewarded with food and drinks after they have been handed in on site. At the DRK, depending on the number of usable donations, you receive a small present - for example in the form of a pin or medal , which members of the fire brigades, the THW and other aid organizations in particular wear as a strap on their uniform or service suit - as well as a small gift now and then for donating. Sometimes special gifts or vouchers are distributed or raffled off, which are made available by sponsors. The German Red Cross has been honoring the following donations with a certificate and pin since 1999: 10, 25, 50, 75, 100, 125, 150, 175, 200, 225, 250, 275 and 300 blood donations.
Statutory Regulations
Germany
In Germany, the Transfusion Act (TFG) and its implementing provisions, the guidelines for haemotherapy, are used by the German Medical Association as the "Guidelines for the extraction of blood and blood components and for the use of blood products (haemotherapy) (RiliBÄK-Blut)" in agreement with by the Paul Ehrlich Institute and published by it, as well as by the “Cross-Sectional Guidelines (BÄK) for Therapy with Blood Components and Plasma Derivatives (QLL BÄK)”: The opinions of the Blood Working Group (RKI) are also taken into account.
Section 2.2.5.1 of the Hemotherapy Guideline specifies the basic requirements for donor suitability: Donors must be at least 18 years old. First-time donors must not be older than 60 years, unless an individual medical decision is made. Repeat donors must not be older than 68 years, but older donors are allowed according to an individual medical decision. Donors must weigh at least 50 kg, show no recognizable signs of illness and meet other minimum medical requirements for blood pressure, pulse, temperature and more.
According to section 2.2.4.3, donors are permanently excluded or postponed from donation for a limited period according to certain criteria.
People with certain serious illnesses and diabetes mellitus , as well as those who have been shown to be infected with HIV , hepatitis B virus , hepatitis C virus , HTLV , protozoonoses , syphilis or certain other diseases are permanently excluded . The same is true for drug users, those at risk of TSE transmission, and recipients of xenotransplantation .
There is a time limit on the donation to people with infections, the duration of which depends on the infection, people who have received certain vaccines in certain periods of time, and people who have been exposed to the risk of acquiring a serious communicable infectious disease. Individuals at risk of acquiring a serious communicable infectious disease are deferred for 12 months. These include people with frequently changing sexual partners , men who have sex with men , transsexuals with risky sexual behavior, and sex workers . Persons who have had sexual intercourse with one of the aforementioned persons are also deferred for four months. Other provisions with different time limits are based on:
- Entry from a risk area for certain diseases or sexual intercourse with a person from such an area,
- close contacts within a domestic community with the risk of infection with hepatitis viruses,
- Transplant and surgery,
- Receipt of blood products and other exposure to foreign blood,
- Acupuncture,
- Tattoo,
- Piercing and other cosmetic procedures with injury,
- minor surgery,
- Tooth extraction,
- dental treatment,
- professional tooth cleaning,
- as well as detention.
There are also other reasons for deferring with different time limits, such as pregnancy and breastfeeding, taking medication, allergy symptoms, alcohol abuse, behavior or activity with a high risk of blood-borne infectious diseases, receiving sera of animal origin, and the presence of epidemics or outbreaks.
German Democratic Republic
According to (1) Sections 15 and 17 of the AO on the blood donation and transfusion service of March 7, 1962, blood donors in the GDR were citizens who usually donated blood for medical purposes several times to the blood donation and transfusion service, either free of charge or for a fee.
Blood donors who in an employment relationship were were to indemnify arranged medical examinations and blood from work. For the duration of the leave, the companies with which the employment relationship existed paid compensation equal to the average wage. Necessary travel costs for public transport incurred by the blood donor in connection with the blood donation or the medical examinations were to be reimbursed in the documented amount by the responsible blood donation and transfusion institution.
The National People's Army (NVA) also ordered soldiers with a rare blood type to donate blood regularly.
Blood donors were entitled to extended insurance cover for incidents involving blood withdrawals .
Austria
In Austria, the blood donation process is regulated in detail by the Blood Safety Act. Probably the most important point in this is the so-called voluntary donation, which for the purpose of quality assurance prohibits remuneration for any blood components (§ 8, Paragraph 4). Instead of remuneration, however, there is sponsorship with food after the blood donation.
Other important regulations include:
- Provisions for the blood donation facility (Section 6)
- Informing the donor (Section 8 (2))
- voluntary self-exclusion of the donor (Section 8, Paragraph 3)
- Protection of privacy (Section 8, Paragraphs 5 and 6)
- Determination of health suitability (§ 9)
- Quality assurance provisions (§ 10)
Switzerland
The ordinance on approvals in the pharmaceutical sector names the following exclusion criteria: people with AIDS or symptoms, HIV or HIV risk behavior, intimate partners of the named, people with a specific risk for prion diseases and people who have received animal transplants, as well as their contact persons. In addition, the regulation refers to the recommendation of the Council of Europe of October 12, 1995 for the manufacture, use and quality assurance of blood components with regard to the suitability for donation.
