As Dr Alison Gould from Lifeblood walks us through the blood products donation process, we hear from a first-time blood donor, a Queenslander who has been giving blood and plasma for over 30 years, a Queensland family who rely on donated blood products.
Featured in this episode
Dr Alison Gould
Dr Alison Gould works at the Australian Red Cross Lifeblood as National Leader of Research Engagement and Communication.
Kate Fisher
Kate Fisher is the host and executive producer of Milkshakes for Marleigh, inspired by her daughter, Marleigh, who is dependent on blood products to stay alive.
Caitlin
Queensland woman Caitlin allowed us to follow the process of her first ever blood donation experience for this podcast episode.
Cathy Stanbrook
Cathy Stanbrook is a senior social worker. She’s also a regular blood donor, having donated more than 100 times in 30 years.
Milkshakes for Marleigh
Milkshakes for Marleigh is a podcast and book created by Kate Fisher. She shares her daughter Marleigh’s journey, who is dependent on blood products to stay alive, and inspirational stories from donation recipients and donors. You can find out more on the Milkshakes for Marleigh website and listen on any podcast app.
Becoming a blood donor in Australia
Has this episode inspired you to donate blood or plasma? Find out more about how to sign up as a donor through Australian Red Cross LifeBlood.
Transcript
Where does donated blood go?
How can I donate if I don’t like needles?
Why does my blood type matter?
Can I donate if I have tattoos?
Narrator: Welcome to It Can’t Hurt To Ask, the podcast from Queensland Health exploring all your health questions, concerns and curiosities.
This season we're exploring all things blood. And today is all about blood donation.
Hi, I’m Lauren and this episode was recorded on the lands of the Jagera and Turrbal people. We acknowledge the Traditional Custodians and pay our respects to the Elders past, present and emerging.
As always, whatever you hear in our episodes is general information. Always speak to your doctor about your individual circumstances.
Ready to dive in?
Have you ever donated blood? Or been the recipient of any blood product?
In Australia, one in three people will need blood or blood products in their lifetime. But currently only one in 30 of us actually donate.
That’s a bit of a gap, and one that can have significant consequences.
There can be many reasons for not donating blood. Maybe you can’t for health reasons, you’re short on time, or you’re just a little nervous or unsure about what is actually involved.
We’re going to hear from a few people today to help us better understand how it all works.
First up, let’s meet Caitlin.
She’s donating blood for the very first time today.
We’ll check in on her throughout the episode, but for now, how is she feeling as she arrives for her appointment?
Caitlin: I’m excited! It’s the first time I’m donating blood. I’ve had many reasons why I haven’t been able to give blood before, either been underweight, anaemic, pregnant or breastfeeding so I feel like this is my time to shine. I’ve always wanted to give blood so it’s exciting it’s actually happening!
Narrator: Before any blood is taken, you'll be assessed by a staff member who will ask you a few questions and take your blood pressure.
While Caitlin gets the blood pumping, let’s rewind little bit further. Because at your first donation, one of the things you’ll learn is what blood type you are.
But what does that actually mean, and why does it matter?
Your blood type is determined genetically. Like your hair, skin, eye colour, it’s all determined by the genes that you inherit from your parents.
You’ve probably heard of blood types like A, B, AB, and O positive or negative.
This way of talking about blood types uses two different blood group systems. The first system is the ABO blood group system, which is the letter of your blood type. The second system is the Rhesus system, which is the positive or negative part of your blood type.
But there are actually 44 blood group systems, and about 350 different possible blood groups. That’s a lot, right?
Unfortunately (or fortunately!) we won’t be covering all of them today. So, we’ll just focus on those two you’re most likely to be familiar with already.
To explain more, let’s meet Dr Alison Gould. She works at the Australian Red Cross Lifeblood as National Leader of Research Engagement and Communication.
Dr Gould: So, the A and B and Rhesus antigens, which is what we're talking about when we talk about A, B, O, and RH, are actually markers on the outside of your red blood cells.
