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NEWS AND INFORMATION FOR BLOOD DONORS

WINTER 2008

“I was crying with the pain”

Looking at leukaemia Not just one disease but many

… S Y A S S E N I A C L E A MICH life as a gift” “Now I see li

PLUS ✦ NEWS ✦ LETTERS ✦ AND MORE...


In this issue Transplants save lives

COVER STORIES

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FREMANTLEMEDIA

“Now I see life as a gift”

Chef Michael Caines faced a major challenge after an accident. But it hasn’t stopped him becoming a top restaurant owner and chef

“I’m proud to be a platelet donor”

Platelets are vital for the treatment of many blood disorders. Colin Waite explains how he became a platelet donor

10 Donors helping research PAGE 4

How blood donors are helping research into life-threatening diseases

11 Blood brothers

Two brothers who have been giving blood for 40 years

12 “I was crying with the pain”

A rare complication turned Andrea’s pregnancy into a life-threatening drama. Only emergency surgery and blood transfusions offered her hope

14 Bag it up! PAGE 12

The humble blood pack is a cunning piece of technology, designed to be spun, squeezed and frozen to create blood components

16 Myths of blood

Bizarre, brutal and frankly batty beliefs about blood through the ages

20 Over to you

Catch up with readers’ letters, plus health Q&As

21 Living with sickle cell anaemia

How Annie McDonald copes with a devastating blood disease

Join the NHS Organ Donor Register 0845 60 60 400 www.uktransplant.org.uk

PAGE 23 WRITE AND TELL US your news, views and interesting or unusual donor stories. Write to The Editor, The Donor, NBS, Colindale Avenue, London NW9 5BG or email thedonor@nhsbt.nhs.uk

23 Looking at leukaemia

Did you know there are over 100 different types of leukaemia?

26 A born survivor

At birth, Nicola Langlands was given three weeks to live. But she survived, thanks to life-saving surgery and a pioneering transplant

28 Getting a great sense of satisfaction

Our expert Robin Knight is helping set up blood services in Malawi

30 Ask The Doctor

We explain the changes to our donor age limits

31 Crossword

Another prize-winning puzzle

The cost of producing, printing and posting each copy of this magazine is less than the price of a second class stamp. The Donor is published by the National Blood Service (NBS) which is part of NHS Blood and Transplant (NHSBT). Reproduction in whole or part is strictly forbidden without the prior permission of NHSBT. Larger print versions are available via the website. Design and production:Ant Creative (London). Reproduction: Portland Media (London). Printed by Apple Webb Offset on 70% recycled paper.

WINTER 2008 THE DONOR

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COVER STORY

“Now I see life as a gift”

Chef Michael Caines faced a major challenge after an appalling accident.But it hasn’t stopped him becoming an acclaimed restaurant owner and award-winning chef Is it right that you needed a blood transfusion?What happened? Yes I had a terrible car accident which resulted in me losing my right arm. The blood transfusion saved my life. Do you know how much blood you needed? I am not sure of the exact amount. I think it was about four litres in all. It must have been a scary

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time.What was going through your mind? I was conscious but when I realised I had lost my arm I just wanted to give up, because I thought my life as a chef was ruined. But then I decided I did want to fight and do my best to survive. When did you manage to return to work? I went back on a part time basis after two weeks, returning

THE DONOR WINTER 2008

full time after just three weeks. Has your outlook on life changed since your accident? Yes absolutely. I am more positive in outlook, live life for today and also see life as a gift. What would you like to say to blood donors who helped save your life? I’d like to take this opportunity to say a huge thank you to all of those donors. Before your accident had you ever given blood? No I hadn’t. Unfortunately I can’t give blood now due to the restriction asking those donors who have received blood since 1980 not to give. You worked with us to promote our Big Summer BBQ appeal that highlighted the importance of giving blood and eating an iron-rich diet to help maintain healthy blood.Why did you want to get involved? I wanted to get involved because of my past experience and the help that I received. Also to help to highlight the cause. Where does your love for food come from? When did you decide to pursue a career as a chef? My love of food comes from growing up in a large family, helping dad grow vegetables in the garden and mum with the cooking. My decision to pursue a career as a chef was a late one and was not made until my last

awards like Chef of the Year to my MBE, to being a father. You’ve worked with some of the world’s top chefs.Who has inspired you the most? Raymond Blanc has been a mentor throughout my career both as a friend and a fellow professional. There have been many others who have inspired me including my father. You clearly work very hard. Do you have time for any year of schooling. I did not realise hobbies? I love skiing, walking/trekking that this was a career option. and I also like to try and keep fit What has been your biggest although I am a little ‘time poor’ achievement? I am lucky to have experienced a at the moment but I am working few in my time – from winning on that. ●

“I am more positive in outlook,live life for today and also see life as a gift”

Michael won the AA Chefs’Chef of the Year Award in 2007

LIFE STORY

● Born 1969 in Exeter and adopted into a large and loving family ● 1987 – earned the accolade ‘Student of the Year’ at Exeter Catering College ● 1990 – worked with Raymond Blanc at Le Manoir aux Quat'Saisons in Oxfordshire ● 1994 – head chef at Gidleigh Park. Two months into the job, Michael lost his right arm ● Given catering industry’s Acorn Award as one of 30 young achievers under 30 ● 1999 – awarded a second Michelin star and founded Michael Caines Restaurants ● 2000 – opened his first signature restaurant Michael Caines at The Royal Clarence in Exeter ● 2001 – won Chef of the Year at the prestigious Cateys Awards ● 2006 – made MBE for services to the hospitality industry ● 2007 – awarded AA Chefs’ Chef of the Year

WINTER 2008 THE DONOR

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ews Update • News Update • News Update • News Up Update • News Update • News Update • News Updat

Babies need blood E

very year, many thousands of premature and sick babies rely on blood products to survive. That’s why we have teamed up with special care baby charity, Bliss, to raise awareness of this crucial fact. A Christmas campaign is planned to highlight how platelets can help premature babies and information about blood donation will be included in the going-home packs provided to new parents.

