Blood transfusion remains the most commonly performed tissue transplant and is life saving in situations such as trauma, surgical blood loss, and severe anemia. The provision of transfusion services by hospitals, however, remains under pressure by concerns over safety, costs, and blood availability. There is little doubt that despite the best efforts of the transfusion services, a definite risk of complications remains with blood transfusion. The incidence of some of these, including transmission of infective agents and immunological reactions because of human error or undetected incompatibility, has been documented with a certain degree of precision. However, the clinical impact of immunosuppression, potentially leading to infection, cancer recurrence, and poor postoperative outcome, is difficult to quantify.
In the last decade, new procedures have been implemented in advanced countries to guarantee the safety of stored blood. These include routine nucleic acid testing for transfusion transmitted infections and universal leukodepletion. However, as a consequence, the cost of stored blood has risen dramatically and its inappropriate use will result in a progressively greater wastage of resources. Strict donor selection and a progressively ageing population already limit the number of potential blood donors. There is growing concern on the potential impact of transmissible disease screening on the number of volunteers willing to donate blood and the handling of those testing positive because shortages in supply may influence red cell use independently of clinical indications for transfusion. Therefore, hospitals have been forced to elaborate strategies to ensure appropriate use of blood and components.
Indian Journal of Transfusion Medicine
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