So basically, the antigens, which are the AB and RH antigens that determine your basic blood groups, are markers on the outside of your red blood cells. So, if you'll imagine, a lot of people have seen pictures of red blood cells that look like little squished, almost like donuts. Imagine if you're zooming right in; you'll look, a tiny little picture standing on one of those and that's like a planet. If you look around you, you'll see all sorts of molecular markers on the surface of those cells that are a bit like a forest, trees forming a surface on that, on the surface of that red blood cell.
And those are all sorts of protein molecules with all sorts of different sugar decorations on the outside of them. And some of them have things that have been recognised as antigens, which are things that other people's bodies will recognise as foreign if they come in. And the biggest ones are the A, B, AB, and Rhesus.
Narrator: As we’ve just learnt, blood type is genetic which means that depending on people’s ethnic ancestry, we might see more or less of certain blood groups in different areas of the world.
In Australia, 38% of people are O positive, making it the biggest blood type. Only 7% are O negative.
The second most common blood type at 32% is A positive. 12% of people are B positive, 4% are AB positive, and just 2% are B negative. The rarest is AB negative, represented by just 1% of the Australian population.
The blood type you have also determines the blood type you can receive. This is because our bodies react against things they don’t recognise as a safety mechanism to protect us. That applies to red cells too.
Dr Gould: If you receive a transfusion of a red cell that has an antigen on it, your body doesn't recognize, then your body may react against it.
So, people who have got the A antigen or the B antigen can receive red cells from anybody who has the A antigen or the B antigen or who doesn't have either of those, which is the O blood type.
So, our most versatile blood group is the O negative because they don't have that RHD antigen, which gives you plus or minus, and they don't have the A and they don't have the B.
They can be given to anyone in an emergency. So interesting fact, only 7% of Australians are O negative, but about 18 or 19% of demand for red blood cells is for O negative. So, if people out there are O negative donors, and they feel like getting called more often than their friends, that will be why.
Narrator: Speaking of, shall we check in with how Caitlin is doing with her first donation?
She’s passed the initial interview, her blood pressure is fine and her haemoglobin levels are good to go.Haemoglobin is a protein in your red blood cells that carries oxygen to your body’s organs and tissues and takes carbon dioxide back from these to your lungs.
Caitlin is now settling into the chair to donate.
Caitlin: So, I’ve got my seat, Taylor’s got me up high with my legs out and some exercise I have to do to keep the blood flowing through my body. I’ve got to squeeze my leg muscles and wiggle my ankles around. She’s got my arm prepped and cleaned and had a squeeze of a squeezie and got a blood pressure cuff on. The area is all ready for the needle to go in so just waiting for that to happen.
The chair is so comfy. This chair is lush, I love it (laughs).
Vox pop: How can I donate if I don’t like needles?
Dr Gould: There's a lot of people who are afraid of needles and I was afraid of needles when I started donating blood, but there’s a few things you can do. One is don't look when the needle goes in. It doesn't actually hurt that much. And if you look away and think about something else or chat to the nurse, then that's a really good distraction. Also think of who you're helping at the time. So, it's like, it might be a small prick in the arm for you, but it's saving someone's life.
But for helping with anxiety, there are things like deep breathing, chatting to a friend. So go in and donate with a friend. The app actually has now a function where you can click, I want to make an appointment with a friend and it'll tag them and they will say, yes, I'll come and donate with you. So that's a great function that's there now. Take a book, listen to your favourite music.
Narrator: Other ways you can prepare include staying hydrated from the day before and eating a salty snack beforehand. You'll be reminded of these before your appointment.
There are also helpful diagrams showing simple exercise you can do in the chair, like pointing your toes and crossing your legs. This can help keep your blood pressure up and distract you if you’re nervous.
Narrator: When you go to a Lifeblood centre, you can donate either blood, plasma or platelets.
When you donate whole blood, your donation is separated into three components: red cells, platelets and plasma. Often, they will go to three different patients, so each time you donate, you’re potentially saving the lives of three people.
Plasma is an element that helps make up our blood. Dr Gould describes it as almost like the water in a water slide. So, your red cells and your platelets are the people going down the water slide, and the plasma is the water that keeps everything moving smoothly.