Bliss chief executive, Andy Cole, says, “We are delighted to be working in partnership with the National Blood Service. Many babies born prematurely or sick require blood or platelets - they are often vital for their survival. “Blood and platelet donors have such an essential role in giving these babies the best chance in life. We hope this campaign will encourage more people to donate blood to help our most vulnerable babies.” For more information about Bliss, visit www.bliss.org.uk●

Campaigner dies

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aniel De-Gale, a leukaemia sufferer and the inspiration behind the African Caribbean Leukaemia Trust (ACLT), has died aged 21. Daniel, known as ‘Playzo’, was diagnosed with the disease in 1993. Over a five year period he underwent two courses of chemotherapy and then a bone marrow transplant. In 1996, his mother Beverley and stepfather Orin Lewis established the ACLT and began the campaign to increase the number of black and mixed race donors. They were awarded the ‘Pride of Britain’ special recognition award in 1996. Over 1,000 mourners, including ACLT patron the Duchess of York, attended Daniel’s funeral service at Croydon Parish Church, South London. A young man who inspired so many has left a truly lasting legacy. For more information visit www.aclt.org ●

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THE DONOR WINTER 2008

School’s pack success W

e’ve just released our new 2008 edition of the ‘Give and Let Live’ education pack to UK secondary schools. This follows last year’s successful launch where over 1,800 secondary schools asked for them. The new pack contains lesson plans for science covering blood, organs and tissues, and bone marrow donation, plus a plan for religious education lessons – all this in addition to the Citizenship and Personal, Social and Health Education resources featured in last year’s pack. The web site has also been revised and features new ‘true and false’ interactive quizzes and PowerPoint presentations as well as fact sheets and short films to stimulate debate. The pack is dedicated to the memory of Jeanette Crizzle, a teacher who sadly died while waiting for a bone marrow transplant.●

Come on you reds

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Be a ‘superhero’! A

new fun viral game with a serious message has been launched to encourage more people to sign up as organ donors. It’s part of the NHSBT ‘Superhero’ campaign and we hope the game will catch on and spread the word. Angie Burton, from NHSBT, says, “The online game gives internet users the opportunity to upload their picture to make themselves a superhero and pass the results on to friends and family. It’s designed to be fun with a serious message that we hope people will pass on. Everyone can be a superhero and save a life by joining the NHS Organ Donor Register. Superhero-me means they can also make themselves look like one!” You can go online and superhero yourself now at www.superhero-me.co.uk ●

A new way to recruit donors W

e’ve linked up with the Body Worlds exhibition currently on at the O2, London to promote blood and organ donation and recruit new donors. Visitors can sign up to become blood and organ donors by completing the registration forms at our special stand at the exhibition. Body Worlds displays human bodies in various states of health and disease and shows the human life cycle in all its stages. For more information visit the Body Worlds web site www.visitlondon.com/bodyworlds ●

Suffolk football club is helping to spread the word about blood donation with its new team kit. Thanks to our sponsorship, Trimley Red Devils in Felixstowe now trot out onto the pitch wearing their familiar blood-red strip proudly promoting our logo, web address and the ‘Give Blood’ message. “It doesn't take a great deal of effort to be able to provide the blood that could save another's life and it is important to make people aware that the NBS provides this vital service. We are proud to be sponsored by the NBS and hope to encourage more people to donate as a result,” says Bob Race, chairman of the Trimley Red Devils and a regular blood donor. The club has 13 teams ranging from the Under 7s to adults and around 200 families are involved with the club. ●

Improvements

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ou may have noticed a change in The Donor magazine; it’s looking thicker and brighter than before. We’ve been listening to your feedback and whilst many of you like reading it, some have commented that the paper we use lets it down. We are now printing The Donor on a heavier gloss paper that still retains a high recycled content. And it still costs less than the price of a second class stamp to print and deliver to your door. ● WINTER 2008 THE DONOR

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Platelets are vital for the treatment of certain types of blood disorders, especially cancer. Blood donor Colin Waite explains how he became a platelet donor “

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en years ago was when I first saw an advert about the need for platelet donors. I had given my first whole blood donation at the age of 18 and after six donations I decided to swap to platelets,” says Colin Waite, who lives in Bristol. Platelets help the blood to clot, and are given to many different kinds of patients (see box). But with just a five-day shelf life, donors like Colin are always needed. “The first step started at the next blood session I attended,” he says. ”Along with the routine blood samples

another sample was taken to measure my platelet count to make sure it was high enough.” Colin got the green light and now donates as often as he can at our Bristol donor centre. “I currently work shifts so find I have the time to give platelets on my days off. It’s very convenient for my lifestyle.” A platelet donor donates on a cell separator machine and is on it for up to 90 minutes. During the donation donors can watch TV, DVDs, read, make calls from their mobile

phone and use their laptop. Colin says, “I bring a book and my Nintendo DS to help pass the time, but often I just chat to the nurses. I find staff at the sessions very friendly; you get to know their names and faces when you visit them so often.”

What happens? He now takes platelet donation in his stride. “It’s like giving blood – the booking-in and confidential health check are the same. The only difference is that I can’t give platelets if I have taken aspirin in the last five days or a non-steroidal antiinflammatory drug (NSAID) such as Nurofen, in the last 48 hours. Colin finds staff at the donor centre very friendly

DR YORGOS NIKAS / SCIENCE PHOTO LIBRARY

PLATELETS

A blood platelet among red blood cells. Here,the platelet is coloured white. The structures sticking out from the cell surface mean the platelet is ‘activated’, causing the blood to clot.

different so they can adjust the settings on the cell separator machine. I know when my donation has finished because the machine beeps. Then the nurse takes the needle out and it’s all over.” Typically, a platelet donor would expect to give 400ml 600ml of straw-coloured liquid, Platelets are disc-shaped cell fragments in the blood which help it to enough for two or three adult clot. Under the microscope, they look like small plates – hence the doses or eight to 12 infant doses name. They are formed from large cells in the bone marrow called of platelets. megakaryocytes and normally survive about ten days in the blood Says Colin, “Giving blood before they are broken down by the spleen. Their function is to stop doesn’t cost anything and I bleeding. When skin is cut, platelets immediately move to the area feel that by donating I can give and stick together to form a plug to stop the bleeding. ● something back to the “You can choose to have a The staff offer drinks and community. There are only a small local anaesthetic to numb the refreshments. They always ask number of ethnic donors and I’m area before the needle goes in. me to tell them if I start to feel proud to be one of them.”●

What are platelets?

Could you become a platelet donor? To be a donor you need to: ● Be male and aged 18-65 years ● Have an average or above average platelet count ● Have given blood at least once within the last two years without any problems such as fainting or bruising ● Be over 7st 12lbs (50kg) ● Be of blood group O, A or B ● Be able to get to a permanent donor centre once a month If your platelet count is not high enough for you to be a donor it doesn’t mean you are unhealthy and you can still carry on saving lives by donating whole blood. ●

“I’m proud to be a platelet donor” 02 8

THE DONOR WINTER 2008

WINTER 2008 THE DONOR

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RESEARCH NEWS

Donors helping research With a little help from blood donors, researchers have made important discoveries about the role of genes in the development of life-threatening diseases

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lood donors have been helping researchers to uncover some of the ways that genes affect health. Three and a half years ago, scientists started the first nationwide study into the link between genes and some of the common diseases in modern society: bipolar disorder, coronary artery disease, hypertension, inflammatory bowel disease, rheumatoid arthritis and diabetes types 1 and 2. Researchers compared healthy people’s DNA (the chemical from which genes are made) with DNA from patients. They found 24 genes involved in these diseases, and the findings appeared in the renowned scientific journal, Nature, last year. The “healthy” DNA came from consenting blood donors who had agreed to take part in the study. In total, 3,000 samples were obtained from blood donors across Great Britain. During a donation, an additional 15ml sample of blood was taken for researchers to study. The link between the donor and sample was removed a

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month after the donation to make the collection anonymous.

