South African National Blood Service
Encyclopedia
The South African National Blood Service, (SANBS), is a non-profit organisation that provides human blood for transfusion
that operates in South Africa, with the exception of the Western Cape
. The head office is in Weltevredenpark
, Gauteng, near Johannesburg
, but there are blood collection operations in eight of the nine provinces. Western Cape has a separate blood center, the Western Province Blood Transfusion Serivce. SANBS was founded in 2001 from a merger of seven blood centres, and was embroiled in controversy in 2004 over a policy of racial profiling for blood safety.
from volunteer unpaid donors and processes that blood into components for transfusion. The donors are screened for health risks and tested for diseases on every donation. Not all parts of the donated blood are always used, such as with first time donors, to establish a history of negative test results in the donor before the blood is used in patients. The red blood cells from the first donation are discarded because they cannot be stored long enough to wait for a second donation and a second set of testing, but the blood plasma can be frozen and used.
SANBS relies on donors that return consistently, as the history of testing makes it less likely to miss a positive result from a laboratory error or from a donation in the window period
. Testing has included Nucleic acid test
ing (NAT) since 2005, which directly detects the virus instead of waiting for the body to develop an antibody
. This test shortens but does not eliminate the window period. SANBS performs NAT testing for each individual donor, instead of in pools. NAT testing is expensive, and blood banks in many countries, such as Canada, perform the testing on pooled donor samples. The individual testing is more sensitive to window period donations. The testing is performed at central laboratories in Johannesburg and Durban.
Whole blood
is collected to make packed red blood cells
and plasma
for transfusion. Plasma and platelet
s for transfusion are also collected by automated plateletpheresis
. Collections take place at fixed sites, but SANBS also collects blood on mobile blood drives at community locations such as shopping centres. The blood is then processed into components at seven processing locations throughout South Africa. During 2008, SANBS collected 718,962 donations of Whole Blood and 11,657 donations of apheresis platelets.
and the HLA
typing of bone marrow
donors, though the actual bone marrow donations are handled by the Sunflower Fund, a separate organisation. The organisation also prepares an annual haemovigilance report on transfusion complications, conducts research, and provides clinical training.
policy for not collecting blood from high risk groups. Health minister Manto Tshabalala-Msimang raised concerns that the policy was racist. SANBS changed the policy later that week. The current Chief Executive Officer of SANBS is Dr. Loyiso Mpuntsha, a black woman who was once rejected as a blood donor.
Blood transfusion
Blood transfusion is the process of receiving blood products into one's circulation intravenously. Transfusions are used in a variety of medical conditions to replace lost components of the blood...
that operates in South Africa, with the exception of the Western Cape
Western Cape
The Western Cape is a province in the south west of South Africa. The capital is Cape Town. Prior to 1994, the region that now forms the Western Cape was part of the much larger Cape Province...
. The head office is in Weltevredenpark
Weltevredenpark, Gauteng
Weltevreden Park is a suburb of Roodepoort, South Africa adjacent to Johannesburg. It is situated roughly between Beyers Naude Drive and Hendrik Potgieter Street....
, Gauteng, near Johannesburg
Johannesburg
Johannesburg also known as Jozi, Jo'burg or Egoli, is the largest city in South Africa, by population. Johannesburg is the provincial capital of Gauteng, the wealthiest province in South Africa, having the largest economy of any metropolitan region in Sub-Saharan Africa...
, but there are blood collection operations in eight of the nine provinces. Western Cape has a separate blood center, the Western Province Blood Transfusion Serivce. SANBS was founded in 2001 from a merger of seven blood centres, and was embroiled in controversy in 2004 over a policy of racial profiling for blood safety.
Blood donation
SANBS collects bloodBlood donation
A blood donation occurs when a person voluntarily has blood drawn and used for transfusions or made into medications by a process called fractionation....
from volunteer unpaid donors and processes that blood into components for transfusion. The donors are screened for health risks and tested for diseases on every donation. Not all parts of the donated blood are always used, such as with first time donors, to establish a history of negative test results in the donor before the blood is used in patients. The red blood cells from the first donation are discarded because they cannot be stored long enough to wait for a second donation and a second set of testing, but the blood plasma can be frozen and used.