Whole blood is the quickest form of donation. It actually only takes about 10 minutes in the chair, but it’s recommended to allow for an hour total. That includes the interview and prep at the start, and recovery and snacks at the end. You can donate blood every 12 weeks.
Plasma, which can be donated as often as every two weeks, takes a little bit longer. You’re in the chair for about 45 minutes, so allow about an hour and a half for the full appointment.
The joys of a podcast? We can fast-forward a bit. So, let’s see how Caitlin is doing now her first donation experience is complete.
Caitlin: So, something I didn’t expect was that my blood was really slow to go into the donor bags, some is fast, some is slow, so mine is slow so I had to have heat packs put on me to make my blood goes faster and the needle turned, but I got there in the end. So I’m learnt that you have to give 450 mls of blood to be able to use a bag, and I just got over it. My blood is AB negative so I’m a universal donor for plasma, so it will be used likely for plasma which is really exciting.
Narrator: So, what happens after it’s collected? Where does donated blood or plasma go?
While trauma or emergency situations are certainly part of the story, your favourite medical soap opera may have misled you about the frequency.
Dr Gould: I know before I started working for LifeBlood, I thought that's for people who have car accidents and plane crashes and cut their arms off with chainsaws and things like that.
But actually, most red cells are not used in trauma. A little over a third is used for treatment of cancer patients. And then there's around about another 30% used in various sorts of surgery, including orthopedic surgery, heart surgery, and that kind of thing. 2% is used in trauma, but only a very, very small amount. And then there's about 4% used in obstetrics for when women are having babies and have big bleeds at that time.
Narrator: It’s obviously put to very good use. But how does it get there? And how quickly?
Dr Gould: So, while the blood is being processed into red cells, platelets and plasma, a small sample of each donation goes to the testing labs and it gets tested for blood types, so the ABO and RHD in the first place. And then it gets tested for any antibodies that it may have in it, that may be to other antigens that may be disruptive if they get transfused into a patient.
Narrator: There’s also testing for infectious diseases including HIV, hepatitis B and C and syphilis. Screening for bacterial contamination is also done to check no bacteria has grown.
All this happens in about a day!
Dr Gould: Theprocessing has happened and then each unit of blood is released, labelled as okay. And then it gets popped into that inventory and distribution centre, which is basically just like a row of fridges next to a bunch of computers where people take orders. And it's all divided up into all of the different blood types and a range of specialist treatments that can happen. It's just like a giant supermarket, clear fronted fridge. And then hospitals, when they need stuff, put orders through and people get orders up on their computers, pack them into boxes and send them off to hospital.
Narrator: You can think of plasma as being a bit like liquid gold. Currently, plasma can be turned into 18 different, life-saving products, and that number grows each year with further innovation and research.
These products are often taken from plasma through a process called fractionation.
Fractionation is when the various types of proteins in plasma are separated, purified and concentrated into medicine for a whole range of different situations or conditions.
One of these proteins created in the fractionation process is called albumen. It can help people who have severe burns.
Dr Gould: Other things that are in plasma are things like clotting factors. So, things that help those platelets form clots. They send signals and help form fibres that stabilise the clots. Some people don't have all of those clotting factors in their blood, so they need to have them topped up from someone else’s blood.
And there's another thing called anti-D, which is an antibody against that D antigen that we talked about that gives you your positive and negative.
Narrator: Anti-D immunoglobin injections are given to RH negative women who are pregnant. Anti-Dinjections are made from plasma from a small group of blood donors who have both the Rh (D) negative blood type and anti-D, a protein made by their immune system. The life-saving injections help the women from developing potentially harmful antibodies that attack the baby’s red blood cells.
Dr Gould: So, plasma can be used for so many different things to help people with immune deficiencies, new mums, even people who have been exposed to infectious diseases like chickenpox, tetanus, measles.
Narrator: One of the biggest ways antibodies sourced from plasma are used is a factor known as intravenous immunoglobin. This is a collection of the antibodies in someone’s plasma which can help people who have immune deficiencies or auto immune conditions like lupus.
So, what do blood product donations mean to the people who receive them?
Marleigh Fisher is one of the many recipients who relies on regular infusions of intravenous immunoglobin to stay alive.
