The National Voluntary Blood Services Program

Since it's enactment in May 1994, the National Voluntary Blood

Services Program (NVBSP) under the Department of Health, has been
working hand in hand with other government and private agencies to
promote voluntary blood donation.
The two(2) major functions of the program are:

-Program development and management: which include among

others, the conceptualization, planning, and coordination of core
activities such as promotion of voluntary blood donation, public
education and advocacy, upgrade of blood services and facilities,
and effective and equitable collection and distribution of blood,
and other resources and

-Regulation and quality control: which include mainly licensing

and authorization of blood services facilities and ensuring
compliance with national specifications and standards and
quality.

VISION

In the year 2004, we envision a network of modernized national and

regional blood centers operating on a fully voluntary, non-remunerated
blood donation system that will ensure safe, adequate, accessible and
rationally used blood supply.

MISSION

In pursuit of our vision, we will ensure adequate, safe, and accessible

blood supply by:

o promoting voluntary blood donation as a way of life for

every qualified healthy Filipino
o establishing new blood service facilities and upgrading
existing ones.
o organizing association of blood donors, and

training medical (nurse, doctor) practitioners on rational

blood use.
The NVBSP in action...
What is R.A. 7719?

Republic Act 7719 is otherwise known as the "Blood Services Act of

1994".

The main objectives are:

• to promote and encourage voluntary blood donation by the

citizenry and to instill public consciousness of the principle that
blood donation is a humanitarian act;
• to provide, adequate, safe, affordable and equitable distribution
of supply of blood and blood products;
• to mobilize all sectors of the community to participate in
mechanisms for voluntary and non-profit collection of blood.

What are Blood Types?

The normal human adult has approximately 5-6 liters of blood in his
body. During each blood donation between 250 to 450 ml. of blood is
removed from the circulation. The exact amount taken will depend on
the body weight.

The small loss will be rapidly made up by the body. The fluid portion
will be replaced within 24 hours, and the cells will be replaced by the
body's bone marrow within weeks, so that by the end of the month,
the body will have the same amount of blood as before the blood
donation.

Complex chemical substances found on the surface of red blood cells

are different for each blood group. The two most important ways of
classifying blood in transfusion work are a person's group (A B O
system) and their type (Rhesus (Rh) system).

Within the A B O system people can be one of four groups - O, A, B, or

AB, whilst the Rh system they can be either Rh positive or Rh negative.
Thus, there are eight main blood groups.

The 'Rh' Factor

The Rhesus factor is another blood group antigen which was

discovered on 1940. Those who have this Rhesus factor in their red
blood cells are called 'Rhesus Positive'. Those who lack the factor are
called 'Rhesus Negative'. Thus every person is either 'Rh Positive or Rh
Negative' while he belongs to one of the A-B-O groups. The percentage
distribution of the Rh antigen varies on racial groups.
The vast majority of the Malays and Chinese are 'Rh positive'. Among
Europeans, about 85% are 'Rh positive' and the remaining 15%, 'Rh
negative'. About 5% of Indians and Eurasians are 'Rh negative'. Here in
the Philippines, the estimated number is 1% or less the total number of
population.

The giver receiver chart below shows the compatibility of different

blood groups.

Composition of Blood

Blood appears to be red liquid. 45 % of the blood consists of cells,

namely the Red Blood Cells (RBC), White Blood Cells (WBC) and
platelets. The remaining liquid portion is plasma. Plasma consists
largely of water with some salts and proteins.

Red Cells

The red cells are made in the marrow cavities of certain bones,
especially the spine, ribs and breastbone.

The red cells contain a substance called hemoglobin. Hemoglobin

consists of iron-containing red pigment (heme) combined with a
protein substance (globin). Hemoglobin gives the red cells their color
and their ability to take up oxygen in the lungs. Red cells provide the
body with a vehicle for gasses. After picking up oxygen in the lungs,
red cells deliver it to tissues, where it is used.

