Sangre is the bank with the highest returns in La Rioja. An entity that brings solidarity to life, without any demands or interests, only the altruism of nearly 8,000 Rioja people who donated a very valuable asset. Your red blood cells, platelets and plasma have different uses, from treating heavy bleeding from a car accident to preventing bleeding after chemotherapy or acting as a clotting agent for people with liver problems. A very necessary investment because one in 10 people who enter Rioja hospitals require a blood transfusion. But before reaching this result, blood follows a meticulous and divided process from donor to recipient: analysis, separation, storage, research, monitoring… This is a wonderful road to new life.
The tour starts at the donation point. A sign at San Pedro Hospital warns: “You are one step away from saving three lives.” At the same time, blood banks’ mobile units are approaching the streets, where they receive the highest number of visitors: three quarters of blood donors donate blood in these mobile spaces. Carlos Sola, director of the La Rioja Blood Bank, emphasized that the requirements are simple: be between 18 and 65 years old, weigh more than 50 kilograms, be in good health, and “willing to help others.” Once these four points are completed, health workers accompany the donor through the initial process that many Riojas go through. The staircase of the mobile unit heralds a welcoming space where discreet and simple actions become crucial.
2,281
red blood cell unit
Needed emergency services last year
60,000
blood-derived drugs
Receive Rioja health care through donating plasma
Each donor provides 450 ml of blood. The estimated amount is 13% of the volume of a 50 kg human. The added “ingredients” to maintain red blood cells (red blood cells) and the ease of storage, administration and use prove that everyone can donate to the same extent regardless of weight. The bags with these supportive and precious elements are placed in butanol trays and initially controlled at a temperature of 22 degrees. «Before separating the components, at least 3 hours must be allowed for homogenization of the blood, if we do not wait for this time, the fractionation will not be sufficient. The time also cannot exceed 10 hours, because the clotting factors may be destroyed,” explains Carlos Sola. Therefore, the blood drawn in the morning will be prepared in the blood bank facilities in the afternoon.
Approval of analysis
But you don’t have to rush it, because the blood needs approval. In addition to the 450 ml bags, four samples were collected from each individual and placed in separate test tubes for analysis. “The law requires a range of analyses, but this has not changed since 2005, so the centers tend to adapt to new developments and incorporate issues that have proven beneficial,” Sola said. In a blood bank, each test tube is inserted into a different machine. One will analyze the blood type; the other will screen for irregular antibodies that can attack the recipient; also perform a blood cell count to study the proportions of blood components; and, depending on recent travel, analyze for hepatitis B, hepatitis C, HIV , syphilis, Chagas disease, etc. to avoid infectious diseases.
The “ok” sound from the lab initiates a pause in the journey of donating blood, although the process never completely stops. The extraction bag goes into the route of acquiring these three units which, as the campaign highlights, can save three lives. First, they pass it through a centrifuge, which prepares the blood to separate its three components (red blood cells, platelets, and plasma) in a fractionator, which works through pressure.
The products are basically ready, but first they undergo separate inactivation processes using vitamin B2 and ultraviolet light to eliminate any bacteria that may be present in the blood. Zero risk does not exist, but we strive to reduce risk as much as possible.
Then there’s storage, which can last anywhere from a few days to three years, depending on the components. Blood banks keep the most valuable parts of their facilities in the same room but in separate compartments. The most commonly used red blood cell concentrates can be stored in an incubator at 4 degrees Celsius for up to 42 days. They are a completely reddish liquid, unlike yellowish platelets or plasma, and in each bag there is a large label that collects all their information: blood type, donation code, date, analysis performed, results ,Antibody…
Platelets have the worst durability, only 5 to 7 days. They are constantly agitated in bags of porous material so that they can breathe. Each unit needs to donate five people with the same blood type because they make up less than 1% of the blood’s components. “With platelets, because of their limited lifespan, we tend to rely on the community; during certain peak periods we may ask for help from Navarra or Aragon, or vice versa,” explains the director of the blood bank.
