The banks that give back

03 January 2023

Each year - especially across the festive season, Australians are asked to roll-up their sleeves and donate blood. But when you donate, what happens to your blood? Where does it go, and who are the people handling it?

SA Pathology manages the blood banks for public hospitals in metropolitan and regional locations across the state. 

Before blood reaches the RAH or any hospital, it must journey from the blood donation centre to a depot where it’s processed. 

The whole blood donation is separated into a variety of products including, red cells, platelets, - plasma, and even cryoprecipitate (part of plasma that contains specific clotting factors). 

These products are then distributed by Australian Red Cross LifeBlood based on requests from blood banks, such as the Royal Adelaide Hospital. 

Helen Stathopoulos manages the Royal Adelaide blood bank, a high-pressure environment that assists about 70% of the state’s trauma patients. 

Every laboratory does an inventory check every single day, and orders what they need. The stock levels must be optimal, as each blood product can assist with a different medical issue. 

Helen explains, “If the patient has a low haemoglobin, they may require a red cell transfusion. If they have a low platelet count and are bleeding, they’ll be given platelets. During a massive bleed they may require additional clotting factors which are contained in fresh frozen plasma and cryoprecipitate.”

But supplying the blood product isn’t as simple as just handing it over to the medical team.  

A patient's blood must be tested thoroughly for antibodies (part of the body’s self-defence system, which kills off viruses and bacteria) and antigen expression. If incompatible blood is given the consequences can be deadly. It can take as little as 10 ml of blood to have a detrimental effect.

“Our priority is to get the right blood to the right patient at the right time, that’s our motto!”

Testing is paramount for the blood bank team and checking a patient’s compatibility may require a series of tests to be performed.

First, they check to make sure the sample is suitable for testing, then they check the patient’s history and their blood is placed on the analyser for a blood group and antibody screen. If the antibody screen is positive, they will perform an investigation to identify the antibody (or antibodies) present so they can find safe compatible units for the patient. 

Some investigations are simple and can take a few hours. Others can take a few days and then sourcing the blood can sometimes take two to three days longer depending on the antibodies identified. “It’s not always as simple as a phone call from the doctor saying can we have blood in two hours - sometimes depending on how many antibodies we identify during our investigation, or how rare the antibody is, it can take days to source an appropriate match.”

In these situations, Helen and her team liaise with the patient’s clinicians, haematologists, and senior scientific staff to work out the best outcome for the patient. 

“It’s a discussion about whether the patient can wait for us to source compatible red cells, or do we give something now which may not be a perfect match but will save their life. There are lots of discussions between the clinical teams and the lab to work out what’s best for the patient.”

There is no such thing as an average day within the blood bank but there are certain things that occur daily. 

Inventory management is a large part of what we do every day. We make sure we have enough stock, it is stored and monitored appropriately, and we work very hard to keep wastage to a minimum. SA blood banks are leaders when it comes to keeping blood product wastage low. Every day we are processing samples, performing blood group and antibody investigations, and crossmatching red cells for patients.

There’s no denying the pressure the teams who work in SA Pathology blood banks are under, but Helen says they’re driven by a strong desire to help patients. 

“The patient is central to everything we do in the blood bank lab. Our focus is on providing accurate results and safe blood products for transfusions every time. When a request comes through for a critical bleed, it’s “all hands on deck”, and the team on shift works together to get blood products out fast as every minute counts. When we hear the patient is improving, it’s the best feeling. We know we made a difference to someone’s life.”

To learn more about donating blood click here.