The SRK blood donation service has issued the following decrees:
- People who have received a blood donation themselves since 1980 are generally excluded from the donation
- Men who have had sex with men in the past 12 months
- People who have had commercial sexual contact since 1977 are generally excluded from the donation
WHO
New techniques such as minimally invasive surgery and machine autotransfusion have low blood consumption. However, this does not compensate for the decline in blood donation. Since 2011 the World Health Organization has been calling for a more conscious use of blood products and the following alternatives for blood transfusions. When patient blood management , consumption should be minimized by blood in therapy and surgery, so hospitals can get by with fewer blood transfusions.
literature
- Gernot Schiefer : Motives of donating blood: A depth psychological investigation with design options for the marketing of nonprofit blood donation organizations . Gabler Verlag, 2006, ISBN 978-3-8350-0572-3 .
- Guidelines for the collection of blood and blood components and for the use of blood products (hemotherapy): Established in accordance with the Transfusion Act by the German Medical Association in agreement with the Paul Ehrlich Institute . Complete amendment 2005, Deutscher Ärzte-Verlag, Cologne 2007, ISBN 978-3-7691-1250-4 .
- Peter F. Schlottke, Werther Schneider: Motivation to donate blood. An Empirical Study of Recruiting and Preserving Regular Donors , 1983, ISBN 3-597-10435-5 .
- blutspende.heute - free magazine of the DRK blood donation service NSTOB, Springe
- Reinhard Latza: International quality standards for human blood products. Habilitation thesis, Free University of Berlin, 2006.
See also
- directed donation
- Organ donation
- Plasma donation
- Stem cell donation
- Platelet donation
- Universal dispenser
- History of blood donation, see blood transfusion
- Blood donation needle
Web links
- Collection of Legislation on Transfusion Law (PEI)
- DGTI - German Society for Transfusion Medicine and Immunohematology (DGTI)
- VUBD - Association of Independent Blood Donation Services V. (VUBD)
- StKB - Association of Doctors from State and Municipal Blood Transfusion Services
- Directive 2002/98 / EC: Quality and safety standards for human blood and blood components.
- Blood donation services near you. Federal Center for Health Education (BZgA)
Individual evidence
- ↑ Amendment to the law abolishes the age limit for donating blood. In: roteskreuz.at. Austrian Red Cross , June 26, 2008, accessed on November 26, 2015 .
- ↑ No more age limit for blood donors. In: The world . May 22, 2009. Retrieved November 26, 2015 .
- ↑ Blood Donation: New Age Limits. In: DerWesten. February 1, 2010, accessed November 26, 2015 .
- ↑ meinlebendeinblut.ch
- ↑ Chaste gays are allowed to donate blood in Germany. In: Queer.de. August 4, 2017. Retrieved August 7, 2017 .
- ↑ Christoph Landolt: Why gays are not allowed to donate blood. In: Tages-Anzeiger . October 25, 2010, accessed March 27, 2012 .
- ↑ Kai Kupferschmidt: Gays are not allowed to save lives. In: The time . June 3, 2010, accessed March 27, 2012 .
- ↑ Homosexuals in England are allowed to donate blood again. In: Deutsches Ärzteblatt . September 8, 2011, accessed March 27, 2012 .
- ↑ Explanations and regulatory options on the exclusion of blood donation or on the deferral of people whose sexual behavior poses a risk for the recipient of blood products. (PDF; 0.7 MB) Consultation result of the working group “Exclusion of blood donation of persons with sexual risk behavior”. German Medical Association, April 25, 2012, accessed October 4, 2019 .
- ↑ Blood groups & distribution in the population. drk-blutspende.de; accessed on February 1, 2015
- ↑ Annual report of the BRK 2017. Retrieved on August 12, 2020 .
- ↑ Issue 01. (PDF; 0.7 MB) (No longer available online.) In: blutspender.mag - The magazine for red cross blood donors. DRK Blood Donation Service Ost gGmbH, archived from the original ; accessed on October 4, 2019 .