Kate:My name is Kate Fisher. I'm the host and executive producer of a podcast called Milkshakes for Marleigh, inspired by our incredible little girl, Marleigh, who is dependent on blood products to stay alive. We're on the beautiful Sunshine Coast in Queensland. We relocated here from Canberra, as Canberra doesn't have a local paediatric intensive care unit.
Narrator: That’s Marleigh’s mum, Kate. As well as an award-winning advocate for blood donation, her podcast shares the incredible stories of blood donors and their recipients.
Kate and her husband were regular blood donors before, but it wasn’t until Marleigh became unwell that they realised just what a difference it makes.
When she was three years old, Marleigh was diagnosed with a rare autoimmune disorder called autoimmune encephalitis as well as epilepsy.
Kate: Marleigh was developmentally age appropriate up until the age of three. She was a little girl that loved playing in the backyard with her brothers, loved ballet dancing, loved a good girly date and a milkshake with mummy. Everything was tracking along fine. And then she began having what we now recognise as absence seizures.
Narrator: The family went through some very scary experiences with Marleigh’s seizures that left her incredibly sick. She went from a chatty, independent little girl to not being able to communicate, walk and sometimes not even recognising her parents.
Her case was conferenced with specialists all over the world, trying to find a similar case that could determine a treatment that would help keep her alive.
That treatment ended up being a product made from Australian blood and plasma donors and their kindness.
Kate: So, it's really exciting to report that while autoimmune encephalitis is a condition that has no cure, treatment options are possible if you can find the right one.
And for Marleigh, that is the intravenous immunoglobulin infusion. She is in remission at the moment, so she doesn't have active disease in her brain right now. Our teams talk about when she relapses, not if she relapses, based on her history.
But she will be lifelong dependent on Australian plasma donors.
Narrator: While the journey is ongoing and not without challenges, Marleigh’s life looks decidedly different now because of donors.
Kate: To give a snapshot of Marleigh's life now, we're living on the beautiful Sunshine Coast in Queensland and that has meant that she has got such a love of the outdoors and the beach. She has a seizure response and autism service dog named Patty. He's a beautiful chocolate Labrador who is with her all the time.
He can alert us to seizure activity sort of two to four hours before the onset of seizure activity which has just completely changed her life and gives that emotional support in hospital and during her extensive rehabilitation process as well.
So, she loves to sing, she loves to dance, she's a beautiful creative soul. Loves spending time with her brothers and I think that's one of the things that we've really highlighted through the podcast as well is that Australian blood donors don't just keep people alive. People think about it so much in terms of life saving. It can be life prolonging as well. And you know, it's kept a little sister with her big brothers and it's kept a daughter with her parents and an incredible little girl in the world giving these beautiful big messages about the importance of just really living life to the fullest.
Narrator: To learn more about Marleigh, Kate and the family’s story, you can find a link to the Milkshakes for Marleigh podcast and their lifeblood donation group in the description of this episode.
Narrator: And what makes a good blood donor?
Generally, it’s about being healthy and well and with good iron levels if they’re donating whole blood. And it’s not essential, but having good, findable veins can make the process easier.
Other things that are taken into account are your blood pressure, and your weight.
Dr Gould: We need people to be over 50 kilos and under 200 kilos, just because there is a weight limit. But more than that, someone who is kind and generous and actually wants to give a bit of themselves to help someone else. I think that's one of the biggest characteristics of all of the blood donors that I've ever met.
Narrator: There are also other eligibility factors that are taken into consideration.
These are done in collaboration with organisations like the TGA, or the Therapeutic Goods Association, who are part of the national health department and are responsible for regulating therapeutic goods including medicines and blood products.
These are regularly reviewed.
Dr Gould: Whatis important is that we base all of our decisions on evidence that's available at the time. And because evidence is always changing, then our decisions are always changing. And there are two things that we're always thinking about when looking at who's eligible to donate. One is, is it safe for the donor? And secondly, would that be safe for the patient?
And internally we have, and actually globally, a lot of the operators have what they call a risk assessment framework, because there is never zero risk of passing on a disease. So, they do have to think about what is the lowest possible risk that we're prepared to accept. And there's lots of maths and lots of epidemiology goes in behind that.
