A little more than a century ago, humanity did not know about the existence of various blood groups. We learned about the Rh factor later, only 76 years ago. Since then, transfusion has ceased to be deadly in nature and has become an almost ordinary procedure that allows saving the lives of a huge number of people around the world.
Transfusion science
Transfusiology is one of the areas of hematology, the science of blood. She is engaged in the study of transfusion, canning, splitting of blood into parts, the invention of artificial blood substitutes, as well as the treatment of possible problems during and after transfusion. Hematology, and transfusiology in particular, is an advanced industry in modern medicine. And this is not surprising.
For surgeons, resuscitators, obstetrician-gynecologists, anesthetists and transplantologists, the emergence and development of a science such as transfusiology is a huge step forward.
A hundred years ago, a blood transfusion was used only as a last resort and, one might say, as a last chance. In situations where the disease progressed, and all other medical and surgical measures were ineffective, the doctor and patient could take a risk. The patient and the doctor always knew that the probability of success is approximately equal to the probability of death.
Today transfusiology is a modern and rapidly developing science. She still has many discoveries and inventions ahead.
Fundamentals of Transfusiology
The science of transfusiology is based on the discoveries of 1900 and 1940 on blood groups and Rh factors. It was then that humanity learned about the existence on earth of people with four different groups:
- I - 0.
- II - A.
- III - B.
- IV - AB.
And about the existence of two Rhesus factors:
- Positive (Rh-).
- Negative (Rh +).
Further studies made it possible to determine the causes of deaths during transfusion and to display a table of compatibility by blood group (see below).
Patient's blood type | Suitable blood transfusions for the patient | Patients with which blood group can give blood |
I | I (0) | I (0), II (A), III (B), IV (AB) |
II | I (0), II (A) | II (B), IV (AB) |
III | I (0), III (B) | III (B), IV (AB) |
IV | I (0), II (A), III (B), IV (AB) | IV (AB) |
The blood group and Rh factor cannot change over time, do not depend on race, gender, but are inherited individual characteristics. Transfusiology proved this and taught doctors to use this knowledge to help patients in need of transfusion.
Transfusion
Today, transfusion of human whole blood without the use of canning and stabilization is practically not used. Basically, components necessary for the patient, isolated by fractionation, specially processed and most often frozen, are used. Use platelet concentrate, erythrocyte mass, plasma, leukocyte concentrate.
Depending on the injection site of the blood components, the following types of transfusions (infusions) exist:
- Intravenous (through a vein).
- Intraarterial (through the artery).
- Intraosseous (in the body of the patient’s bone).
- Intracardiac (in the left ventricle directly into the heart or by puncture through the skin).
- Intrauterine (with Rh-conflict pregnancy, the fetus is punctured in the womb).
When blood transfusion is needed
Despite the achievements and extensive clinical experience of transfusions, this procedure is considered a serious transplant surgery and cannot guarantee the complete absence of complications and risks in the long term.
However, there are clear indications for transfusion:
1. The indications are absolute (without donated blood, the risks of death of the patient are high, there are no contraindications):
- severe blood loss;
- shock after injury;
- terminal state (death of all tissues on an increasing basis).
2. Relative indications (without blood transfusion, the patient can live, and it is only part of the treatment. The doctor and patient must carefully consider possible contraindications, be aware of the possible risks and the expected result):
- anemia due to blood loss;
- chronic anemia in the stage of leukemia;
- pervasive blood clotting syndrome inside the vessels;
- blood loss of more than 30%;
- bleeding disorder, not amenable to therapy;
- hemophilia, cirrhosis, acute hepatitis, causing insufficient blood coagulation;
- blood cancer and some other types of cancer;
- severe poisoning;
- sepsis.
When is blood transfusion not allowed?
Severe diseases of the cardiovascular system, stages 2 and 3 of circulatory failure, atherosclerosis, cerebral hemorrhage, tuberculosis during the exacerbation, tendency to form blood clots, bronchial asthma, rheumatism, allergies, pulmonary edema - all these are direct contraindications for transfusion . Any transfusiology center will refuse to accept a patient with such diseases and will recommend looking for other, less risky treatments.
Procedure
When a patient enters the Institute of Hematology and Transfusiology, blood is taken from him to determine the group and Rh factor. This quick clarification analysis is usually done right in front of a person. An examination is also carried out in accordance with the diagnosis, blood is taken for clinical analysis, blood pressure, pulse, body temperature are measured. After that, biological samples are made for the compatibility of the recipient and the components of the blood to be transfused. About 15 milliliters of the component is injected into the patient's vein and the body reaction is monitored.
If everything went well, the paramedic prepares packages with components (heats or defrosts), and the patient signs the necessary documents. Blood is transfused according to the method of transfusion chosen by the attending physician.
After the procedure, bed rest is prescribed , the recipient is regularly examined, body temperature is monitored (up to three times per hour throughout the day), and urine and blood are analyzed.
What kind of blood is used for transfusion
Of course, the main source of blood for its further processing and preparation of components are donors. But there are other sources.
Utility - this is primarily blood from the umbilical cord and placenta. It is collected after the birth of the baby. The umbilical cord is cut, and the remaining blood is transferred into special flasks under sterile conditions. After each birth, an average of 200 ml is collected. In connection with the rapid development of science, it is now recommended that it be stored in special banks for their children. It is expected that soon doctors will be able to treat a huge number of diseases with cord blood .
Cadaveric - the blood of practically healthy and suddenly dead people (as a result of disasters and accidents, myocardial infarction, electric shock, cerebral hemorrhage, acute heart failure, etc.). The fence is made no later than six hours after death in a volume of one to four liters. Never use the blood of people with infectious diseases, oncology, HIV infection, tuberculosis, syphilis, who died from poisoning.
Autohemotransfusion - transfusion of previously withdrawn purified patient blood to him. It is also possible with abdominal injuries and extensive internal bleeding to collect the blood that has poured in the body cavity and, after cleansing, to introduce it to the patient again. This procedure is safer, as the possibility of rejection is excluded.
Donation
Every hospital in our country constantly needs donor blood. So-called donor days pass , there are staff donors, active donors and even honored donors, but nonetheless, resources are sorely lacking.
Each relatively healthy resident of our country, aged 18 to 55, can become a member of the program to help save lives. To do this, you only need to contact the nearest blood transfusion station. A free screening test (including syphilis, hepatitis and HIV) is done before the test. Most volunteers donate their blood for free, but there are also financial incentive methods. All donors are required to receive breakfast and lunch or financial dinner compensation, as well as an additional day off on the day of blood donation. Blood can be donated every eight weeks, up to five times a year.
Research Institute of Hematology and Transfusiology
Blood transfusion is the procedure available in many hospitals today. But in Russia, the Russian Research Institute of Hematology and Transfusiology of the FMBA, which is considered the country's leading central scientific and treatment institution, operates. It is located in St. Petersburg at the address: 2nd Sovetskaya Street, 16.
The Transfusiology Research Institute provides all types of the most advanced medical care related to blood problems and related diseases. Within its walls, cancer treatment is carried out, stem cells are stored, organs and tissues of the human body are collected and stored. Also, the institute organized departments of orthopedics and traumatology, radiology, radiology, surgery, and various types of laboratory diagnostics work.