New project Now there’s a new project underway. We, as part of NHS

The Cambridge team Blood and Transplant (NHSBT), are working with the University of Cambridge to set up a new resource, the Cambridge BioResource, for the benefit of scientists working in biomedical and healthcare research. Information and samples will be made available for future ethicallyapproved studies into the links between genes and diseases. Cambridge BioResource will recruit 10,000 healthy volunteers to give blood samples and fill in a lifestyle questionnaire. So far, 5,000 volunteers have taken part, 4,000 of them blood donors who have given a small extra blood sample during their routine

THE DONOR WINTER 2008

donation. The remaining 1,000 are local volunteers.

Extra tests The extra sample undergoes all our routine blood tests plus a full blood count – this measures the number of red and white cells and platelets in the blood. DNA and blood components, such as plasma, are isolated and tested in detail to establish a bank of genetic information and biomarkers. Biomarkers can be used to indicate a person’s health. For example, haemoglobin shows the amount of iron in the blood. Relevant information from donor records is also collected, such as blood group, tissue type, gender and age. These are kept in a standalone BioResource database. Blood samples are never labelled with names or contact details but are assigned study numbers to maintain donors’ anonymity. The Cambridge BioResource is currently looking at the genes and mechanisms behind cardiovascular disease, particularly the role of platelets. Other researchers are looking into diabetes and obesity. By understanding how genes function and interact, better prevention and treatment of diseases will be possible in the future, and it all starts with a little extra blood from a donor! ●

✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦ Blood brothers Alan and Richard Godfrey, retired farmers from Bedfordshire, are extraordinary blood donors. The brothers live next door to one another, and worked together on the family farm for many years. They have also given blood regularly for over 40 years, and each has made 100 donations. Alan, 61 (seated), who plays the organ in his local church, made his first donation on 4th February 1965. He knew how important giving blood was from first-hand experience. His mother had returned home after an operation and started to haemorrhage. She was rushed back to hospital and given a blood transfusion. Alan went along to a local blood donor session with his parents’ written consent to donate, because he was under 18 at the time, which was the lower age limit for donors back in the 1960s. Richard, 65, started donating at the same time as Alan and is an equally committed blood donor. But, being older, he escaped the necessity of parental consent before he could give his first pint! ●

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PATIENT STORY

“I was crying with the he pain” A rare complication turned Andrea Harrop’s pregnancy into a life-threatening drama

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ndrea Harrop was delighted when she discovered she was expecting identical twin girls. But, five months into her pregnancy, she suddenly developed worrying symptoms. “It was October 2004 and I knew something was very wrong. I was in pain and was stretched to the size of a 39week pregnancy, although at that time I was only 24 weeks pregnant. I rang the local maternity ward and they advised me to come and be checked over. Whilst I was waiting, a consultant came in. At this point

I was crying with the pain. He rushed me to a room and I was immediately assessed by him and a midwife. Within half an hour, I had been scanned and given the news that I had a ‘twin-to-twin transfusion'. “

Twins and mother in danger

Twin-to-Twin Transfusion Twin-to-Twin Transfusion Syndrome (TTTS) happens when identical twin babies share the same placenta and there is an unequal flow of blood from one twin to another. One twin (the recipient) may become larger and supplied with too much blood, which can put a strain on the baby’s heart and cause heart failure. Also, because the baby has too much blood, it produces more urine which can dramatically increase the volume of amniotic fluid in the womb. The second twin (donor twin) may have too little blood and become starved of nutrients. It will show poor growth and reduced urinary output. TTTS affects about one in every thousand identical twin pregnancies and is detected by ultrasound scan. The condition is not linked to genetics, and its cause is unknown, although researchers have suggested several explanations. ●

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From the left:Andrea, Jessica,Steve,Hannah and Nicola Above: The twins are now happy,healthy four-year-olds

A twin-to-twin transfusion happens when twins share one placenta and some of the blood vessels go directly from one twin to the other. Blood from twin daughter Hannah was transferring to the other twin, Jessica. This made Jessica urinate more, but the urine had

THE DONOR WINTER 2008

nowhere to go. “My stomach had swelled up so much I couldn’t move,” says Andrea. She was taken immediately to hospital in Newcastle where the surgeon told her unless he operated straight away, she and her twins would die. The surgeon and his team performed a laser cauterization of some of the placenta’s blood vessels and drained 2.5 litres of fluid from around the babies. But this made Andrea go into premature labour. At 24 weeks and five days her first twin was born and immediately taken to the special care baby unit. But her sister did not follow.

Andrea's second twin was delivered by a very difficult emergency C-section three hours later and rushed to the special care baby unit.

Tiny babies The twins weighed 540g (1lb 3oz) and 567g (1lb 4oz) and they were so small that they fitted in an adult’s hand. But Andrea herself now had problems. She began to bleed uncontrollably. “I needed six units of blood. Eight hours after the first twin had been born I was brought round and was in horrendous pain. Of course, I knew nothing

of what had happened. My first twin also needed several blood transfusions, and the second twin actually had to have her blood diluted. “My family were beside themselves worrying about me. I was in hospital for nine days. At the time my eldest child, Nicola, was just three and my mam was a great help looking after her. My dad drove down from Glasgow just to spend an hour with me the next day, but my stepmum had just had a hysterectomy so he had to get back for her. So to say the least, he was out of his mind worrying about his wife and his daughter! “The twins' dad, Steve, was coming and going between work and hospital.There was an

“If it had not been for donors, I would not be here to be a mother to all three of my beautiful girls” infection going round the ward and I wasn't allowed to go to see the twins for a few days. Steve could only see me and not the twins for fear of spreading it to the baby ward.” Four years on, and twins Hannah and Jessica are happy, healthy and unaffected by their dramatic entrance into the world. Andrea says she is very grateful to the blood donors who helped her. “If it had not been for them, I would not be here to be a mother to all three of my beautiful girls.” ●

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SCIENCE & TECHNOLOGY

Bag it up! That humble blood pack we attach to your arm is actually a cunning piece of modern technology. It’s carefully designed to be spun, squeezed and frozen in order to create lifesaving blood components

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blood pack is far from simply being a bag into which you make your donation. Each pack is a complex arrangement of bags and tubes which are an integral part of the processing system that turns blood into its components of red cells, platelets, white cells and plasma. The pack’s design allows all this to be done without it being opened, so the contents remain sterile. The manufacturing of these packs is rigorously controlled. Their dimensions, air content, labelling, thermal stability, water vapour transmission, transparency, plus chemical and biological requirements, are just some in a long list that must comply with British Standards, be CE marked and satisfy other regulations. Today we use two main types of packs, which we process differently to make various components. The Whole Blood Filter (WBF) packs are used to make Fresh Frozen Plasma (FFP), cryoprecipitate and red cells. Bottom and Top (BAT) packs are used to make red cells, platelets and FFP.

