Blood Transfusions in the Management of Hematological Diseases

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Table of Contents

Introduction
Autoimmune Hemolytic Anemia
Sickle Cell Disease
New Instrumentation
Ethical Issues
Conclusion
References

Introduction

Blood is vital for life, and excessive losses are associated with high mortality rates. Transfusions revolutionized the management of serious hematological illnesses by increasing the chances of survival. It is vital to note that the procedure is commonly practiced in most hospitals around the world. The management of illnesses like autoimmune hemolytic anemia in childhood has improved courtesy of new and innovative techniques. Transfusions are essential in the treatment of hematologic illnesses because they improve clinical outcomes.

Autoimmune Hemolytic Anemia

A variety of illnesses lead to a decrease in the circulatory system’s effectiveness in both adults and children. Autoimmune hemolytic anemia in childhood is often caused by the production of antibodies that target antigens on red cells, which are then prematurely destroyed (Ladogana et al., 2017). The disease is diagnosed by conducting an exhaustive history and clinical exam. The clinical tests involved include a white blood cell count, a reticulocyte count, the assessment of hemolysis indices, a urinalysis, red cell morphology on a peripheral smear, and the evaluation of the patient’s blood group (Ladogana et al., 2017). It is vital to note that affected individuals usually have high reticulocyte counts because of increased erythropoiesis.

The direct antiglobulin test is conducted to identify the antibodies attached to red cells. The test is first conducted on polyspecific sera to identify IgG and C3 (Ladogana et al., 2017). If the result is positive, a monospecific antiserum is used to identify the collected sample’s individual antibodies.

The treatment of autoimmune hemolytic anemia involves the use of steroids and transfusion therapy. In the U.S., approximately 11.3 million units of platelets, red cells, and plasma are transfused every year (Scharman et al., 2017). However, it is worth noting that the administration of packed red cells to affected individuals is relatively uncommon because of difficulties associated with matching recipients to donated blood samples.

The procedure is reserved for patients with severe anemia, and only 3-5ml/kg is administered during therapy (Ladogana et al., 2017). Some patients benefit from plasma exchange processes where circulating immune complexes are removed. It is estimated that each cycle is capable of eliminating approximately 65% of antibodies, which means that the procedure must be repeated in serious cases of the illness (Ladogana et al., 2017). Transfusions increase the chances of survival in people suffering from a variety of hematological illnesses.

Patients diagnosed with the illness must be tested to identify specific red cell phenotypes and the presence of alloantibodies whose existence is obscured by auto-antibodies. Therefore, laboratories are often required to conduct extensive red cell antigen typing to facilitate effective transfusion. It is recommended that molecular methods should be applied to limit the chances of adverse reactions during treatment. It must be pointed out that the blood products used in affected patients must be leucodepleted before storage. The administration of blood must be done slowly, with a maximum of four hours allocated for the procedure (Ladogana et al., 2017). This ensures that the patient’s immune system adjusts to the introduction of foreign antigens, thus reducing the possibility of an adverse reaction.

Sickle Cell Disease

Sickle cell disease is a common genetic disorder that mostly affects children. The affected individuals have defective red blood cells with limited blood carrying capacity. The illness is diagnosed by conducting hemoglobin electrophoresis and a baseline blood study. The disease is primarily managed through transfusions, which restore the blood’s ability to transport oxygen (Akaba et al., 2019). A simple transfusion is conducted when patients experience acutely lowered hemoglobin levels. This is common when affected individuals experience aplastic or sequestration crises. For long-term management of the illness, patients receive between 2-3pints of blood every four weeks to maintain a hemoglobin level of above 10g/dl (Akaba et al., 2019). Transfusions help reduce the incidence of complications associated with reduced oxygen flow to vital tissues in people diagnosed with the ailment.

New Instrumentation

The current practices in transfusion medicine place emphasis on precision and safety. Testing for infectious disease markers is an essential step that involves several intricate measures. For instance, complex donor questionnaires are used to gather vital clinical information. In addition, comprehensive skin disinfection techniques have been introduced to eliminate sin bacteria, and leucodepletion is applied to eliminate intracellular organisms. Contemporary test technologies like pathogen reduction and nucleic acid testing are used to increase efficiency (Prudent et al., 2019). Improved instrumentation is necessary for the delivery of effective transfusion services in health institutions.