- ↑ Blood Donor Service West, Bad-Sulzen , accessed on October 4, 2019
- ↑ so z. B. in a pedestrian zone in Essen (archive link from the original ), accessed on October 4, 2019
- ^ Overview of the DRK blood donation services
- ↑ Introduction of the blood donation card in Germany . ( Memento from April 19, 2012 in the Internet Archive ) drk-blutspende.de; Retrieved December 20, 2012
- ↑ RFID chip . drk-blutspende.de; Retrieved December 20, 2012
- ↑ What is stored on the RFID chip? drk-blutspende.de; Retrieved December 20, 2012
- ↑ Can I only attend blood donation appointments in future with the new blood donation card? drk-blutspende.de; Retrieved December 20, 2012
- ↑ Facts & Figures ( Memento from September 17, 2008 in the Internet Archive ) in: haema.de
- ↑ M. Goerig, J. Schulte am Esch: The anesthesia in the first half of the 20th century. In: Jürgen Schüttler (Ed.): 50 Years of the German Society for Anaesthesiology and Intensive Care Medicine: Tradition and Innovation. Springer, Berlin / Heidelberg / New York 2003, ISBN 3-540-00057-7 , pp. 27–65, here: p. 51.
- ↑ Christian Frey: Stasi even dealt with the blood of their prisoners. In: The world . January 14, 2014, accessed October 4, 2019 .
- ↑ blood for foreign exchange. (PDF; 0.3 MB) In: Deutsches Ärzteblatt, issue 4 January 24, 2014, accessed on October 4, 2019 .
- ↑ Blood capitalism in socialism: GDR prisoners: Working for Aldi, bleeding for the Stasi
- ↑ Millions of foreign currency for GDR forced labor and blood from prisoners. In: Focus Online. January 14, 2014, accessed October 4, 2019 .
- ↑ Hanno Müller: GDR sold blood for foreign currency - partly also infected with HIV. In: Thuringian General. January 15, 2014, accessed October 4, 2019 .
- ↑ Report Mainz: City Clinic Karlsruhe was also involved in blood trade with the GDR / Clinic management confirms import of blood products. In: press portal. SWR, January 16, 2014, accessed October 4, 2019 .
- ↑ Julia Renner: New questionnaire for blood donation: Have you already had sex for money? In: HNA.de. Hessische / Niedersächsische Allgemeine, October 26, 2016, accessed on June 1, 2018 .
- ↑ Paul Ehrlich Institute orders hepatitis E virus testing of blood donations. In: Deutsches Ärzteblatt. Deutscher Ärzteverlag, June 18, 2018, accessed on October 4, 2019 (article restricted access: free registration required).
- ↑ New rules for donating blood. (Audio; 5 minutes, 4.35 MB (mp3)) (No longer available online.) In: Impuls. SWR2, August 15, 2018, archived from the original ; accessed on October 4, 2019 .
- ↑ Michael K. Hourfar: Experience of German Red Cross blood donor services with nucleic acid testing. Results of screening more than 30 million blood donations for human immunodeficiency virus-1, hepatitis C virus, and hepatitis B virus. Transfusion, May 6, 2008, pp. 1558–1566 , accessed on May 28, 2014 (English, not publicly available).
- ^ BGH judgment of March 14, 2006 - VI ZR 279/04. March 14, 2006, accessed October 4, 2019 .
- ↑ What do you find out about your blood donation? ( Memento from December 5, 2011 in the Internet Archive )
- ↑ Barmer: BPM could save a third of blood reserves. Barmer Ersatzkasse , accessed on August 18, 2020 .
- ^ Rupprecht Podszun: Antitrust law in non-competitive sectors - the example of the blood donation system. (PDF; 0.1 MB) (No longer available online.) In: ZWeR (magazine for competition law), issue 2/2008. RWS Verlag, p. 3 , archived from the original ; accessed on October 4, 2019 .
- ↑ Law on the regulation of the transfusion system (TFG)
- ↑ Guideline on the collection of blood and blood components and on the use of blood products (Guideline Haemotherapy) , general amendment 2017; accessed on October 4, 2019.
- ↑ Cross-sectional guidelines (BÄK) on therapy with blood components and plasma derivatives. (PDF; 1.44 MB) 4th revised and updated edition. German Medical Association, 2014, accessed on October 4, 2019 .
- ↑ Guidelines for the collection of blood and blood components and for the use of blood products of the German Medical Association . ( Memento from September 6, 2012 on WebCite )
- ↑ Robert Koch Institute: Votes of the working group blood
- ↑ GBl. II 1962 No. 18 p. 158 in the version of AO No. 2 of March 2, 1967, GBl. II 1967 No. 23 p. 144 and AO No. 3 on the blood donation and transfusion service of 4. June 1986, Gazette I 1986 No. 22 p. 332
- ^ Austrian Red Cross : From now on, blood donors will nibble Soletti salt sticks
- ↑ Ordinance on approvals in the pharmaceutical sector (Medicines Approval Ordinance, AMBV) of October 17, 2001 (as of January 1, 2018) (PDF; 0.2 MB)
- ↑ Who can donate blood? - Blood donation from the Swiss Red Cross
- ^ Patient Blood Management , Global Forum for Blood Safety, Dubai, 14. – 15. March 2011