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Every day we need to make sure we have enough of all the different types of blood components on our shelves. Based on what the hospitals have used in the last few days, we can calculate how many blood donations we need to collect in BAT packs and how many in WBF packs. Before our teams start a session, they are given a list by time, type of donor and into what type of pack they need to collect donations.

Making platelets As platelets have a shelf life of five days, we need to make them daily. So, often the first donors at a session will donate into BAT packs. However, the red cell unit made in the course of making platelets (using a BAT pack) will contain slightly fewer cells than one made using a WBF pack. But the more red cells in the unit the better for the patient. So once we have enough blood collected in BAT to make sufficient platelets for the day, all other donations are collected into WBF packs. This ensures that we maximise the amount of red cells in as many

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Main Blood Pack

Sample Diversion Pouch

Needle

Sample Site Coupler

donations as possible, which is better for the patient. Blood packs are kept in temperature-controlled storage, to ensure they remain in peak condition before use. The bags are made of PVC with a special plasticiser that makes them flexible and less fragile. The PVC doesn’t damage any proteins or cells in the blood and it stops them sticking to the sides of the pack. The PVC tubing is of a very precise size, allowing us to make sterile welds to attach other bags to it during processing. The main donation bag contains 63ml of anticoagulant which stops the blood clotting and acts as a preservative.

Different parts The first part of each blood pack is the needle. Then comes the small

Next is the sample site coupler, which Leuco Leucodepletion Filter allows blood to be taken from the pouch. We don’t waste this blood. It’s put into three differentlycoloured sampling tubes that all have the same unique bar code Red RedCell Cell Filtered Plasma Transfer Transfer Red Cell Transfer pack number and will travel Pack Pack Pack with the main donation to be tested for various viruses as well as blood group. The main donation bag is where the actual donation is collected. We aim for Every part of the blood pack is carefully 470 ml but normally designed so that all the blood components between 405ml and remain sterile during processing 495ml is collected. There is also a leucodepletion filter included in the pouch where the first few millilitres tubing. This removes the white of blood are collected at the blood cells (leucocytes) that can beginning of the donation. This cause transfusion reactions in some diverts any skin bacteria from the patients. It also reduces the risk of needle and prevents it getting into transmitting vCJD. the main pack.

Two or three other empty bags are also attached as part of the process of splitting the blood donation into its component parts. One bag contains 100 ml of special clear solution, containing glucose, that is added to the red cells to keep them in good condition and provide energy to keep them alive.

Separation The BAT pack is first spun. Rapid spinning makes the blood separate: red cells fall to the bottom of the bag, plasma floats to the top of the bag, the platelets and white cells remain suspended in the middle. The pack is then squeezed, pushing the plasma up into another bag and the red cells pass into a transfer bag at the bottom of the pack – these are then mixed with additive solution and passed through a leucodepletion filter (if a WBF pack is used leucodepletion takes place before spinning). The remaining platelets and white cells (called a buffy coat) stay behind in the main bag. Amazing!●

The good old days Up until the 70s we used glass bottles. They were reused just like milk bottles, washed on a sophisticated conveyer-type bottle washer and then, under clean conditions, the anticoagulant solution was added to stop the blood from clotting. The bottles were then sealed with a rubber bung before being sterilised. Unsurprisingly, having dozens of glass bottles full of blood on show didn’t suit every donor. Bobbi Roan, a recently retired blood donor, recalls her very first session in 1956. “I was 18 when I went along with some friends to give blood. The blood was in large glass bottles and stacked up like crates of milk. One of the girls

looked at these bottles of blood and promptly fainted! She never lived it down.” ● WINTER 2008 THE DONOR

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BLOOD FACTS Today we understand the make-up and function of blood. But for centuries, many civilisations believed blood had mystical powers and built up bizarre belief systems around it

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lood has attracted more than its fair share of myths and mysteries over the centuries. Scratch the surface of many ancient, and not so ancient civilisations, and you will uncover bizarre rituals, sayings and beliefs about blood. Take the Aztecs. They believed human blood was vital for keeping the gods fed, and bloodletting and human sacrifices were the inevitable consequence of this belief. No less strange are beliefs about vampires, the undead Left:Aztec sacrifices were made to appease the gods

vampire corpses merely helped to spread the plague further - and pushed the vampire myth firmly into folklore.

In a word

creatures who need fresh blood to survive. These myths occur all around the world, so are clearly tapping into an ancient human fear. In medieval times, tales of vampires really took off as the bubonic plague swept across Europe. Over 25 million people died, and it was thought that this terrible disease might be spread by vampires. Such a contagious disease resulted in hasty burials, often causing people to ‘rise from the dead’, because they were, in fact, still alive! Attempts to cleanse towns and villages by digging up and destroying the suspected

A sign of how powerful a hold the word “blood” has on our imaginations is the number of phrases using it that have been coined over the centuries. Shakespeare peppered his plays and plots with bloody references – remember the ghostly “bloodboltered Banquo” in Macbeth? And of course blood makes an excellent metaphor. How about Winston Churchill’s famous “I have nothing to offer but blood, toil, tears and sweat” wartime speech to the Commons.

Family ties Don’t forget all those sayings about family traits and ties ‘blood will out’, ‘blood will tell’,

Beliefs about blood 400 BC – Hippocrates claims that the body comprises four humours: blood, phlegm, black bile and yellow bile. He believed their imbalance caused disease.

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1665 – Richard Lower carries out the first animal blood transfusion using a quill and bladder as instruments. 1667 – French physician Jean-Baptiste Denis transfuses a teenage boy suffering from a persistent fever with nine ounces of lamb's blood.

Right:A mid 18th century diagram of the arteries in the human body

WINTER 2008 THE DONOR

MARY EVANS PICTURE LIBRARY

1553 – Michael Servetus, a Spanish physician suggests that blood flows from one side of the body to other via the lungs. He was later burned at the stake for his suggestion. MARY EVANS PICTURE LIBRARY

Myths of blood

300 BC ��� A Greek anatomist called Herophilus of Chalcedon determines that arteries are thicker than veins and carry blood.

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A Japanese view of blood groups

Closer to home British history is steeped in violence that has left its mark on our language. Mary Tudor earned herself the name Bloody Mary for her persecution of Protestants. Then there’s the Bloody Tower, part of the Tower of London. Here traitors were held before execution and the two little princes, sons of Edward IV, were supposed to have been murdered and buried. And on the subject of royalty, the phrase ‘blue blood’ is believed to have been coined by old Castilian families in Spain who claimed to have ‘sangre azul’, because they had no Moorish, Jewish or other foreign

blood. Possibly the phrase refers to the well-known fact that bluish veins are more visible in the skins of paler people.

