Blood transfusion is an important part of hematological care. Blood transfusion therapy is critical and life saving despite the fact that it is need-based. This is because a lot of information is needed depending on a patient’s clinical condition prompting further advancements. There has been need for use of better techniques and equipments by the relevant specialists. For instance, some advancement include the betterment or introduction of open heart surgeries in third world countries as well as the gastro surgery procedures just as the case in cholecystectomy. In addition, transfusion medicine calls for efforts in the advancements of the sensitivity of diagnostic tests in order to increase the levels of detectable pathogens.
Following the high rates of incompatibility in donor recipient bloods, many commercial companies are or will come up with models of how to find substitutes for red blood cells (RBC). In addition, some are in the run to developing a hemoglobin solution. There are also advancements in the development of universal red blood cells because of incompatibility cases between donor’s and recipient’s red blood cells. These advances are most likely to continue in the future. Furthermore, there are future prospects in the development of production of artificial blood from culture plate. This is expected in 10-15 years which will only work for neutral blood groups and where there is no fear for all immunization. However, it is challenged by the fact that it is expensive and the risk associated with the development of artificial medium. Moreover, questions arise over the feasibility of commercial production of RBC and its final price. The most probable use may be in 2025. The biggest challenge is that they may come to use and available in the market but may not be in a position to replace RBC because of their price and biological half-life.
Autologous Blood Transfusion
This method of blood transfusion is the most commonly used because of its safety. However, there are risks associated with it in several surgical operations. This method is basically used in countries where there are shortages of compatible and safe blood. This method cannot be solely used because it is almost non-detectable, and the dangers are only detected when the patient’s condition is dire.
Some of the advantages of autologous blood are that there are no chances of blood reactions because the patient receives his/her own blood. In addition, there is no chance for transmission of infectious disease agents. Again this process supplements community blood supply. Furthermore, this process of donating blood promotes production of blood cells by the relevant bone marrows. On the other hand, its disadvantages include the possibility of contamination of autologous blood with disease agents during the process of donation. Furthermore, there can be chances that an allegoric blood be transfused unintentionally. Moreover, process involved is expensive as well as storage is costly. About 44% of autologous blood is not transfused leading to wastage.
Some of the pathogens routinely tested in transfusion blood include viral infections such as hepatitis infections, HIV, and ‘human T-cell lymhotropic virus’. Others include the ‘Creutzfeldt-Jakob disease (vCjD). Other viral pathogens include Alanine transaminase and west Nile virus. Bacterial pathogens tested for include Babesiosis, and Chagas disease. Others include Syphilis and Lyme disease. However, plasma and cryoprecitate are in most cases subject to threats caused by pathogens that may have not been screened during the transfusion. For example, traces of Delta agent pathogens can be transmitted to the recipient because it is not majorly screened for since it is believed to be a great infection of Hepatitis B. In addition, it cannot exist on its own, thus if Hepatitis B is not well tested, then it may be transmitted.
Development of new blood cells originating from artificial blood is basically done by taking cells from an umbilical cord. Specialized machines and equipments are then used in mimicking the functioning of the bone marrow in the production of blood. Because artificial blood is basically made for one sole purpose, it becomes easier to identify the blood group that has been produced artificially. This is owing to the fact that artificially produced blood is used in the transportation of both oxygen and carbon dioxide in the entire body.
Owing to the fact that both male and female have their ‘x’ chromosomes and ‘x’, ‘y’ in male and female respectively, the chemical information is coded in every chromosome that is passed to the offspring. This is because the nucleotide sequence of genes in every parent is hereditary and thus must be passed to the offspring. The gene responsible for the formation of blood cell codes an enzyme that is responsible for the biochemical formation of the RBC inherited from the parents. This implies that the particular gene contains a particular sequence of nucleotide bases that plays the role of organizing amino acids in an order that will lead to formation of antigens and antibodies. Any disruption may lead to human disorders in the offspring such as sickle cell anemia.
Transfusion between individuals who have artificial blood should be taken with a lot of care. Some of the issues to be addressed during this process include the fact that blood supplements can be stored for long periods compared to biological blood. This calls for proper storage since improper storage can lead to its contamination. In addition, artificial blood must not be stored under refrigeration till its use; this implies that it is prone to unfavorable temperatures either too high or too low that can contaminate it. Furthermore, transfusions between artificial blood groups rarely register reactions. However this should be taken into consideration because unlike antigens and antibodies may introduce to the same system leading to an eventual loss of life or complications.
Dealing with naturally occurring heterophil involves the use of an immunoglobulin that is to specifically react with the antigen that is naturally induced as a result of the synthesis of a similar molecule. There classification is done basing on their way of agglutinin. The anaphylactic antibody (IgE) is responsible for the cause of anaphylaxis. To block the antibody, there is production of the IgG that in turn reacts with the antigen preferentially. As a result, IgG is stopped from reacting with the cytotropic antibody (IgE). Furthermore, this production leads to a hypersensitivity reaction. As a result, there is the production of the complement-fixing antibody that is responsible for the reaction with the particular antigen. In addition, IgM and IgG play the most important role of fixing complements through the classical pathway; IgA by the substitute pathway. For the success of this process to be achieved, individuals must produce the right amount of antibodies are produced in the body. In addition, the production of antibodies must begin from the stem cells meaning that the plasma of any individual must be healthy and safe.
Despite the fact that blood transfusion has become safer than it was in the recent past, there are certain emerging diseases that pose threat to the entire process. Blood and plasma products remain vulnerable to emerging infections. These include the newly discovered hepatitis viruses. In addition, the agents of transmissible spongi emerging from encephalopatheis, as well as the tick bone pathogens are a risk to many people because they are emerging threats. These pathogens warrant concerns because they can lead to fatalities and high risks in patients if not well taken care of.
Current blood supply is safer compared to the way it was in the previous years. This is because the safety procedures rely on various steps. These include interviewing of donors and their selection. In addition, the donor is monitored with serologic examinations as well as screening of the blood samples that have been collected. The plasma of donor’s blood is tested for various infections including inactivation of plasma-derived products as well as leukodepletion of blood components.
Some of the issues affecting third world countries in adapting to the advancements in Transfusion Medicine include poverty. This is undoubtedly a crucial factor leading to severe health factors in most third world countries. In addition, poverty is increased by lack of political will by the leaders of the respective countries. In addition, certain social norms especially in Africa has played a major role in fighting development in Transfusion medicine. They include taboos, or lack of institutions that can play a role in controlling the situations. Furthermore, HIV and AIDS prevalence in Third World Countries is high making Transfusion Medicine difficult to be realized. This is owing to the fact that HIV/AIDS come along with certain ailments that make blood be considered contaminated in transfusion. China has proved to be one of the leading recipients of blood in the world. According to WHO, Chinese authorities have tried to deal with illegal blood donations, but it still poses as the world’s leading blood recipient because its blood supply is highly contaminated with HIV. This makes its demand for blood products high creating an economic incentive for most hospitals in the country.