Development of Blood Donation Activities in Kyrgyzstan and General Implications for Blood Donation

Objectives: This article is aiming to give an essential informative principle about 
the development of blood donation activities in Kyrgyzstan. Background: The 
sequence of blood donation procedure steps before donation, during donation, 
and after donation was shown and discussed. Methods/Materials: Rhesus factor 
determination in donors was achieved by “COLICO” method which is based on the use of 
monoclonal antibodies solution. Results: According to the blood 
donation activity of donors in Osh, Kyrgyzstan for the 2018 year, it was found 
that gratuitous donors who donated blood in 6 months were 269, in 9 months were 
366, and in 1 year were 499 people. Relative donors who donated blood in 6 
months were 3480, in 9 months were 5100, and in 1 year were 6701 people. Active 
donors donated blood in 6 months were 12, in 9 months were 14 and in 1 year 
were 17 people. Conclusion: No agglutination was observed in any of the 
plates for the first blood group; agglutination was observed with anti-A 
monoclonal antibody solution for the second blood group; agglutination was 
observed with anti-B monoclonal antibody solution for the third blood group; 
agglutination was observed with both of anti-A and anti-B monoclonal antibody 
solutions for the fourth blood group.


Introduction
First-time donors indicated that they had experienced a reaction to blood donation, and donors who reacted were less likely to intend to return to donate [1].
One of the main requirements for donors is that blood donations from individuals found to have a positive direct antiglobulin test (PDAT) [2]. The decision for blood donation has been investigated around the world for decades to understand the blood donation process better, and to increase donation efficiency, safety, retention, collection numbers, and diversity of the donor pool [3]. Barriers and obstacles to blood donation among regular, lapsed blood donors and non-donors have been researched previously [4]. Most prevalent factors influencing blood collection process are fear of needles, general apprehension, negative feelings about the sight of blood, fear of adverse physiological reactions such as weakness or fatigue, dizziness, nausea, or fainting complicating the blood collection process, and are a significant disincentive for repeat donation [5]. Benefits and harms of blood donation were reported as after one blood donation total hemoglobin mass was reduced by about 8% -9% and to recover pre-donation values after 35 days on average [6]. Blood donor's suitability criteria based on science, medical opinion, and regulatory rules such as age, gender, hemoglobin deferral patterns [7].
A service quality scale for the blood donation was analyzed [8]. The blood donors associated with voluntary act of donation and care of patients were analyzed [9].
In Kyrgyzstan, not only the Kyrgyz citizens can be donors, but also foreign citizens who are legally residing and have appropriate registration can donate blood. There are strict requirements due to the lack of potential people who want to donate their blood. Limitations in this work were not healthy, overweight, donors younger than 18, and older than 60 years old. Selection of a donor based on compliance with the following criteria was shown in Figure 1.
Gender does not matter, but there are some restrictions, as a man without risk to health can donate blood up to 5 times in a year, and a woman only 4 times in a year. At the same time, the break between the next donations should not be less than 2 months. Types of blood donation can be classified into several kinds as it was represented in Table 1.

Study Design and Methods
"COLICO" method used for blood Rhesus factor determination in donors.

Results and Discussions
It is better to avoid the use of protective equipment of healthcare providers, re-

Blood Components
Essential blood products of human origin on the 2017 World Health Organization listed as following: blood and blood components (fresh-frozen plasma, platelets, red blood cells, and whole blood), immunologicals [12].

Plasmapheresis
Plasma exchange (PE) or plasmapheresis can be defined as a therapy that involves the removal of a patient's plasma in exchange for exogenous fluid such as albumin [14]. Plasma exchange during blood donation lasted for about one hour. Plasmapheresis can be defined as blood plasma exchange, or therapeutic procedure in which whole blood is removed from the circulation, proteins such as antibodies and clotting factors filtered from the plasma, and then the whole filtered blood is returned to the circulation [15]. There are several types of plasmapheresis as shown in Figure 4. Blood plasma itself is a protein-rich solution

Inquiry point
After donation donors receive certificate and money compensation Step by step procedure: a) disinfection b) clenching and unclenching c) blood intake d) bandage on the elbow Open Journal of Blood Diseases in which white and red blood cells, platelets are suspended, and serum is the remaining fluid after removal of the clot from whole blood with the protein concentration in plasma/serum of 60 -80 mg/mL from which 50% -60% are albumins and 40% globulins (10% -20% IgG) [16].
Therapeutic plasma exchange is necessary for the management of autoimmune diseases: acute disseminated encephalomyelitis, polyradiculoneuropathy/Guillain-Barre syndrome, anemia, myasthenia gravis, vasculitis, etc. [20]. In TPE plasma is separated from the blood cellular (BC) components, discarded, and replaced with an isosmotic fluid containing commonly 5% albumin to maintain the patient's oncotic pressure [21]. However, some complications of TPE exist such as bleeding, thrombosis, hydroelectrolytic disorders, hypertension, allergies, arrhythmias, and catheter-related infections including bacterial, mycobacterial, and viral infections [22].

Thrombocytapheresis
Thrombocytapheresis is included in common therapeutic cytapheresis procedure which is based on the red blood cell (RBCs) exchange where intravascular volume is maintained by replacement of removed element with normal RBCs, crystalloids, or colloids [23]. In cases of extreme thrombocytosis, therapeutic thrombocytopheresis can be a useful procedure [24]. Therapeutic thrombocytapheresis involves the removal of platelets from patients with thrombocytosis, who have a platelet count of >500,000/μl [25] (Shaz, 2009). Platelet depletion can be used in the treatment or prevention of complications from thrombocytosis in patients with hematologic malignancy, as 1.5 -2 total blood volumes processed usually results in a 30% -60% platelet count reduction [26]

Conclusion
The main steps during blood donation procedures have been described. Donors were selected according to age, weight, and health criteria. Blood group types were determined according to these results: no agglutination was observed in any of the plates for the first blood group; agglutination was observed with anti-A

Ethical Approval
All procedures performed in studies involving human participants were following the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.