Safe blood transfusion practices.

The advent of AIDS has raised a concern regarding transfusion transmitted diseases. Blood transfusion is safer than ever before through continued improvements in safe donor recruitment, screening of donors, testing of donated blood and appropriate clinical use of blood. The risk of residual infections is further reduced through inactivation of pathogens in blood components. Prevention of technical and human errors in blood grouping, avoiding bacterial contamination of blood components and using leuco-depleted products to minimize immunomodulatory effects also increase blood safety. For safety, efficiency and effectivity it is necessary to improve clinical transfusion practices through alternatives to traditional hemotherapy such as autologous transfusion and audit of blood utilization practices by hospital transfusion committees.

Current status of transfusion medicine in India.

A review of current scenario of transfusion medicine (TM) in India indicates an urgent need for restructuring the blood transfusion service (BTS). The BTS is hospital based with extreme variations in management and technology in different parts of the country. Compliance of quality assurance and good manufacturing practice is not ensured at all centres. Inspite of compulsory legislation, 34% of blood banks are yet unlicensed. Nearly 50% of 3 million units collected annually against a requirement of 6 million are estimated to be provided from paid blood sellers. Only 5% of voluntary donors are repeat donors. Complete testing of all donated blood is questionable due to operational problems. Only 40 centres are equipped to provide blood components. The shortage of blood is enhanced by inappropriate use of blood. Efficient clinical practice demands introduction of TM as a specialty.