Different from what happens with any medicine before being released to be used in human beings, blood has never gone through safety and effectiveness tests. According to the strict FDA (Food and Drug Administration) rules, if BLOOD was a MEDICINE, a medication, it would have HARDLY got the approval of this organ to be used by the population in general.
Relative to blood safety, WHO says: “Blood transfusions have the potential to lead to acute or of late effect complications, besides being able to transmit infections. The risks associated to transmission can be reduced through minimizing the number of unnecessary transfusions…”. National and international scientific evidences prove that these WHO affirmations are REALLY TRUE. See more in the. SCIENTIFIC EVIDENCES session.
Hospitals all around the world try to establish protocols and/or strategies to ration blood consumption and this has become a criterion of hospital quality pursued by quality certification agencies like, for instance, Joint Commission International. A hospital center which receives one of these quality seals has the commitment to reduce the transfusion medical practice. Several ways can be used as part of these blood conservation protocols.
Worried about the risks related to the traditional transfusion practice,done with donation bags, WHO strongly encourages the creation of a program to keep blood from the patient themselves (Patient Blood Management – PBM). It was noticed, in this last decade, that the truth of these facts is more and more evident through the scientific researches published by several researchers all over the world.
See in the SCIENTIFIC EVIDENCES section a summary of the Global
Forum for blood safety: Patient’s Blood Conservation, carried by WHO.
The SIXTY-THIRD WORLD HEALTH ASSEMBLY: Availability, safety and quality of blood products, 21 May 2010, “Recognizing that excessive and unnecessary use of transfusions and of plasma-derived medicinal products, unsafe transfusion practices, and errors (particularly at the patient’s bedside) seriously compromise patient safety. Bearing in mind that patient blood management means that before surgery every reasonable measure should be taken to optimize the patient’s own blood volume, to minimize the patient’s blood loss and to harness and optimize the patient-specific physiological tolerance of anaemia following WHO’s guide for optimal clinical use (three pillars of patient blood management)”. http://apps.who.int/gb/ebwha/pdf_files/WHA63/A63_R12-en.pdf
Finally WHO recommends: “… reduce unnecessary transfusions and minimize the risks associated with transfusion, the use of alternatives to transfusion, where possible, and safe and good clinical transfusion practices, including patient blood management”. World Health Organization. Blood safety and availability. Fact sheet N°279. Reviewed June 2015. http://www.who.int/mediacentre/factsheets/fs279/en/
Therefore, it is important to make known the main options of treatment instead of transfusion to save blood components, which are already short in number in the blood banks.
When the multi-professional purpose and involvement of the practitioner, the surgeon, the anesthesiologist and/or intensive care doctor to manage and keep autologous blood (from the patient themselves) is present, it is possible to perform complex and serious surgeries without using other person’s blood (allogenic). Ask your doctor for more.
Strategies for the conservation (management) of the patient’s blood (Pacient Blood Management – PBM), in the area of Transfusion Medicine, have shown, through impactful scientific publications, a better clinical outcome, with reduced morbidity and mortality for patients and costs for the health system. The real and marked shortage of blood stocks, especially during the COVID-19 pandemic, has encouraged the URGENT search for therapeutic options for blood transfusions.