Dracula story Vampires in films certainly always seem to prefer pale-skinned maidens, especially that most famous vampire, Dracula. He was the creation of the Victorian writer Bram Stoker, whose

Did you know…? ● Only identical twins have exactly the same blood type ● Almost every Peruvian is blood group O ● About 5 per cent of Americans are members of the AB blood group – including John F. Kennedy and Marilyn Monroe ● Mr. Spock’s blood type is T-negative, one we’ve never heard of, perhaps that’s why it’s green!●

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THE DONOR WINTER 2008

A Japanese fortunetelling box based on the blood groups,with a hole for groups A,B,AB and O fictional monster was based on a real life monster – the warlord Vlad Tepes. Known as ‘Vlad the Impaler’ because of the thousands of enemies he impaled on stakes, he was murdered in 1476 and reputedly buried in a monastery on an island near Bucharest. However, excavations failed to uncover his remains – strengthening the superstition that he’d risen from the dead.

Modern myths We may no longer believe in vampires, but there are still plenty of unusual beliefs about blood around today. In Japan, they attach special importance to blood groups, believing it determines personality. This concept even has a name – ketsu-eki-gata. Most Japanese, whether they’re a blood donor or

DAVID SOUTH

Group O – You are agreeable, sociable and an optimist, but can be vain, careless and ruthless. Group A – You are earnest, creative, sensible and calm, but watch out as you may be fastidious and over-earnest. Group B – You are wild, cheerful and always try hard, but can be selfish, irresponsible and arrogant. Group AB – You are cool, controlled and rational, but can be critical, and indecisive. ●

not, know their own blood group and think it odd that some people in the UK don’t think it’s important to know theirs. Rather like star signs, blood groups are meant to point to certain characteristics in a person and can even be used to create

“We may no longer believe in vampires, but there are still plenty of unusual beliefs about blood around today” the right sort of blend of personalities in an office! So wellknown are the personality traits of each blood group that the popular characters in anime (Japanese animation), manga (comics) and video games will often display their blood group. These beliefs are not confined to Japan. Other East Asia countries also take blood groups seriously, and in 2005 there was a South Korean romantic comedy called ‘My Boyfriend is Type B’. Of course, most scientists treat these theories with the same scepticism as horoscopes. Another interesting theory relates your blood type to the kind of foods you should eat for

MARY EVANS PICTURE LIBRARY

‘blood brothers’ and ‘blood is thicker than water’. For some communities, still, today, an insult or injury against a sister, cousin, uncle or any relation, however remote, is seen as a slight against the whole clan – who then have a duty to avenge the insult. And, as history tells, these blood feuds can escalate into wars. ‘Blood will have blood’ indeed!

optimum health. This blood type diet is based on the idea that each blood group has a different geographical origin and evolved under different dietary conditions. Despite most medical and nutritional experts dismissing the idea, some celebrities are said to have given it a try, amongst them actors from EastEnders and Friends. Of course all these myths might seem silly, and are certainly not what our medical experts

An early picture showing the end of a vampire with a poker through the heart believe in, but people who don’t donate often have their own misconceptions around giving blood. Some common ones are “It will hurt” or “I can’t because I smoke” and the ever popular “You wouldn’t want my blood!” If you hear anyone uttering one of these modern myths, please don’t be afraid to speak up and put them right!●

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OVER TO YOU ★★★★★★★★★★★★STAR LETTER★★★★★★★★★★★★

NOT TOO OLD At my last donation, the carer pointed out that this was to be my 66th ‘pint’. It brought home to me, having just passed my 69th birthday, that I would only be making a further two or three donations, and wouldn't make that next award for my 75th donation. Why is the ‘retiring’ age for donors not subject to a health review rather than a compulsory age limit? I received a phone call, and two A STAR LETTER is chosen for every issue. written reminders to ensure I turned The winner will be up this time to donate (so you really invited to a behind-the needed my blood)! -scenes tour of a Blood Centre. He or she will don a white coat and see what happens to a donation of blood. (You must be 16 or over.)

DAVID REEVES, BY EMAIL EDITOR’S RESPONSE: I am sure you will be “I ‘d lik e to make more do nations” delighted to read that the upper age limit for regular donors will be removed from 1st January 2009. There is more information about changes to donor selection criteria on page 30.

★★★★★★★★★★★★★★★★★★★★★★★★★★★★★★★★★★ This is your chance to tell us your news, views and interesting or unusual donor stories. Write to The Editor, The Donor, NBS Colindale Avenue, London NW9 5BG or email thedonor@nhsbt.nhs.uk

Good advice I e-mailed you only a week ago about medication preventing donation, and today I received a reply advising me that the guidelines had been relaxed, and that I could now probably safely make a donation. I found a donor session this afternoon and without an appointment I went along. I was looked after very well, and I left within the hour, having made my 70th donation. I am now

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back on course to make my Call 0845 7 711 711, someone century before I reach the age will be able to help you. limit. Thank you very much to Better security everyone concerned. A LARLHAM, BY EMAIL I enjoy doing The Donor EDITOR’S RESPONSE: We are very crossword. But I am not willing impressed that you went to send my name, address and straight off to give your 70th. telephone number on a Congratulations on achieving postcard for various people to witness. Is it possible for such a milestone. competition answers to be sent Brownie talk in an envelope? I run a Brownie pack and as a MRS L J GODDARD, OXFORDSHIRE blood donor would like to EDITOR’S RESPONSE: Anyone introduce the girls to why I give entering the crossword blood and what happens during competition is quite welcome to a session and to my blood send their answer and contact afterwards. Can anyone from details in a sealed envelope. the service come and talk to us? DEBBIE THORPE, BY EMAIL

Helping new donors

EDITOR’S RESPONSE: Although we have limited staff to do this, we can arrange talks for different groups and ages.

I am a seasoned donor and see many new donors arrive from local colleges for their first session. Many of them attend

THE DONOR WINTER 2008

✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦ Living with sickle cell anaemia Annie McDonald was just three years old when she was diagnosed with sickle cell anaemia. Her red blood cells can become rigid and misshapen, so they obstruct small blood vessels and cut off the blood supply to tissues. The result is painful ‘crises’ in her bones and organs. Annie has needed blood transfusions throughout her life to help her to manage her condition. Despite this, Annie spends two days a week with Croydon Sickle Cell & Thalassaemia Support Group helping other sufferers. The charity offers financial and emotional support to sufferers and their families. When not helping there, Annie is a keen flower arranger! She says, “People with sickle cell are in constant need of blood. I am grateful to blood donors who have enabled me and the many other sufferers out there to live our lives.” ●

✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦✦

WINTER 2008 THE DONOR

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OVER TO YOU alone and sometimes seem to be a bit apprehensive. Would there be any merit, when a new donor [of any age] arrives, in asking one of the more experienced donors [with the permission of the new donor] if they would ‘team up’ with the new donor? The experienced donor could then explain each step of the process and reassure the new donor.

