Global Blood Resources

Autologous Blood Management at its Best

 

Surgery

 
 
 Background

Safety concerns, rising costs, and blood shortages are some of the reasons behind the move towards blood management and promoting autologous infusion. The prevailing medical consensus is summarized by Isbister:

 Altruistically donated allogeneic blood transfusion should only be used as therapy when there is evidence for potential benefit, there are no alternatives, a quality product is available and the risks are appropriately considered and balanced against the benefits.

SAFETY

Providing safe blood for transfusion remains a challenge. Despite advances in preventing transmission of hepatitis B, hepatitis C, and AIDS/HIV, transfusion-transmitted bacterial infection remains a significant risk.

As well, many adverse events are associated with the transfusion of allogeneic blood products:

Viral risks such as HIV, although extremely rare, have not totally disappeared:

There is growing evidence that human herpesvirus 8 (HHV-8), previously thought unlikely to be transfusion-associated, may be transmissible by blood transfusion:

Chagas Disease

There are now multiple reported cases of transfusion-transmitted Chagas disease (caused by the parasite caused by Trypanosoma cruzi) in the USA and Canada, with continued calls for blood banks to screen for the T. cruzi parasite:

vCJD

Other risks such as variant Creutzfeldt Jakob Disease (vCJD) remain worrisome. Blood centers worldwide have instituted criteria to reject donors who may have been exposed to vCJD. There are now four suspected cases in the United Kingdom and donors whose blood was transfused to people who died of vCJD have been warned that they may be carrying the disease.

WNV

Because West Nile Virus (WNV) can be transmitted by blood transfusion and most patients with WNV infection are likely to be asymptomatic, a blood donor screening test for WNV was implemented in July 2003.

TRALI

Transfusion-related acute lung injury (TRALI) remains a life-threatening complication of transfusion:

Transfusion-Related Acute Lung Injury (TRALI) (Canadian Blood Services)

Blood Donations From Previously Pregnant Women Restricted

Transfusion-associated Immunomodulation

Transfusion-associated immunomodulation (TRIM) has been reported since the 1970s. Evidence-based approaches suggest that an adverse TRIM effect probably does exist, and even if the effect is small, it represents a clinically important complication of transfusion:

Human Error

Human errors present more of a risk than transmissible diseases as shown by the Serious Hazards of Transfusion (SHOT) reports from the UK. Human error also results in many recalls of blood products that were mistakenly issued from blood suppliers.

Misidentification leading to blood of the wrong blood group being transfused can result in life-threatening transfusion reactions: 

OTHER FACTORS

Costs

Costs have risen due to adoption of improved screening tests for transmissible diseases and government-mandated patient and hospital notification requirements for blood products identified as having increased risk for disease transmission. While such advances improve safety, they also increase the cost of obtaining and processing blood. See, for example:

Various blood conservation strategies have been used to reduce costs, e.g.,

To learn how the Hemobag® can reduce costs, see

Shortages

Blood shortages exist in the United States and worldwide. In many industrialized countries 5% or less of the eligible population are blood donors. Screening for transmissible diseases and deferral policies for vCJD designed to improve safety have contributed to shrinking the donor pool. Blood centers are increasingly forced to encourage blood donation with giveaways and the AABB operates a National Blood Exchange to help ensure blood is moved where it is needed.

THE HEMOBAG®

For these reasons the global medical community has moved away from allogeneic blood and towards autologous infusion. When blood is required, the safest blood is almost always the patient's own autologous blood.

The Hemobag® is a medical device developed by medical professionals with years of experience in cardiac, thoracic and vascular surgery, to assist in salvaging the patient's own whole blood in the perioperative setting.

The  Hemobag® makes it easy to get the benefits of concentrated hyperoncotic whole blood  with the use of any extracorporeal circuit used in surgery. 

With The Hemobag® patients receive their own concentrated whole blood quickly and receive less allogeneic blood with its associated risks.

The Hemobag® takes patients one step closer to blood free surgery by making their own Autologous Whole Blood rapidly available for infusion at the end of the procedure.

Also see
Intraoperative Autologous Blood Salvage and
The Hemobag®

The Hemobag® - An Improved Way to Salvage Autologous Whole Blood in Surgery

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