Are transfusion-free transplants without donor blood promising?

blood transfusions pose a risk for infections such as HIV, hepatitis and others bloodborne diseases. As a result, patients and their families are often reluctant to seek treatment transplants, also for the kidney and heart, because of the risks involved. However, experts suggest that with the advances in medical technology and the advent of transfusion-free transplants, patients can now receive a new organ and even undergo reduction postoperative risks.

What are the problems with blood transfusions?

Transfusions greater than 60 mL/kg were also associated with an increased risk of serious adverse events, including postoperative sepsis, dialysis, and transplant failure, said Dr. Vishal Khante, Chief Cardiothoracic Surgeon, Kamineni Hospitals, Hyderabad.

“Some recent prospective studies suggest that the use of blood products, even in low-risk patients, may adversely affect clinical outcomes. Although still rarely reported, transfusionally Graft versus host disease is almost always fatal, which is a systemic disease in which the donated tissue is not accepted by the recipient’s cells,” said Dr. Khante.

What are transfusion-free transplants?

This is where the idea of ​​transfusion-free transplantation comes into play. The patient’s own blood is protected from loss and transfused into the patient’s own body. “Not only does this limit blood loss to almost zero, but it also limits the risk of infection and reduces the likelihood of the body having an adverse reaction to an external organ immunity compromiseand accelerates the patient’s recovery process,” said Dr. Dhiren S. Shah, Director and Consultant, Department of Cardiothoracic and Vascular Surgery, Director of Heart and Lung Transplant Program, Director of Mechanical Circulatory Support Program – Marengo CIMS, Ahmedabad.

blood transfusion Is transfusion-free transplantation better? (Source: Pixabay)

Also called bloodless surgery, it is a safe alternative for patients who have serious medical conditions but cannot or do not want to receive blood blood products (red blood cells, white blood cells, plasma, or platelets), said Dr. Shrey Srivastav, MD (Internal Medicine), Sharda Hospital.

How is it done?

Blood preservation techniques include:

* Simulation of bone marrow to produce red blood cells

*cell saver: This machine collects blood lost during surgery and recycles it back into the patient’s body. The Cell Saver removes all debris and other contaminants from the blood and separates the red blood cells, which are delivered to the patient through an intravenous line.

*Cardiopulmonary bypass: The heart-lung machine is used to divert blood and add oxygen before it is returned to the heart. This replaces the function of the lungs and is primarily used to stop the heart for an operation.

*hemodilution: Before the operation, a certain amount of concentrated blood is taken from the patient and the same amount of fluid is infused into the patient’s body to thin the blood so less blood is lost during the operation. After the operation, the concentrated blood is returned to the patient’s body.

how do they help

Blood-sparing (or blood-conserving) surgery offers patients a transfusion-free alternative with numerous advantages:

In addition to avoiding blood-borne viruses and infections through transfusions, a stronger immune system and the prevention of inflammatory u allergic reactionthere are fewer reactions from blood stored for long periods of time, said Dr. Srivastav.

In addition, transfusion-free heart transplants relieve Indian blood banks, which are already stretched due to the high blood demand, said Dr. Khante.

“The future of transfusion-free transplants in India is bright as medical technology continues to advance and more hospitals are adopting the technology. With the increasing demand for safer transplant procedures and a reduction in the risk of blood transfusions, the number of transfusion-free transplants is likely to increase in the future,” added Dr. Khante added.

How is it touted as better than traditional blood transfusions?

dr Shah mentioned that bloodless patients have been shown to perform better than those receiving transfusions.”

Aside from transfusion-free surgeries that avoid the complications associated with blood transfusions, Dr. Srivastav, like traditional methods, usually requires a large-volume blood substitute that is “sometimes hard to come by.” Obtaining large amounts of blood of the same blood type can be difficult at any time. Transfusion-free surgery circumvents this problem,” he said, adding that hospitalization and postoperative complications are lower with transfusion-free surgery.

Can transfusion-free surgery be recommended for everyone?

Such transfusion-free operations can be performed only on the recommendation of the attending physician and if necessary. “Such transfusion-free practices are very effective in low-weight populations, children, neonates and patients with severe heart problems,” said Dr. Srivastav

according to dr Srivastav, in a world after covidit will definitely have an added advantage over traditional techniques.

What more?

The average cost can vary from three to seven lakhs depending on other comorbidities, said Dr. Srivastav, compared to traditional transplants of Heart which vary from 10 lakhs to 25 lakhs. “Although it is becoming increasingly popular, not all hospitals currently offer transfusion-free transplant surgery,” said Dr. Srivastav.

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