Blood transfusion can save lives, significantly in emergencies involving extreme blood loss, childbirth problems, surgical procedure and severe diseases.
However, when donated blood just isn’t correctly screened and examined for compatibility, a process supposed to save lots of a affected person’s life can expose them to doubtlessly deadly problems.
While figuring out a donor’s blood group is a necessary first step, medical laboratory scientists say it’s not sufficient to determine whether or not the blood is safe for a recipient.
Adedoye David and Olaiya Oluwatoba, who’re medical laboratory scientists, defined to PT HEALTH WATCH that donated blood should endure further laboratory assessments, together with crossmatching and screening for transfusion-transmissible infections, earlier than it’s launched for transfusion.
According to the scientists, blood grouping establishes an individual’s ABO and Rhesus (Rh) blood varieties, however doesn’t independently verify compatibility between a donor and recipient.
They defined that crossmatching includes testing donor and recipient blood samples to determine attainable reactions between antigens on crimson blood cells and antibodies within the recipient’s blood. Such reactions may cause the destruction of crimson blood cells, leading to doubtlessly severe transfusion reactions.
The scientists additionally cautioned in opposition to the idea that blood group O is mechanically safe for each recipient. Although group O crimson blood cells are generally utilized in emergencies when a affected person’s blood group is unknown, some group O whole-blood donations include excessive ranges of anti-A and anti-B antibodies that may trigger haemolysis in recipients.
Beyond compatibility, one other necessary facet of blood security is making certain that donated blood doesn’t carry infections that could possibly be transmitted to sufferers.
Screening for infections
The scientists recognized hepatitis B, hepatitis C, human immunodeficiency virus (HIV 1 and a couple of) and syphilis as infections that should be screened for earlier than donated blood is launched.
They defined that insufficient screening might flip hospitals and blood banks into channels for transmitting infections to sufferers who might already be susceptible due to their medical circumstances.
They highlighted enzyme-linked immunosorbent assay (ELISA) as a most well-liked screening technique however famous that infections can typically escape detection when donors are within the window interval, throughout which an an infection is current however might not but be detectable by a selected take a look at.
Although ELISA is a longtime screening technique, it doesn’t fully get rid of this danger. Nucleic acid testing (NAT), the place out there, can detect some infections earlier by figuring out viral genetic materials.
Risks of incompatible or unsafe blood
According to the scientists, one main consequence of transfusing incompatible blood is a haemolytic transfusion response, which happens when the recipient’s immune system destroys transfused crimson blood cells.
They recognized acute and delayed haemolytic transfusion reactions as attainable problems. Acute reactions might current with sudden fever, chills, low blood strain and haemoglobinuria, whereas delayed reactions can develop days or even weeks after transfusion.
Infections corresponding to hepatitis B, hepatitis C, HIV and syphilis might also be transmitted by way of inadequately screened blood.
Although these problems can often happen regardless of routine screening, the scientists mentioned strict adherence to laboratory procedures and quality-control measures stays important to lowering the dangers.
Maintaining requirements in blood banks
On the requirements guiding blood financial institution operations, the scientists referred to the International Organisation for Standardisation’s ISO 15189, which outlines high quality and competence necessities for medical laboratories.
They additionally highlighted exterior high quality evaluation, by way of which laboratories’ testing efficiency is evaluated, typically with the assist of reference laboratories.
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Acknowledging that hospitals might expertise blood shortages, the scientists maintained that shortage mustn’t justify abandoning important security procedures. They mentioned emergency launch of blood earlier than completion of all compatibility assessments should observe established protocols, with acceptable authorisation and documentation.
They additional defined that medical laboratory scientists are answerable for figuring out blood teams, conducting compatibility assessments, screening donations for infections, checking packed cell quantity (PCV), monitoring expiry dates and sustaining information of blood financial institution actions.
The scientists urged blood donors and sufferers’ kinfolk to ask questions on blood financial institution procedures, together with donor eligibility necessities, haemoglobin ranges, well being circumstances and an infection screening.
They mentioned better communication between laboratory professionals, donors and sufferers’ kinfolk would enhance public understanding of blood security and strengthen confidence in transfusion providers.
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