Why transfusion medicine

Bhende and Dr. Bhatia discovered the Bombay blood group phenotype[ 5 ] and Lt. Bird described the A1 lectin. The NIIH continued its research in immunohematology with study of molecular characterization of ABO blood groups[ 7 , 8 ] and development of monoclonal antibodies against these blood group antigens,[ 9 ] D antigen variants,[ 10 , 11 ] platelet antigens polymorphisms, to name but a few.

From hospital based Departments of Transfusion Medicine, data on red cell antigen frequencies in donors[ 12 , 13 ] and alloimmunization problems in recipients have been published in peer reviewed journals. Until early s blood transfusion in India was largely whole blood, but the introduction of plastic blood bags in the country began to transform the blood processing techniques.

Blood components become available. Innovations like pooling of platelet concentrates to yield an equivalent apheresis unit have been published from AIIMS, Delhi.

Double unit red cell collections are possible and would be of immense help in the collection of rare red cell units. Apheresis technology has helped the transfusion medicine specialist in direct patient care. In a large series of patients with neurological disorders and atypical hemolytic uremic syndrome patients published from PGI, Chandigarh, therapeutic plasma exchange TPE was effective and less expensive as compared to intravenous immunoglobulins IVIG.

TPE has been helped in making ABO incompatible stem cell transplants and solid organ transplants possible through removal of the incompatible antibodies in recipients. The discovery of causative agents of TTIs led to the development of diagnostic tests and subsequent screening of donor blood became mandatory as per Government of India notifications. This widened the scope and range of pretransfusion testing and blood transfusion services entered into the realm of ELISA technology, donor counseling and epidemiology.

Cellular therapies are progressively becoming an accepted treatment modality for a large number of inherited and acquired disorders. Sources of stem cells include bone marrow, peripheral blood and cord blood. Stem cell collections from peripheral blood by leukapheresis are generally easier than bone marrow collections and postcollection processing is less from peripheral blood stem cell PBSC products.

Since stem cell mobilization through granulocte colony stimulating factors is required in PBSC donors, stem cell donation is not without adverse effects.

Stem cell donor management and follow-up has emerged as a major activity in transfusion centers supporting stem cell transplant programs. The first reports of collection and cryopreservation of cord blood stem cells were published from AFMC, Pune. A major concern with allogeneic hematopoietic stem cell transplant is still the risk of recurrence of the primary disease. Pharmacological and immunological approaches are being explored.

Donor lymphocyte infusions, NK cells, co-transplantation with mesenchymal stem cells and CD-8 depleted T cell preparations are all under evaluation. Draft guidelines on stem cell research and therapy have been put up on the ICMR website.

Blood derived biomaterials — fibrin sealant, platelet gel, and platelet-fibrin glue are used in many surgical specialties. They have distinct advantages over synthetic products as they are physiologically compatible, do not cause necrosis, are readily colonized by cells and are totally biodegradable.

Fibrin sealant can also be prepared on a commercial scale and is available in India from Reliance Life Sciences as ReliSeal. Platelet gel — prepared from platelet rich plasma has a high concentration of growth factors which help in tissue healing and repair.

It is being evaluated in orthopedic and maxillo-facial surgery, bone reconstruction, sports medicine, cosmetic and dental implant surgery. Since transfusion medicine services provide biological products, cells and plasma for patient therapy, quality system implementation akin to the manufacturing industry have been adapted to blood centers. The concept and model of Total Quality Management which aims at continuous improvement and customer satisfaction implies implementation of Quality System Essentials and assigns a managerial role to the transfusion medicine specialists.

Standards for accreditation of blood banks have been developed by the National Accreditation Board for Healthcare providers. Clinical transfusion is becoming more evidence based.

Transfusion audits and hemovigilance are taking center stage for optimum patient transfusion requirements. In India, a national program on recipient hemovigilance has been launched since December , as a joint venture between the National Institute of Biologicals and Indian Pharmacopoeia Commission, Ministry of Health and Family Welfare, Government of India. Laboratory attempts to convert A and B red cells to O red cells by using bacterial galactosidases have been successful more for B than A cells.

The potential of induced pluripotent stem cells to generate large amounts of red cells is also being explored. Considering the leaps and bounds by which the specialty has grown in the last decades, the need for trained personnel became essential. Sensitization and training of bedside transfusion staff is still a major challenge. Blood banking traditionally is a more pharmaceutical like activity involving screening of donors, blood collection, component preparation and blood testing.

Transfusion medicine includes research and active involvement of specialists in patient management with cellular therapies and therapeutic apheresis. Laboratory staff members perform the crossmatch testing to make certain that a patient is given compatible blood. In addition, the Division of Transfusion Medicine is involved in the training of health care professionals through its work with medical technology students, pathology residents and Mayo Clinic blood banking and transfusion medicine fellowship.

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Blood transfusion is a medical therapy that can be life-saving. As with any treatment, however, transfusion of blood or blood components must be ordered and administered safely and appropriately. Transfusion is more than a single discrete event—it is a process. The transfusion chain begins with donor considerations whether their donation is safe for them to make and whether the donation is safe for any patient to receive.

Once blood is collected, the safety of the blood product is a focus of activity infectious disease testing, compatibility testing, necessary modifications such as irradiation or leukocyte reduction. The endpoint of the transfusion process involves recipient considerations proper identification of the unit and the patient, appropriateness of blood as the best treatment modality, administration of the unit, evaluation of the recipient.

In this area of the website, users will find information on all aspects of the transfusion process. Frequently Asked Questions about blood, information on blood donation, a standardized donor history questionnaire, a Circular of Information for the Use of Human Blood and Blood Components, and fact sheets on emerging infectious diseases are featured.

Other useful information, such as highlights of transfusion medicine history, are also available. Because a focus of AABB is the practice of appropriate transfusion medicine, relevant information can be found through a search of the entire website.

Users are encouraged to browse content in both the cellular therapies and patient blood management areas for additional information on blood and transfusion.

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The Association works collaboratively to advance the field through the development and delivery of standards, accreditation and education programs. AABB is dedicated to its mission of improving lives by making transfusion medicine and biotherapies safe, available and effective worldwide.

Blood donations are urgently needed now to ensure blood is available for patients in need. Make an appointment to donate now. Annual Meeting. National Blood Foundation.