Narrator: One example is the recent rule change that now allows people who lived in the UK for more than six months between 1980 and 1996 to give blood in Australia.
This was previously prevented due to the UK outbreak of vCJD, more commonly known as ‘mad cow disease’. This is a fatal disease that can remain undetected in someone for many years. No screening test meant donated blood could not be tested for it.
Dr Gould: But on the recent re-evaluation of all of that showed that there was a very low risk to the Australian blood supply for those people to donate now. Very exciting to have all those people who lived in Britain being able to donate now.
Narrator: Another relatively recent change has been for those who have or get tattoos.
Changes were made in October 2022 to allow people to donate plasma straight after getting a tattoo. In June 2023, the rules were expanded further to allow anyone who had had a tattoo in an Australian tattoo parlour to donate whole blood just one week later.
Cathy: My name is Cathy Stanbrook. I've been a health employee for just over 23 years, and I work as a senior social worker in women's and children's which is antenatal through to paediatrics.
Narrator: That’s Cathy. A regular at her centre over the past decade, she’s clocked over 100 visits since her first donation more than 30 years ago.
Living in Townsville, she heard a radio call out for blood donors and despite a fear of needles, decided to roll her sleeves up.
Cathy: After I had my first child I used to have a morbid fear of needles and you have so many blood tests when you're pregnant I thought you know what it can't hurt worse than childbirth I'm going to give it a red-hot go.
I started donating plasma, oh gosh, probably about 10 years ago. I had a few years in between. I started donating over 30 years ago, but then I had about 10 years in between where I was chronically iron deficient, and I was unable to donate for a while. Then they discovered I had coeliac disease, so that kind of figured it out for me. When you do plasma, you get your red blood cells back, so you keep your iron stores. It works for me because I don't build it up very quickly.
Narrator: While she admits she’s still not a big fan of the needle, she uses the time in the chair to relax, popping in her headphones and listening to music. Current genre of choice? A bit of country.
Cathy also gets to see the other side through her work, seeing firsthand how patients benefit from the donations made.
Cathy: What I really like about what the Red Cross do now after you've donated your blood, they will send you a text message the next day to tell you where your blood is off to, who you're helping today. And it's really, I think it's reassuring for me to know that it's going to a good place.
Narrator: Before we finish, as always, we’ve got a few final myths to bust from your submissions.
Vox pop: How many people faint during their donations?
Dr Gould: Infact, fewer than 3% of our doners either feel dizzy or faint. So first off, it's really unlikely that you will faint or feel dizzy. And if you are someone who does go that way, there are staff to help. And you once again, you can make sure that you have salty snacks beforehand and plenty to eat and drink and that will minimise the risk.
Vox pop: Once blood is donated, does it expire or can it last for ages?
Dr Gould: I think some people think, you know, I've got to donate blood and it goes in a bank, like it's frozen away and it will be there when somebody needs it. But our red cells can only be stored for 42 days and platelets can only last seven days. So, we just need this constant supply. It's more like thinking about milk, going to the supermarket and buying milk than thinking about buying a book to put on the shelf.
And most people think there are plenty of blood donors, and they're really unaware of the fact that only 3% of the eligible people in this community donate. So, there's a lot more people out there who are eligible who could come in and help. So, don't rule yourself out. Don't leave it up to someone else to step up to join the team.
Narrator: Thank you for listening to It Can’t Hurt To Ask. We’ve followed the journey of blood and plasma from donor to recipient, heard first-hand how it saves lives, discovered what our blood type means and learnt some tips on overcoming nerves around needles.
If you want to donate, you can call Lifeblood on 13 14 95 or book online.
Thank you to Dr Gould and the Lifeblood team, and to Kate, Cathy and Caitlin for sharing their stories.
We’ve got plenty more blood-related topics coming up this season, including periods, organ donation, blood sugar, mosquito-borne viruses and much more.
New episodes drop every Wednesday.
If you enjoyed this episode, please rate or review. Even better, tell or share with a friend, family member or colleague who you think would also enjoy it.
Until next time, goodbye. And remember, it can’t hurt to ask.