A green issue

I'm perturbed by the apparent waste involved in donating. For example, in the past, a swab of cotton wool was used to clean the skin before donating. Now, a large solid plastic ‘instrument’ is used for each donor and then discarded. These must add up to a mountain of waste. Of course I realise the importance of hygiene but surely there must be a happy JOHN CAMPBELL, BY EMAIL EDITOR’S RESPONSE: This is a very medium? Can't we save lives good idea and one which without destroying the planet?! many regular and new donors LUCINDA MORRISON, BY EMAIL may be willing to try. EDITOR’S RESPONSE: The instru-

BLOOD FACTS ment is a chloraprep wand. It was introduced to improve arm cleaning, a critical part of making sure blood is safe for patients. Since the introduction of the chloraprep we have almost a 100 per cent pass rate in arm cleanliness, a marked improvement over previous methods. We are now looking at wipes to see if there are any that meet the standards of the wand. We do have a strong environmental policy, but we need to continue to work to improve blood safety.

IS IT TRUE THAT...

Q

We reply to some of your questions about donating

I started to donate blood after the birth of my first child in April 1980 after needing a blood transfusion.I continued donating until the vCJD guidelines were introduced stating that anyone who had received blood after 1 January 1980 could no longer donate.I was disappointed but accepted that blood safety was necessary.Will the date ever move as years pass, and if not why? Surely the 25 year safety limit has been exceeded now. If any changes are made to this, will affected donors be automatically notified?

A

The date of 1 January 1980 was decided on because experts believe that before this date, BSE disease, the probable cause of vCJD, was not prevalent in the cattle population.The only thing that might change this guideline would be the

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introduction of a test for vCJD, which is currently being researched. But it is very unlikely to be introduced for several years.

Q

Having given blood three times, I’ve noticed that, compared to other donors, it doesn’t take me long to complete a donation.Is it because I have higher blood pressure or thinner blood or another reason?

A

The time it takes to donate largely depends on the size of the vein used. Large veins have a faster blood flow.Another factor may be the total blood volume circulating and how warm you are. Men will usually be quicker to donate than women for all these reasons.

Q

I always feel uneasy about the questions regarding sexual practices in the Donor Health Check.In my experience the blood donors I know tend to be

THE DONOR WINTER 2008

people who are responsible in all aspects of their lives including their relationships. Could there not be a box for those who are in a long-term heterosexual relationship or celibate, even, which one could tick and then move on to the next section?

A

We really do have to ask these questions each time as they are very important screening questions. For patient safety we can’t accept one single answer to all the questions currently in the “lifestyle”section.

Q

Once, my donation was refused because I was using a lotion for a fungal foot infection.I wrote to you and was told that I had been misinformed.The problem has returned and I am again applying the lotion (Trosyl). Can I still donate?

A

Yes you can give blood,we look forward to seeing you soon. ●

Looking at leukaemia

L

eukaemia is a cancer of the blood or bone marrow, characterised by the abnormal production of white blood cells. Normal bone marrow produces stem cells which mature into ‘adult’ blood cells. With leukaemia, the bone marrow releases too many immature white blood cells. These disrupt the normal balance of cells in the blood. As a result, the body simply doesn’t have enough red cells or platelets in the blood to do its job properly. This causes symptoms of anaemia and the risk of excessive bleeding and bruising. As the white cells are not properly formed, patients are left more vulnerable to infection too.

Most of us have heard of leukaemia – but did you know there are over 100 different types?

marrow cells that normally form the lymphocyte type of white blood cells which are affected. In myeloid leukaemias, it’s marrow cells that normally form other types of white cells which are the cause of the problem. Acute lymphoblastic leukaemia (ALL) is the only form of leukaemia, and one of the few forms of cancer, that is more common in children than in adults. It is also the most common form of leukemia in young children, accounting for more than 80 per cent of cases. Chronic lymphocytic leukaemia (CLL) is the most common form of chronic leukaemia, with Quick or slow Different cells affected 4,000 new cases occurring every One important way the disease Leukaemia can also be divided year in England and Wales. It’s can be classified is how quickly into lymphoid and myeloid types. most common in the over 55s, the disease is developing– In lymphoid leukaemias, it’s and very rare in children. Acute myeloid leukaemia (AML) is more common in adults than children. Chronic myeloid leukaemia Cell type Acute Chronic (CML) affects mostly adults, Lymphoblastic Acute Chronic and there are 500 new cases leukaemias lymphoblastic lymphocytic every year in England and Wales. leukaemia (ALL) leukaemia (CLL) Fewer than 15 children per year in the UK develop the disease. Myeloid leukaemias Acute myeloid Chronic myeloid Hairy cell leukaemia (HCL) leukaemia (AML) leukaemia (CML) so-called because of hair-like whether it’s a chronic or acute form. With acute leukaemia the condition comes on rapidly, some times in just a few weeks and often the first symptons noticed are extreme tiredness, suffering recurrent infections or bleeding. Immediate treatment is needed. With chronic leukaemia, the condition comes on much more slowly, sometimes over years. This is more likely to be picked up in other ways such as routine blood tests. In the case of chronic leukaemia, often the patient is monitored for some time to judge the best way forward before any treatment is needed.

Four major kinds of leukaemia

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growths seen on the white blood cells when looked at under a microscope. It is much rarer than the other types and about 80 per cent of affected people are adult men and there are no reported cases in young children.

Treating acute leukaemia

Joe’s story Joe Males, pictured right, was 14 when he was diagnosed with ALL and AML (usually called biphenotypic leukaemia). His best chance was a bone marrow transplant, and after four months a perfect match was found in Canada. Joe and his family were delighted. But, nine months after his transplant, the leukaemia returned, and, sadly, no more could be done. Joe died at home, surrounded by his family, six days after his 16th birthday and just 16 days after his relapse. Joe’s twin sister Jessica, now 17, recently gave blood for the first time. She says, “Giving blood was easy and I’d encourage anyone thinking about donating to just go and do it. I’ll join the British Bone Marrow Registry as soon as I turn 18 as, without the kindness of the bone marrow donor that allowed Joe to have his transplant, my brother may not have been able to find a match and we wouldn’t have been able to spend the quality time with him that we did.”●

Due to the rapid and aggressive nature of acute leukaemia, treatment will usually begin within days of the diagnosis. However, many therapies cause serious side effects. Children and adults in good health can usually tolerate the regimes, but older people or those in poor health often can’t. In these cases it may be possible to achieve a remission in symptoms but not a cure. Treatment for acute leukaemia is carried out in three stages: Induction aims to kill the leukaemia cells in the bone marrow, restore blood to proper working order and resolve symptoms with a combination of chemotherapy medications. Treatment is carried out in hospital and the patient will probably need regular blood transfusions to help increase the count of healthy blood cells. The count falls due to a combination of the disease and the chemotherapy. The induction phase can last from two weeks to several months, depending on how well the patient responds to of cancerous treatment. Consolidation is the next cells remain in the body. stage. Leukaemia can return Consolidation treatment aims to even if only a small number kill off any remaining leukaemia