Iron is a key raw material required by the red cell factories. It is

necessary to have enough iron in the body to keep the production of
hemoglobin up the normal rate. If iron is lacking, the amount of
hemoglobin and the number of red cells in the blood is reduced. This
gives rise to the condition known as anemia.

White Blood Cells

White cells are made in the bone marrow and in certain lymphoid
tissues of the body. The white cell : red cell ratio is 1:100. The se white
cells are among the most important agents by which the body defends
itself against disease.
White cells can be thought of as the defending army, with various
corps having their own specialties. When the body is attacked by an
invading disease, the white cells close in. One group, the neutrophilic
granulocytes, "fights" the bacteria by "eating " them. Another group,
the lymphocytes, produce antibodies that combat the invading
bacteria. Some antibodies remain in the bloodstream for a while to
protect the body from further attack.

Platelets

Platelets are formed by fragmentation of giant cells, megakayocytes,

in the bone marrow. There are about half a trillion platelets in the
normal bloodstream. After a short life of 10 days they are removed
from the blood by the spleen, lymph nodes and liver.

Platelets help control bleeding. They stick to injured surfaces of blood

vessels, and provide the surface for clotting factors to accumulate on,
thus, plugging up breaks in the blood vessels.

Plasma

Plasma is composed of water (90%), proteins (about 7%), and very

small amounts of fats, sugar and mineral salts. The sticky or gummy
quality of the blood that is necessary for maintaining normal blood
pressure is partly caused by the plasma proteins. Plasma proteins
include the blood clotting factors.

How are blood groups inherited?

Blood groups for each individual are determined by genes (small

packets of information in cells) which are inherited from both parents.
Genes for the Rh negative and O groups from one parent are masked
by the presence of Rh positive and A or B genes from the other parent.
Thus people who are apparently A or B Rh positive may also carry
genes for the O and Rh negative blood groups which can be inherited
by their children.

Are there any other Blood Groups?

Many other blood groups systems, each with several sub-types, have
been found. Altogether there are well over 300 known blood group
factors. However, the A B O and Rhesus systems are still the most
important as far as blood transfusion is concerned.

What are Antigens and Antibodies?

On the surface of each cell there are complex molecules called

antigens which have their own characteristics. This is true for all types
of cells including bacteria and viruses. Thus, when foreign cells are
introduced, the body recognizes that they are different because of the
special characteristics of their antigens. The body then produces
proteins called antibodies which can combined with, and neutralize,
these foreign antigens. These antibodies are made by specialized
white cells and circulate in the plasma.

What is the role of Antibodies?

Antibodies produced against bacteria and viruses are an essential part

of the body's defences against infection. In preventive medicine
doctors give injections of the appropriate antigen to help the body
build up its immunity to diseases such as diphtheria, tetanus, polio and
typhoid. This is called "active immunity".

Injections of specially prepared antibodies, called immunoglobulins can

be used to give "passive immunity" to help patients fight severe
infections against which they have no active immunity. For example,
tetanus immunoglobulin (tetanus antibodies) is now available to treat
patients who develop this serious disease, but it is better to prevent
tetanus by regular ten-yearly booster injections to sustain "active
immunity".

Many antibodies are passed from the mother to the unborn child
during the latter months of the pregnancy, and some are secreted in
her milk during the baby's first weeks. This "passive immunity" helps
to protect the baby from the infections during the first six months of
life.

Who can donate?

To ensure the safety of blood supplied, donors must meet certain

requirements before donating.

You may be eligible to be a blood donor if you

o weigh more than 45 kilograms (100 lbs.) for 250 ml. of

donated blood
 50 kilograms (110 lbs.) for 450 ml. of
donated blood

o are in good health

o are aged 16-65 years of age ( for ages 16 & 17, parental
consent is needed)
o blood pressure in safe range - 90- 160 mmHg systolic
o 60-100mmgHg diastolic
o hemoglobin is at least 125 g/l (12.5 g/dl)

Conditions that can prevent you from sharing your blood

o Diabetes
o Cancer
o Hyperthyroidism
o Cardiovascular diseases
o Severe psychiatric disorder
o Epilepsy / convulsions
o Severe bronchitis & other lung disorders, such as TB
o AIDS, Syphilis & other sexually transmitted diseases (past
or present)
o Malaria
o Kidney & liver diseases, such as Hepatitis
o Prolonged bleeding
o Use of prohibited drugs

Where can I donate?

