Primacy for safe blood transfusion

Focus should be on promoting repeat and regular voluntary blood donors

The incident of a nine-year-old acquiring transfusion-transmitted HIV infection, while under treatment at the Regional Cancer Centre (RCC) here, has once again brought to focus the need to promote “repeat and regular voluntary blood donors” to ensure better transfusion safety.

This is the third reported case of transfusion-transmitted HIV infection in the State.

Earlier cases

In both prior instances too - in 2005 and 2013 - it had been children who acquired the infection from hospitals.

Transfusion medicine experts point out that no blood transfusion is 100% safe. Even while observing all mandatory safety precautions before accepting blood from a donor, there is always the risk that the donor is in the window period.

Window period

(The window period is the time window after getting an infection, when the person might have already contracted the infection, but sufficient number of antibodies have not been developed in the blood for laboratory tests to detect it.)

“All government blood banks follow the NACO (National AIDS Control Organisation ) guidelines and use the Elisa screening test for screening blood donors. This test has a window period of 45 days to two months. Even screening tests with the highest sensitivity such as NAT (Nucleic Acid Amplification Test) can only minimise the risk by reducing the window period to 10-14 days, but cannot eliminate the risk,” a blood bank official said.

Kerala State AIDS Control Society (KSACS) officials said they were focussing on blood donors during the period and trying to trace if any of them could have been in the window period when they donated blood.

They were also investigating if all qualitative screening procedures to be mandatorily followed by blood banks were being adhered to. HIV testing was a complicated business and it would not be an easy process, the officials said.

“Transfusion-transmitted infections are a universal risk, which is why blood transfusions are always better avoided, unless benefits outweigh the risks. This is why we need to promote awareness on repeat, regular voluntary blood donation because such donors are repeatedly tested through the year and the records maintained, ensuring almost total blood safety,” a transfusion medicine expert said.

In Kerala, voluntary blood donation constitutes only about 30% of the total blood donated, the rest being replacement donation. Amongst the 30% voluntary blood donation, repeat, regular donors constitute about 8-10%.