Blood products

WCBS follows a formalised protocol for requests for blood for non-clinical use from tertiary training institutions, tertiary training affiliated organisations, diagnostic testing laboratories and life science companies.This protocol describes the specifications for donor consent, sample anonymity, testing of blood, use of blood that is surplus to the Service's requirements, and human research ethics approval. Specific information is required from the requesting organisation and approval is decided by the WCBS Medical Director/CEO.

For blood for non-clinical use queries please contact Hayley Alie, WCBS Marketing Officer.

Hayley Alie: Telephone +27 (0)21 507 6326 | Cell +27 (0)83 454 3455 | Email marketing@wcbs.org.za

As of the 31st of March 2018, WCBS terminated its red cell autologous donation service.

For any enquiries please contact Sr Tania Paarman, WCBS Specialised Donations Supervisor.

Sr Tania Paarman: Telephone +27 (0)21 507 6393 | Email Tania@wcbs.org.za

Babies may require multiple red cell concentrate infusions for the management of prolonged anaemia. Through the Limited Donor Exposure Programme (LDEP) doctors can reserve a minimum of two up to a maximum of four units of single donor infant red cell concentrates for their patient. The advantages of LDEP include reduction in donor exposure for the baby to limit the risk of red cell alloimunisation and infection transmission.

The clinician must clearly indicate "LDEP" on the cross-match laboratory request and the number of units to be reserved. If the quantity is unspecified, the Blood Bank will reserve a minimum of two units for the patient. A new Blood Bank sample is required if the previous unit of blood or blood product was issued more than forty-eight hours before.

Neonates who possess irregular red cell antibodies are ineligible for the LDEP. As there is a risk of transfusion-related haemolysis in cases of necrotising enterocolitis (confirmed by the crypt antigen test), neonates who test strongly reactive for crypt antigen are ineligible for the LDEP unless the clinician in charge specifically requests an infant red cell concentrate and accepts responsibility for the transfusion.

For LDEP enquiries please contact Mrs Caren Overall, WCBS Red Cross War Memorial Children's Hospital Blood Bank Supervisor.

Mrs Caren Overall: Telephone +27 (0)21 685 5489 | Cell +27 (0)83 443 6859 | Email Carenm@wcbs.org.za

WCBS performs gamma-irradiation of blood and blood products on request. This method results in the eradication of donor T-lymphocytes in the blood product for the purpose of prevention of transfusion associated graft versus host disease (please refer to the Clinical Guidelines for the Use of Blood Products in South Africa (5th Edition) for more information about the indications and benefits of gamma-irradiation). The clinician must clearly indicate on the cross-match laboratory request if gamma-irradiated blood is required. Please note that there is an additional cost for this procedure and this is only performed at specific Blood Banks so timeous ordering is required.

Plasma products are derived by the centrifugation of anticoagulated whole blood within 18 hours of donation. These products are typically prescribed for the replacement of coagulation proteins (or clotting factors). Fresh frozen plasma (FFP) contains all the clotting factors at normal physiological levels and can be leucocyte-depleted to reduce the risk of immune-mediated adverse transfusion reactions. Cryoprecipitate is formed by the thawing of FFP and precipitation of the product that is rich in Factor VIII, Factor XIII and fibrinogen.

Fresh frozen plasma
Volume: 210 ml to 350 ml
FVIII:C≥0.7IU/ml
Anticoagulant: CPD
Storage temperature: Below minus 18 ºC
Shelf life: 6 hours from time of removal from storage.
Leucocyte depleted fresh frozen plasma
Volume: 200 ml to 340 ml
Anticoagulant: CPD
Storage temperature: Below minus 18 ºC.
Shelf life: 6 hours from time of removal from storage
Cryo poor fresh frozen plasma (Cryosupernatant)
Volume: 200 ml to 340 ml
Anticoagulant: CPD
Storage temperature: Below minus 18 ºC.
Shelf life: 6 hours from time of removal from storage
Cryoprecipitate
Volume: 9 ml to 11 ml
FVIII:C≥80 IU/unit
Fibrinogen:≥12 mg/ml
Storage temperature: Below minus 18 ºC.
Shelf life: 4 hours from time of removal from storage

Platelets are responsible for cessation of bleeding at the sites of endothelial injury. Platelet transfusions are indicated for the prevention or management of active bleeding as a result of reduced platelet numbers (thrombocytopenia) or abnormalities of platelet function. There are three types of platelet products that differ according to their mode of collection, donor exposure and cost. Random donor platelet products (RDP) are collected from multiple donor buffy coats whereas single donor platelet products (SDP) are derived from the collection of platelets from one donor by apheresis technique. SDP products should be reserved for use in patients with chronic platelet transfusion needs so as to limit their exposure to donor platelet antigens and potential alloimmunisation (platelet antibody formation). Leucocyte reduced RDP products can also be requested that significantly reduce the risk of antibody formation to donor platelet antigens.