Listed are the following DOH / private hospitals and PNRC blood
service facilities where you can donate your blood:

Steps on how to donate blood:

• Go to the nearest BLOOD COLLECTION UNIT (BCU) located in a

government hospital
• Register as a potential blood donor
• Your health history will be taken
• A physical examination follows to check on your weight,
temperature, pulse and blood pressure.
• A blood test will be done to know your blood group type

What happens to your blood after you donate?

Unless whole blood is urgently needed, your blood donation, once

cleared by all screening tests, is separated into its components - and
using the particular component needed by a patient, it is now possible
to use a single donation to treat several patients suffering from
different illnesses. The technique is known as 'blood component
therapy'.

Who receives blood?

From a single blood donation, up to 13 products can be produced, all

serving a vital function to others in need.

Those who receive blood form donations include:

• patients suffering from shock

• lost 20% or more of blood in an accident
• loss in surgery
• leukemia
• childbirth
• major trauma
• liver transplants
• hemophilia

What are the blood components in common use?

Red cell concentrates are the most widely used blood component.
Most patients requiring transfusions are in need of the oxygen-carrying
capacity of the red cells, however few require whole blood. Most
require red cells only. Red cell concentrates contain all the red cells of
a unit of blood in about half the original volume. These red cells are
mixed with special additive solution containing extra glucose and other
substances to keep the cells alive and functioning.

Platelet concentrates are used to control bleeding due to platelet

deficiencies. These may be caused by disease (e.g. leukemia) or may
follow severe hemorrhage. Platelet concentrates can be stored for 5
days.

Cryoprecipitate is occasionally used for the treatment of Haemophilia

A, the most common inherited bleeding disease, but is more
commonly used in the treatment of massive bleeding.

How is blood kept free from bacteria?

Blood is collected with special care to avoid contamination, then kept

cold to prevent bacteria from growing. Refrigerators with thermostatic
controls keep the blood temperature between 4degC and 6degC. An
alarm sounds if it varies outside these limits and an auxiliary power
source is used to keep the refrigerator operating if the power supply
fails.

When blood is transported, similar temperatures are maintained by

using insulated carrying boxes and ice refrigerated delivery vehicles.

For how long can blood be stored?

Whole blood and red cell concentrates were in the past stored for four
weeks. With the new blood preservatives the shelf life can be safely
extended to five weeks. Plasma can be stored frozen for 12 months.

What to expect when donating...

Upon arrival at the blood collection unit/blood bank, you will be asked
to fill up a Donor's Form.

It is important that we protect both you and the patients who receive
your blood from suffering any adverse affects from your donation.
Therefore, on your first visit, you will be interviewed about your past
and present medical history. This will take about 15 minutes and is
confidential.

To ensure that your hemoglobin (iron) level is high enough for you to
donate, a small sample of blood from your finger will be tested. (We
don't want you to be anemic after you donate).

Before you donate blood, your blood pressure will be measured. The
donation takes 5-10 minutes. Approximately 450cc of blood will be
taken, which is about 7-9% of the blood volume of an average adult.

The volume will be replaced by your body within 24-48 hours and by
drinking more fluids.

Every time you donate, your blood is tested for diseases such as HIV
(AIDS), Syphilis and both Hepatitis B&C. Your donation is also checked
to identify and confirm your blood group.

After donating blood...

Keep an eye on your dressing. You should leave the adhesive dressing
on your arm for at least 3 hours but not more than twelve (12) hours.
Do not be alarmed if some bruising or discoloration occurs. It will
disappear in a few days.
Avoid carrying heavy objects with your donating arm. And do not
smoke for the next 2 hours and avoid alcohol intake for the next
twelve (12) hours.

Eat regular meals and increase fluid intake following your donation.

Source: http://www2.doh.gov.ph/blood/main_frameset.htm