SANBS relies on donors that return consistently, as the history of testing makes it less likely to miss a positive result from a laboratory error or from a donation in the window period
Window period
In medicine, the window period for a test designed to detect a specific disease is the time between first infection and when the test can reliably detect that infection...
. Testing has included Nucleic acid test
Nucleic acid test
A nucleic acid test, often called a "NAT" test, is a biochemical technique used to detect a virus or a bacterium...
ing (NAT) since 2005, which directly detects the virus instead of waiting for the body to develop an antibody
Antibody
An antibody, also known as an immunoglobulin, is a large Y-shaped protein used by the immune system to identify and neutralize foreign objects such as bacteria and viruses. The antibody recognizes a unique part of the foreign target, termed an antigen...
. This test shortens but does not eliminate the window period. SANBS performs NAT testing for each individual donor, instead of in pools. NAT testing is expensive, and blood banks in many countries, such as Canada, perform the testing on pooled donor samples. The individual testing is more sensitive to window period donations. The testing is performed at central laboratories in Johannesburg and Durban.
Whole blood
Whole blood
Whole blood is a term used in transfusion medicine for human blood from a standard blood donation. The blood is typically combined with an anticoagulant during the collection process, but is generally otherwise unprocessed...
is collected to make packed red blood cells
Packed red blood cells
In transfusion medicine, packed red blood cells are red blood cells that have been separated from whole blood for transfusion purposes. The product is typically abbreviated RBC or PRBC, and sometimes LRBC for leukoreduced products...
and plasma
Blood plasma
Blood plasma is the straw-colored liquid component of blood in which the blood cells in whole blood are normally suspended. It makes up about 55% of the total blood volume. It is the intravascular fluid part of extracellular fluid...
for transfusion. Plasma and platelet
Platelet
Platelets, or thrombocytes , are small,irregularly shaped clear cell fragments , 2–3 µm in diameter, which are derived from fragmentation of precursor megakaryocytes. The average lifespan of a platelet is normally just 5 to 9 days...
s for transfusion are also collected by automated plateletpheresis
Plateletpheresis
Plateletpheresis is the process of collecting thrombocytes, more commonly called platelets, a component of blood involved in blood clotting...
. Collections take place at fixed sites, but SANBS also collects blood on mobile blood drives at community locations such as shopping centres. The blood is then processed into components at seven processing locations throughout South Africa. During 2008, SANBS collected 718,962 donations of Whole Blood and 11,657 donations of apheresis platelets.
Other services
SANBS also provides blood-related laboratory services such as paternity testingPaternity testing
Parental testing is the use of genetic fingerprinting to determine whether two individuals have a biological parent-child relationship. A paternity test establishes genetic proof as to whether a man is the biological father of an individual, and a maternity test establishes whether a woman is the...
and the HLA
Human leukocyte antigen
The human leukocyte antigen system is the name of the major histocompatibility complex in humans. The super locus contains a large number of genes related to immune system function in humans. This group of genes resides on chromosome 6, and encodes cell-surface antigen-presenting proteins and...
typing of bone marrow
Bone marrow
Bone marrow is the flexible tissue found in the interior of bones. In humans, bone marrow in large bones produces new blood cells. On average, bone marrow constitutes 4% of the total body mass of humans; in adults weighing 65 kg , bone marrow accounts for approximately 2.6 kg...
donors, though the actual bone marrow donations are handled by the Sunflower Fund, a separate organisation. The organisation also prepares an annual haemovigilance report on transfusion complications, conducts research, and provides clinical training.
History
The organisation was originally founded in 2001 from the merging of seven independent blood banks. The organisation came under fire in 2004 when it was revealed that they used the race of a donor as a consideration in determining disease risk. SANBS stated that the profiling was necessary to reduce the risk of transmission of human immunodeficiency virus (HIV), citing World Health OrganizationWorld Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
policy for not collecting blood from high risk groups. Health minister Manto Tshabalala-Msimang raised concerns that the policy was racist. SANBS changed the policy later that week. The current Chief Executive Officer of SANBS is Dr. Loyiso Mpuntsha, a black woman who was once rejected as a blood donor.