Pooled random donor platelet
Volume: > 40 ml per unit in the pool
Platelet count: ≥ 2.4 x 10 11/unit
Anticoagulant: CPD
Storage temperature: 20 ºC to 24 ºC
Shelf life: 5 days
Single donor platelet
Volume: ≥ 200 ml
Platelet count: ≥ 2.4 x 10 11/unit
Leucocyte count: ≤ 5 x 10 6/unit
Anticoagulant: ACD-A
Storage temperature: 20 ºC to 24 ºC
Shelf life: 5 days
Leucocyte depleted pooled random donor platelet
Volume: ≥ 200 ml
Platelet count: ≥ 2.4 x 10 11/unit
Anticoagulant: CPD
Storage temperature: 20 ºC to 24 ºC
Shelf life: 5 days

All infant and paediatric blood products are leucocyte-depleted to reduce the risk of alloimmunisation, immune-mediated adverse transfusion reactions and disease transmission.

Infant red cell concentrate
Volume: 35 ml to 75 ml
Haematocrit: 0.5 l/l to 0.7 l/l
Anticoagulant: CPD
Additive solution: SAGM
Storage temperature: 2 °C to 6 °C
Shelf life: 42 days
Paediatric red cell concentrate
Volume: 90 ml to 150 ml
Haematocrit: 0.5 l/l to 0.7 l/l
Anticoagulant: CPD
Additive solution: SAGM
Storage temperature: 2 °C to 6 °C
Shelf life: 42 days
Paediatric single donor platelet
Volume:100 ml to 200 ml
Platelet count:≥ 1.0 to 2.3 x 1011/l
Anticoagulant: ACD-A
Storage temperature: 20 °C to 24 °C
Shelf life:5 days
Infant single donor platelet
Volume:40 ml to 60 ml
Platelet count: 0.5 to 0.9 x 1011/l
Anticoagulant: ACD-A
Storage temperature: 20 °C to 24 °C
Shelf life:5 days
Paediatric fresh frozen plasma
Volume:180 ml to 160 ml
FVIII:≥0.7 IU/ml
Anticoagulant:CPD
Storage temperature: Below minus 18 °C
Shelf life:6 hours from removal of storage
Fresh frozen plasma low titre Anti-T
Volume:210 ml to 350 ml
FVIII:≥0.7 IU/ml
Anticoagulant:CPD
Storage temperature: Below minus 18 °C
Shelf life:6 hours from removal of storage
Cryoprecipitate low titre Anti-T
Volume:9 ml to 11 ml
FVIII:≥80 IU/unit
Anticoagulant:CPD
Storage temperature: Below minus 18 °C
Shelf life:4 hours from removal of storage
Paediatric whole blood
Volume:140 ml to 200 ml
Anticoagulant:CPD
Storage temperature:2 °C to 6 °C
Shelf life:21 days

Whole blood products are rarely indicated for use in massive haemorrhage and neonatal exchange transfusions. Red cell components are more appropriate for use in situations where oxygen-carrying capacity requires boosting.

Whole Blood
Volume: 468 ml to 558 ml
Anticoagulant: CPD
Storage temperature: 2 °C to 6 °C
Shelf life: 21 days
Whole blood leucocyte Ddpleted
Volume: 425 ml to 525 ml
Leucocyte count: ≤ 5 x 106/unit
Anticoagulant: CPD
Storage temperature: 2 °C to 6 °C
Shelf life: 24 hours if prepared in the Blood Bank and 21 days if prepared in Components Processing

Red cell components are useful for their iron-rich stores and oxygen-carrying capacity. Red cell transfusions are indicated for a wide range of medical and surgical conditions resulting in acute or chronic anaemia.

Buffy-coat depleted red cell concentrate

Volume: 250 ml to 350 ml
Haematocrit: 0.5 l/l to 0.7 l/l
Leucocyte count: ≤1 x 109/unit
Anticoagulant: CPD
Additive solution: SAGM
Storage temperature: 2 °C to 6 °C
Shelf life: 42 days

Pre-storage leucocyte depleted red cell concentrate
Volume: 210 ml to 310 mll
Haematocrit: 0.5 l/l to 0.7 l/l
Leucocyte count: <1 x 106/unit
Anticoagulant: CPD
Additive solution: SAGM
Storage temperature: 2 °C to 6 °C
Shelf life: 42 days

Leucocyte depleted red cell concentrate (filtered in the Blood Bank)
Volume: 210 ml to 310 ml
Haematocrit: 0.5 l/l to 0.7 l/l
Anticoagulant: CPD
Additive solution: SAGM
Storage temperature: 2 °C to 6 °C
Shelf life: 24 hours

WCBS provides a total of one hundred and one emergency blood fridges to hospitals and community health centres throughout the Western Cape. In life-threatening emergencies, patients can receive group O blood from the emergency blood fridge when there is no time to wait for cross-matched blood..