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THE DONOR WINTER 2008

Boosting survival ● 8 out of 10 children now survive acute leukaemia ● A new test to detect Minimal Residual Disease (MRD) may help up to 9 out of 10 children to survive. The test picks out previously undetectable leukaemia cells and allows doctors to fine-tune treatments ● Scientists hope to develop an MRD test for adults with acute leukaemia ●

Bone Marrow Transplant This is more commonly needed for acute than for chronic leukaemias and aims to cure the disease in circumstances where chemotherapy alone would not be sufficient. But there are risks associated with it. To prepare the patient, aggressive high-dose chemotherapy and radiotherapy are used to destroy leukaemia cells in their body, but as they also wipe

out the bone marrow and destroy normal cells in some tissues of the body, there are potentially serious side effects and complications. Blood products form a crucial part of the patient’s treatment, to replace all the red cells and platelets that the patient can no longer make after their bone marrow is wiped out. Eventually, if successful, the new donated bone marrow takes over. ●

‘You are my lifeline...’

patient for over a year and aims to prevent the return of the leukaemia. But it is not used to treat AML, as it doesn’t seem to be effective.

Treating chronic leukaemia

cells that may be present. Maintenance is the final stage of treatment for ALL. It involves further treatment as an out-

Imatinib is the main treatment for CML and it is usually given immediately after diagnosis. It can be undertaken on an outpatient basis. The medicine prevents the leukaemia cells from growing and multiplying. Interferon alpha is used when Imatinib doesn’t work or causes intolerable side effects. Interferon encourages the immune system to attack leukaemic cells. It is given by injection at home. The patient has regular blood tests to monitor the illness and when symptoms require treatment, the drug can be given on an out-patient basis.

Dianne Stracey, 61, pictured above, was diagnosed with chronic myelomonocytic leukaemia five years ago and has needed more than 400 units of blood products so far. Dianne needs platelets at least twice a week and often spends time in hospital due to nose bleeds, bleeding into her joints and infections – all of which mean more blood and platelets. Because over time, some people can develop antibodies to platelets, she relies on a handful of special, closely-matched platelet donors to keep her alive. “I remember my nurse telling me last Christmas that because of illness and holidays the number of suitable donors for me had fallen to just three or four. I am constantly amazed by the commitment of regular donors – they are my lifeline.”● WINTER 2008 THE DONOR

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TISSUE DONATION

N

icola Langlands was born with half a heart – instead of four chambers she had two, connected by one valve. She had little chance of survival. Aged three months, she had her first operation, to fit a pulmonary band around the arteries that would stop too much blood flowing into her heart and lungs. Growing up was a struggle. “I would get very frustrated as I couldn’t actively play with my friends,” says Nicola. “My mind was active but my body found it impossible to keep up.” Parents Lynne and Jim were very supportive and encouraged her to do what she could. They kept the house and family life as normal as possible and made minimum adaptations for Nicola; even her oxygen cylinder would be put away after use.

A born survivor

Still a fight

Family support As the eldest of four, Nicola had lots of support. Her brothers, Alex and Tom, helped her considerably, even though Tom himself needed surgery to correct a hole in his heart. Nicola developed further problems: as her heart grew it began crushing her lungs. “I could only walk for very short distances and relied on a wheelchair,” says Nicola. “My mum would take me to the bus stop in the wheelchair and at the other end my friends would help me into school.” She developed her own way to climb stairs, and would slide up on her bottom. Nicola defied the odds by

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THE DONOR WINTER 2008

family. She first wrote to them two years after the transplant and again three years later. The family replied and they exchanged several letters over the years before they finally met and they are still in touch. Megan, now aged ten, helps her mother with the shopping trips and around the home. Nicola says, “Having Megan has given me a real purpose in life. Because of my condition I’m not allowed to work so I can devote all my time to her.”

Born with half a heart, Nicola Langlands was given just three weeks to live by doctors. But she beat the odds thanks to life-saving surgery and a pioneering transplant

reaching the age of 11, old enough to be put on the organ donor waiting list for a heart and lung transplant. She had to wait a further two and half years before a matching donor was found, a young boy of ten. The operation at the Harefield Hospital in Middlesex was one of the first carried out on a British child. Doctors told Nicola that having a baby when she grew up would be too great a risk to her health. She never really questioned the advice. “I’d been given the gift of life and felt that I should be content.” But then Nicola met Neil, an IT manager, in 1996, and unexpectedly fell pregnant. A hospital check-up showed her health and lung function were good. Doctors advised her that if she did become ill, they would not be able to treat her as it would

Opposite:Nicola likes to relax by cleaning the house Above:With daughter Megan and the family cat affect the baby. She was also advised that she could not go to full term with the pregnancy nor have a natural birth.

Baby Megan To ensure that the baby developed fully, it was given steroid injections whilst still in the womb. The pregnancy did have its complications and because of her fragile state Nicola went into hospital for three months. Later, at a specialist unit she gave birth naturally to Megan at full term. Nicola is only the third person to have a baby after such an operation in England, and the first to give birth naturally. Nicola and Neil married in 2004. When Megan was four, Nicola finally met the organ donor’s

Nicola’s battle with her condition is not over. She still takes numerous pills, including antirejection drugs, but this hasn’t stopped her volunteering with Help the Aged. After a spell of illness in October 2007, Nicola started to think hard about her transplant, how it had affected her and how it would be good to meet and talk to others like her. Back at home she set up a website www.lookbeyondtheheart.com a place where those affected by organ donation can chat about how they have been affected and offer advice. Despite the huge challenges she has faced, Nicola remains as positive as ever. She says, "I feel so blessed and honoured to have the two most wonderful gifts, my transplant and my little baby girl. Megan is wonderful and is so important to me.” ● To join the Organ Donor Register call 0845 60 60 400

WINTER 2008 THE DONOR

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MEET THE EXPERT

Getting a great sensee oof satisfaction Q A

What is Red Cell Immunohaematology (RCI) and what is your role there? The RCI laboratories help with problems that hospital blood banks sometimes have in finding compatible blood for patients. My role involves looking after the whole of RCI, which includes our ten reference laboratories around the country. I also oversee routine antenatal testing and the reagent production we do – that is quite a major part of the job. You’ve recently been part of a team establishing blood services in Malawi. How did that come about? The Government of the Republic of Malawi established the service in 2001 with €7.8 million of funding from the

Q

A

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Robin Knight has worked for us for over 25 years and now heads up our Red Cell Immunohaematology (RCI) service. His expert knowledge has taken him around the world and he is now helping to establish blood services in Malawi in Central Africa European Commission. The external project manager was someone I had worked with before when he was with the World Health Organisation (WHO) and he invited a number of external consultants to help with setting up the service.

