TME 65: Why Do Blood Banks Irradiate Donated Blood? A Life-Saving Procedure You Should Know About

Blood donation saves millions of lives every year. However, did you know that some donated blood undergoes a special process called irradiation before transfusion? This step is crucial for certain patients. Yet, many people—even regular donors—are unaware of it.

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The Importance of Blood Donation

Blood donation is a noble act that can save lives. Every unit of blood donated can be transformed into its components to treat various medical conditions. Understanding these components can help potential donors see the impact of their contributions.

What Are the Components of Blood?

Blood consists of four vital components:

1. Red Blood Cells (RBCs) – They carry oxygen to tissues.

2. White Blood Cells (WBCs) – They fight infections.

• Part of the immune system.

• Types include neutrophils, lymphocytes, and monocytes.

• Although normally beneficial, they can cause problems in transfusions and attack the recipient’s body.

3. Platelets – They help blood clot.

4. Plasma – The liquid portion contains proteins and antibodies.

   
   

While all these components are essential, white blood cells can sometimes cause issues in donated blood, especially for certain high-risk patients.

Why Are White Blood Cells Troublesome in Donated Blood?

White blood cells are part of the immune defense, but they can create complications in transfusions. Here’s why:

• White blood cells may attack the recipient’s body, particularly if the donor and recipient are closely related. This condition is known as Transfusion-Associated Graft-vs-Host Disease or TA-GVHD.

• They can also trigger immune reactions in immunocompromised patients, such as those undergoing cancer treatments or organ transplants.

  
  

With a fatality rate of over 90%, it is critical to remove or disable these WBCs.

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Who Is at Risk?

Not everyone needs irradiated blood. However, certain patients must receive it to avoid potentially fatal complications:

1. Immunocompromised Patients

• Cancer patients, especially those with leukemia or lymphoma.

• Bone marrow/stem cell transplant recipients, whose immune systems are suppressed.

• HIV/AIDS patients, who have weakened immune systems.

  
  

2. Newborns & Premature Babies

• Their immune systems are still developing.

• Even a small number of donor WBCs can trigger GVHD.

  
  

3. Patients Receiving Blood from Relatives

• A close genetic match increases the risk of GVHD. Donor WBCs may perceive recipient cells as foreign but similar enough to attack.

• This scenario is common in directed donations—for example, parents donating blood for their children.

  
  

4. Patients with Rare Disorders

• Individuals with congenital immune deficiencies, such as Severe Combined Immunodeficiency (SCID), also known as "bubble boy" disease.

  
  

Why Is GVHD So Dangerous?

• It has a 90% fatality rate; once it starts, treatment becomes highly challenging.

• Symptoms may include fever, rash, liver damage, and bone marrow failure.

• GVHD is often misdiagnosed because its symptoms mimic other conditions.

  
  

How Does Blood Irradiation Work?

The irradiation process for blood involves the following steps:

1. Blood is collected as usual.

2. The blood is exposed to radiation (typically 25-50 Gy) to damage the DNA in WBCs.

3. This exposure disables the WBCs, preventing them from multiplying or attacking the recipient.

4. Importantly, RBCs, platelets, and plasma remain functional; the radiation does not harm them.

   
   

Key Facts:

• Does NOT make blood radioactive; the radiation doesn't linger, and it doesn’t alter the blood itself.

• Slightly extends shelf life; irradiated RBCs can last 28 days, while platelets last for 5 days.

• The process is irreversible; once WBCs are irradiated, they cannot recover.

  
  

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The Big Challenge in India: Cost & Infrastructure

While blood irradiation is standard in developed countries, India faces two significant challenges:

1. High Cost – The process requires expensive radiation equipment, like cesium-137 or X-ray machines.

2. Limited Availability – Few blood banks in India have irradiation facilities. This leads to gaps in patient safety.

   
   

Unfortunately, TA-GVHD is often underreported or misdiagnosed in India, meaning many cases go unnoticed.

What Can We Do?

Improving this situation requires collective efforts:

• Awareness – We need more discussions on safe transfusion practices.

• Policy Push – Government support is essential for incorporating irradiation in public blood banks.

• Alternative Solutions – Implementing pathogen reduction technologies where irradiation isn't available can help.

  
  

Final Thoughts

Blood irradiation is a life-saving but often underrated procedure that protects the most vulnerable patients. Although cost and infrastructure pose challenges in India, raising awareness can lead to meaningful change.

Did you know about blood irradiation before reading this? Let us know in the comments! If you found this information useful, please share it—someone’s life could depend on it.