Group O blood is a scarce resource and should be used judiciously. The clinician must submit a patient sample as soon as possible for cross-match testing to avoid the unnecessary use of emergency blood.

WCBS replace the emergency blood stocks at approximately three-weekly intervals to ensure that the freshest blood is available. Ward staff must request replacement stock from their designated Blood Bank as soon as a unit of emergency blood is used to ensure that the fridges remain fully stocked.

For cold chain management purposes, each unit of emergency blood is attached with a cable tie to a ring and stored on the shelf inside the emergency blood fridge. The cable tie must only be cut if the blood is definitely to be transfused. If the cable tie is cut, irrespective of whether the blood was unused , unopened or stored inside the fridge, the blood will be deemed unusable and the unit will be billed to the hospital. Unused units of emergency blood with the cable tie intact will be returned to the general blood supply.

For emergency blood enquiries please contact Nawaal Gamieldien, WCBS Emergency Banks Coordinator.

Nawaal Gamieldien: Telephone +27 (0)21 507 6476 | Cell +27 (0)83 564 9297 | Email Nawaal@wcbs.org.za

Therapeutic phlebotomy refers to the practice of donating blood to assist with the management of medical conditions that result in iron overload or high red cell production. Common causes for these conditions include hereditary haemochromatosis, secondary polycythaemia from smoking or testosterone use, and polycythaemia vera.

Patients who are advised to donate blood for medical reasons must be referred by their clinician through formal referral (see link to the referral documents below). The referral information will be reviewed by the WCBS Transfusion Medical Specialist, in order for the blood services to determine whether it is safe for the phlebotomy to take place at a non-medical facility and if the blood is suitable for transfusion to a patient. Frail patients or patients with significant cardiovascular comorbidity are advised to undergo therapeutic phlebotomies in hospital settings where there is medical support.

The blood from the first therapeutic phlebotomy procedure is not used for transfusion purposes, as per international donation guidelines. A charge will apply for the first phlebotomy and any subsequent phlebotomies where the blood must be discarded due to the underlying diagnosis or other deferral criteria.

It is recommended that the first phlebotomy takes place at the WCBS Headquarter Clinic in Pinelands or the regional branches in Paarl, Worcester or George, in order for staff to assess and interview the donor. Subsequent therapeutic phlebotomies may take place at other clinic sites provided the donor is able to tolerate the phlebotomy procedure comfortably.

We accept new therapeutic donors between the ages of 16 years and 74 years, although special criteria apply for new donors between the ages of 70 - 74 years. Elderly donors are required to obtain regular permission from their doctors to continue donating blood.

Download registration forms

For therapeutic phlebotomy enquiries please feel free to contact Sr Tania Paarman, WCBS Specialised Donations Supervisor.

Sr Tania Paarman: Telephone +27 (0)21 507 6393 | Email Tania@wcbs.org.za

This service allows prospective patients who are to undergo elective surgery or have chronic red cell transfusion requirements to recruit family and friends who have compatible blood groups to donate blood for them. This request must be made by the patient's clinician through formal referral (see a link to the referral documents below) and the decision to donate must be entirely voluntary.

Designated single donor platelet donations can also be requested when HLA-matched platelet products are required. This request typically arises when there is suspicion of platelet antibodies in patients whose platelet counts fails to increment followimg transfusion, and other causes have been excluded (eg. fever, infection or splenomegaly). The patient's clinician must request HLA-typing of their patient via their own tissue immunology laboratory and these results are sent to the South African Bone Marrow Registry for matching with a donor. The donor's contact details are then forwarded to the WCBS Apheresis Unit who will try to locate them to establish if they are eligible and willing to donate. The procedure involves the donor being placed on an apheresis machine for about 90 minutes.

Designated donors must comply with the general blood donor acceptance criteria and undergo mandatory donation testing, although TPHA reactive or cross-reactive donations may be issued with permission from the WCBS CEO/Medical Director in consultation with the patient's clinician.

All designated blood donations from first and second degree relatives must be gamma-irradiated in order to prevent transfusion associated graft versus host disease, which relates to the potential sharing of HLA-haplotypes by the donor and patient.

It is not advisable for women of childbearing age to receive blood from their spouse or his relatives as this could lead to a blood group incompatibility that can affect the safety of future pregnancies.

Download registration forms

For red cell and plasma designated donation enquiries please contact Sr Tania Parman, WCBS Specialised Donations Supervisor.

Sr Tania Paarman: Telephone +27 (0)21 507 6393 | Email Tania@wcbs.org.za

For HLA-matched platelet designated donation enquiries please contact Kay Abrahams, WCBS Apheresis Supervisor.

Kay Abrahams: Telephone +27 (0)21 507 6395 | Email Kay@wcbs.org.za