THE DONOR WINTER 2008

Q A

How often do you get to visit Malawi? Very often. Since 2005 I have been there seven times – and twice this year already. I usually spend between two and four weeks a year in Malawi. My wife has also accompanied me on trips. She is a teacher and when we are

Q A

What’s your own role in Malawi? I have been a technical consultant for the service. My specialised area is donor blood grouping, and I have also been helping set up the components production and ensuring quality control. Since the project started I have also been helping in training local staff. This involves advising them on how to bring themselves up-to-date on current developments in blood transfusion worldwide, plus building their confidence to help them do more things for themselves. Which staff are you training? I have recently been training the hospital blood bank staff. Up to now we have been focusing on working with the transfusion service staff, but we are also trying to improve not just the transfusion service but the whole of transfusion practice throughout the country.

Q A

Q A

What are the biggest challenges facing the blood service in Malawi? The biggest challenge is getting enough volunteer, unpaid donors. Most blood is needed in the rainy season, November to March, when malaria cases peak. In fact, 50 per cent of

transfusions in Malawi are given to children, many of whom suffer from the disease. But many donors are students and during this period they are taking their college holidays, so it’s difficult to get enough donations. Also reaching donors in rural areas can be tough because of the state of the roads after heavy tropical storms. All that travel must be fascinating but also tiring. What keeps you motivated? I'm doing the work I have always wanted to do and I’m very passionate about it. It gives me a great sense of satisfaction that I am helping so many people. Soon there will be three blood processing sites serving around 13 to 14 million people in Malawi. It’s incredibly rewarding to have been able to play a part in making that happen. ●

Q A

Left:Testing blood Below:Many children need blood transfusions

there she volunteers to work in a local orphanage. Is Malawi the only overseas project you have been involved in? No. I’ve worked in several other countries. I’ve done quite a few projects in Southern Africa as well as in Chile. I’ve also been to Libya a couple of times. As well as my hands-on training work, my work for the World Health Organisation has included writing distance-learning projects.

Q A

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ASK THE DOCTOR Our doctor, Susan Barnes, explains why we

CROSSWORD

Golden donors

Complete the crossword. The letters in the shaded squares, when rearranged, spell out a two-word phrase. Send the phrase on a postcard or letter together with your name, address and daytime phone number to: Crossword Competition, The Donor, NBS, Colindale Avenue, London NW9 5BG. You could win an ‘Amazing’ NBS sports umbrella. Answers and the winner will be in the next issue. All entries must be received by 28th February 2009.

are making changes to our donor age limits

Q

Why is the upper age limit for regular donors being removed from January 1st 2009? We had a look at our donors and found that as they get older, they actually have fewer problems with donation. Also, we know that a lot of our older donors do n’t like being retired when they reach the age of 70. Many lead fit and active lives and feel very loyal to the cause of blood donation.

Q

What are the benefits of removing the age limit? The change is a benefit to our existing donors as they are very keen to continue donating. It is a benefit to patients as it helps to maintain a safe and regular blood supply. And it is a benefit to us because donors from the older age group are the most regular and reliable. So, everyone wins.

Q

Is it safe to keep donating past the age of 70? Yes, absolutely. We looked at transfusion services in North America where they removed the age limit and found that older donors can continue to give without any problems. In the USA they have people who are still donating well into their 90s. All the

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research shows that if you are fit and well there won’t be any problems. Though, of course, we will certainly monitor the results of our changes very carefully.

Q

Does this change apply to component donors, such as those giving platelets? Yes, the upper age limit is being removed for our platelet donors also. However, the lower age limits remain the same as before – 17 for a whole blood donor and 18 for a platelet donor.

Q

Why are the lower age limits different? The lower age limit is different because our safety rules require that you have given blood at least once before giving platelets.

Q

Does that mean everyone can keep donating beyond the age of 70? No, this change only affects our ‘regular’ donors. To be a regular donor you have to have donated within the last two years. New and returning donors are still welcome to donate up to their 66th birthday.

Q

Are there any other changes we should know about? Yes. We have removed some of the restrictions concerning donors with high blood pressure and diabetes. These days far more people are

THE DONOR WINTER 2008

being treated for these conditions. The trend is now for earlier treatment to prevent problems arising in the future. Our donors did not like being prevented from giving blood when they felt fit and well. In the past we only let patients give blood whose blood pressure was managed by a limited group of medications. Now we have removed these restrictions for donors, as long as their blood pressure is stably managed, their medication has remained unchanged for the previous four weeks and they have not experienced any other problems. Previously we did not take blood donations ever from diabetics. Now we will do so, as long as their condition is stably managed, they are not receiving insulin and not experiencing any other problems. ●

Keep up-to-date You can find out more about the changes, as well as other information about donating, by calling the 24 hour Donor

ACROSS

1 Drink (6) 5 Make certain of (6) 8 Space for washing machine etc. (7,4) 9 Sculpture of person or animal (6) 10 Warm up again (6) 11 Dogmatic (11) 14 Pattern made of small fragments (6) 16 Underground hollow (6) 18 Area including Devon and Cornwall (4,7) 19 Evergreen shrub or tree (6) 20 With fervour (6)

DOWN 2 3 4 5

6 7 11 12

Climb (5) Stupid (7) Deportee (5) Wing case of beetle (7) Laziness (5) Run amok (7) Entrance (7) Use again after processing (7)

13 Person asked to be a guest (7) 15 Strong point (5) 16 Noise of hen (5) 17 Regal (5)

LAST ISSUE’S SOLUTION

Helpline on

0845 7 711 711 or visit the website

www.blood.co.uk

WE HAVE A WINNER! Congratulations to L A Griffiths from Northwich, who correctly answered last issue’s crossword. The correct answer was: BLOOD DONOR. WINTER 2008 THE DONOR

31


Bridie rece units of bl ived nearly 50 ood during chemand platelets She later re otherapy. ceived a st em cell transp la beat leukae nt to mia.

Sarah needed blood and platelets during chemotherapy and in 2006 received a stem cell transplant. She is now happy and well.

Blood stocks run low at Christmas

Please give blood... . . .you could save someone’s life...today

INFORMATION

Just call our 24 hour Donor Helpline and staff will answer your queries on all aspects of giving blood.

Remember, you can call the Helpline to tell us if you have moved house or changed employers! DON’T FORGET information is also available on our website.

0845 7 711 711 www.blood.co.uk

We always need new donors. So please, if you are not a donor, fill out the coupon below, place it in an envelope and send it to National Blood Service, FREEPOST, 75 Cranmer Terrace, London SW17 7YB, or call 0845 7 711 711 now to enrol as a donor. Mr/Mrs/Ms/Miss FIRST NAME

SURNAME DATE OF BIRTH D D / M M / Y Y

ADDRESS POSTCODE DAYTIME PHONE No

To give blood you need to be in good health, aged 17 to 65 and weigh over 7st 12lbs/50kg. I would like to join the NHS Blood Donor Register as someone who may be contacted and would be prepared to donate blood. I understand that the National Blood Service (NBS) or its partners may phone, write or otherwise contact me with details of local donor sessions. I agree to the NBS holding my personal details on their donor database and processing this information as necessary for the proper administration of the NBS. MO6


The Donor - Winter 2008