Technological advancements play a critical role in improving patient safety during the transfusion process. For instance, using hand-held devices capable of identifying bar codes on patients’ wrist bands coupled with the utilization of miniature printers to produce patient labels helps reduce errors during sample collection (Alli, 2021). In addition, statistical process control charts are vital when tracking performance. They allow laboratories to assess the frequency of mislabeled specimens and make the changes necessary to facilitate efficiency (Suman & Prajapati, 2018). Oxygen sensing probes are also currently used to detect vital parameters prior to the administration of blood products (Papkovsky & Dmitriev, 2018). Finally, the use of computer programs to store important patient information, laboratory results, and physician communications has facilitated the reduction of errors in various clinical settings.

Ethical Issues

The ethical code of conduct on transfusions was designed to ensure that patients access safe blood products in good time. In the management of hematological illnesses, several issues must be taken into consideration. For instance, motives for personal gain, coercion by the patient’s relatives, or monetary incentives should be the basis of prescribing the procedure (Obeta et al., 2020). It is also crucial to inform the patient of the potential risks associated with receiving donated blood as well as potentially effective alternative therapies. It is critical that donors give informed consent and that blood is collected voluntarily.

Compelling individuals to give blood is unethical. A rigid set of rules must be followed when choosing individuals capable of making donations. It is essential that any form of discrimination on the basis of gender, religion, or nationality is avoided (Obeta et al., 2020). Confidentiality must be maintained at all stages of the process, and access to blood products must not be restricted. Adhering to these principles ensures that patients and donors receive the best possible care in healthcare institutions.

Conclusion

Blood transfusion has revolutionized medical practice by providing an effective means of managing illnesses that previously had high mortality rates. Diseases like sickle cell anemia and autoimmune hemolytic anemia are treatable through the administration of specific blood products. Technological advances like leucodepletion, pathogen reduction, and nucleic antigen testing ensure that donated blood is safe. Ethical issues like the administration of transfusions for monetary gains or the coercion of individuals to donate must be addressed. The quality of life among individuals afflicted with hematological maladies has improved thanks in part to revolutionary transfusion techniques.

References

Akaba, K., Bassey, O. B., Akpan, I., & Essien, O. (2019). Transfusion therapy in sickle cell disease. Journal of Blood and Lymph, 9(2), 1–4. Web.

Alli, S. K. A. (2021). Barcoding an automatic identification and data capture system in healthcare settings. The Pharma Innovation Journal, 10(1), 187–200. Web.

Ladogana, S., Maruzzi, M., Samperi, P., Perrotta, S., Del Vecchio, G. C., Notarangelo, L. D., Farruggia, P., Verzegnassi, F., Masera, N., Saracco, P., Fasoli, S., Miano, M., Girelli, G., Barcellini, W., Zanella, A., & Russo, G. (2017). Diagnosis & management of newly diagnosed childhood autoimmune haemolytic anaemia. Recommendations from the red cell study group of the paediatric haemato-oncology Italian association. Blood Transfusion, 15(3), 259–267. Web.

Obeta, K. O., Obeta, M. U., & Lugos, M. D. (2020). Current trend in blood transfusion science: Where are we ?Haematology International Journal, 4(2), 1–9. Web.

Papkovsky, D. B., & Dmitriev, R. I. (2018). Imaging of oxygen and hypoxia in cell and tissue samples. Cellular and Molecular Life Sciences, 75(16), 2963–2980. Web.

Prudent, M., Tissot, J. D., Fontana, S., & Niederhauser, C. (2019). Editorial: Transfusion medicine and blood. Frontiers in Medicine, 6, 1–4. Web.

Scharman, C. D., Burger, D., Shatzel, J. J., Kim, E., & DeLoughery, T. G. (2017). Treatment of individuals who cannot receive blood products for religious or other reasons. American Journal of Hematology, 92(12), 1370–1381. Web.

Suman, G., & Prajapati, D. R. (2018). Control chart applications in healthcare: A literature review. International Journal of Metrology and Quality Engineering, 9(5), 1–22. Web.

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