Replacement donation not the best option, they say
Although the State has an excellent record of voluntary blood donations, the experience of a poor patient from a village makes a mockery of the entire system in place.
Last week, when a patient had to undergo surgery in a private hospital in the city, his family had to make arrangements for five donors. It was a hectic day for the family and those who tried to help the family.
But blood safety experts say this would not be the case, if there was some coordination between hospitals and blood banks.
All three tertiary care government hospitals and the children’s hospital in Egmore have dedicated blood banks with component separators and storage facilities. All major corporate and private hospitals have blood banks and there are also private blood banks. Yet, the family had run around for replacement donors. Blood safety officers say it is legally alright to go for replacement donors but it may not be the best method.
According to these officers, the way forward is for private and corporate hospitals to conduct periodic blood donation camps.
“Legally, replacement donations are allowed but in the interest of patient safety it is best not encouraged. Blood donation camps cost money but will also ensure that donations are voluntary and we do not have to depend on replacement or directed donors,” said N. Rajkumar, head of Transfusion Medicine, Stanley Medical College.
According to former drug controller M. Baskaran, the insistence on replacement donation might make a person a professional donor, “something we have always wanted to avoid.”
One of the reasons for this is that the patient’s relative or the replacement donor may not reveal information about risky behaviour and that may pave way for commercial donors as the patient’s family may fear that surgery may be postponed.
Even if a hospital insists on fresh blood then it can provide a reasonable time frame of five days, thus providing donors four days time to come for donation.
P. Srinivasan, chairman of Jeevan Blood Bank, says some years ago the idea of a central blood bank system was mooted to ensure complete safety and overcome hassles for patients such as searching for volunteers in case of an emergency. “The South African National Blood Service model provides a helpline and all hospitals have to come through this blood bank for its requirements. All this requires is only a couple of telephone lines and a call centre that can be set up at a cost of as little as Rs. 15 lakh,” he said.
One of the reasons for insistence on replacement donors is lack of faith, among various players, in the testing facilities of the government and private blood banks. This is why private hospitals insist on replacement of blood or components used.
Blood safety officers are unanimous in the opinion that it would be cheaper for hospitals to take blood or components from one of the banks and screen them before transfusing them, and it would at least result in reducing stress for patients and their family.