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Indian Express
20 May 2010
Lucknow, India

ATIENTS at ChhaP trapati Shahuji Ma haraj Medical University will no longer need to run from pillar to post in search of blood donors during operations.

The hospital is all set to start the facility of autologous blood donation, in which the patient donates blood before or during surgery for transfusion.

The process is expected to solve the availability problem and also the allied troubles of foreign bodies and infected blood from unknown donors.

On Thursday, a seminar was organised by the Department of Transfusion Medicine for doctors of the university, marking the launch of the facility.

"In donor transfusion, a number of reactions occur due to antigens that may not match with that of the patient," said Dr Tulika Chandra, Assistant Professor, Department of Transfusion Medicine and In-Charge of CSMMU blood bank.

Though such reactions can be managed up to a point, one can never be sure how individual patients will react, she said.

In autologous transfusion, since the blood is that of the patient himself, there is no question of such problems occuring. "Hence, it is the safest mode," she said.

Besides these problems, patients with less awareness often end up buying blood from professional donors, leading to the growth of blood mafias and spurious blood rackets, one of which was busted last August.

Autologous transfusion, however, will be helpful only for elective surgeries, where the date of surgery is set much in advance. Patients will be regularly assessed and since a month before the surgery, can donate blood every week.

To maintain haemoglobin level, the patient is given haematinics and iron tablets and is monitored continuously. By the time of operation, around five units of the patient's own blood is arranged.

In some cases, blood is also collected during surgery — the patient is given crystalloid and colloid fluids to maintain the volume of blood. This is called Acute Normovolemic Hemodilution, a procedure already being followed in the Department of Thoracic & Cardiovascular Surgery.

Around three units of blood can be obtained in this process.

"Most surgeries like joint replacement surgeries, cardiothoracic surgery, plastic surgery and urology can be done with autologous trans fusion," said Chandra.

Around 60 per cent of blood issued from blood bank is for elective surgery, of which 40 per cent goes to cases which can easily be chosen for autologous blood transfusion.

Autologous transfusion does not work in cases of cancer or septicaemia ¿ where blood is poisonous, or in case of accidents.

"But patients of diabetes or hypertension who do not generally donate blood, can also opt for autologous transfusion," she said.

The cost of autologous transfusion will remain the same as that of normal blood transfusion.

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