The dual purpose of plasma
Plasma, on the other hand, although frozen at minus 30 degrees, can be stored for up to 3 years. This component has two destinations and is stored in different chambers of the blood bank. One is purely hygienic, that is, for blood transfusions; the other is for pharmacists, since blood drugs such as albumin or factor VIII are made from plasma. Some of the donated plasma is channeled to the industry and returned to San Pedro for conversion into medicines. In 2022, it received more than 60,000 such doses.
Hospital needs and forecasts always set the tone. «We check our inventory every day and analyze what we use and there is always an “overstock”. This does not usually happen, but in complicated deliveries we have to transfuse 20 units of red blood cells. We have to deliver more than expected and patients can’t wait for their donors to arrive,” said Carlos Sola.
Bloodline
Different routes, different destinations, although at some point the components come together again, for example “in a massive haemorrhage after a traffic accident, 20 units of red blood cells, 5 platelets and 10 plasma can be consumed,” explains Sola . But in normal use, the most common ones are red blood cell concentrates: during scheduled surgery, for various bleedings, during chemotherapy, for chronic anemia… Last year, the San Pedro Hospital infused 7,806 units of red blood cells, with the highest demand for emergencies (2,281), ahead of hematology (686), oncology (553), trauma (542) and ICU (477).
For their part, platelets are used especially in cancer patients to prevent bleeding, but are also used in invasive procedures and bleeding. In 2022, San Pedro Hospital transfused 706 units of platelets, along with 168 liters of plasma. This last compound is the one that has withstood the passage of time best and is used to provide clotting factors to patients with these problems and, along with platelets and red blood cells, to replenish patients with severe bleeding.
Transfusion and monitoring
The blood bank laboratory receives the request. The final process begins with a coordinated blood transfusion process as needed, which may be scheduled, more controlled, or emergent. In the first case, each patient also undergoes a blood test to determine which group they belong to and possible antibodies, and is put on a transfusion bracelet with an identification number. “In an emergency, an emergency is an emergency, and you can only guarantee compatibility with 0-universal,” Sola said.
But there is an end to this journey, which is clinical follow-up. Every patient who receives a blood transfusion has a record showing the blood they received and all of its characteristics. “We have full traceability, and if there is any reaction we have to look back, just like a donor detects something new in a subsequent donation, we have to notify the patient and reanalyze the sample that we retain,” explained the blood bank director. road.
Last year, 5,850 Riojas required blood transfusions. On the other hand, 7,675 people came forward to donate, cooperating with this never-ending wheel and donated 9,637 units of red blood cells, 1,229 platelets and 2,589 liters of plasma. Our most precious values are just one step away from helping others.
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Per capita donations are lower than the national average
The year before, La Rioja still had a fixed cap of 10,000 donations: 9,886. This figure comes despite Rioja blood donors visiting blood banks or mobile stations less frequently, resulting in the region having one of the lowest donation rates in the country, with only 1.3 donations per person compared to the national average of 1.5 donations. not bad. “The trend is downward,” comments Carlos Sola, director of the blood bank, explaining the situation because “the oldest donors are accustomed to making the most donations per year (4 for men and 3 for women). times).” Young people at the beginning only do it once. Regular blood donations are essential to maintaining Rioja reserves at optimal levels, and increasing frequency will make today’s common blood bank calls unnecessary.
Next week, the mobile unit will visit Ludlow on Tuesday and Najera on Friday and Saturday. In addition, it will stop in Cascajos tomorrow in Logroño, on Thursday in front of Capa and Club Deportivo and on Friday in Gonzalo de Berseo. People who want to donate blood can also visit the blood bank at San Pedro Hospital.
Apheresis donation, a more selective approach
Typical blood donations are made at blood banks and mobile stations and usually last no more than fifteen minutes. However, there is another method that is more selective and long-lasting, lasting about an hour: apheresis. This is a more complex formula, but the required blood components are obtained specifically and individually (they can be all or a specific one), and the rest is returned to the donor’s body. This type of donation can only be done at a blood bank facility and by appointment, although it doesn’t require a little extra time from the donor. Last year, only 70 apheresis donations were made in La Rioja, half the number in 2016.