Slightly more than a century ago, humanity did not know about the existence of different blood types. We learned about the Rh factor even later, only 76 years ago. Since then, transfusion has ceased to be deadly and has become an almost ordinary procedure that saves the lives of a huge number of people around the world.
The Science of Transfusion
Transfusiology is one of the areas of hematology, the science of blood. She is engaged in the study of transfusion, canning, splitting 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 branch of modern medicine. And this is not surprising.
For surgeons, resuscitators, obstetricians-gynecologists, anesthesiologists and transplantologists, the emergence and development of such a science as transfusiology is a huge step forward.
One hundred years ago, blood transfusion was used only fornecessary 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 the patient could take risks. The patient and the doctor have always known that the probability of success is approximately equal to the probability of death.
Today, transfusiology is a modern and rapidly developing science. She has many more discoveries and inventions ahead of her.
Fundamentals of Transfusiology
The science of transfusiology is based on the discoveries of 1900 and 1940 about blood types and Rh factors. It was then that humanity learned about the existence of people on earth with four different groups:
- I – 0.
- II – A.
- III – V.
- IV - AB.
And about the existence of two Rh factors:
- Positive (Rh-).
- Negative (Rh+).
Further studies determined the causes of transfusion deaths and developed a blood type compatibility chart (see below).
| Patient's blood type | Suitable blood types for a patient to transfuse | Patients with what blood type can donate 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) |
Blood type and Rh factor cannot change over the course of life, do not depend on race, gender, but are inherited individual characteristics. Transfusiology has proven this and taught doctors to use this knowledge in helping patients who need transfusion.
Transfusion
Today, transfusion of human whole blood without the use of conservation and stabilization is practically not used. Basically, the components necessary for the patient are used, isolated by fractionation, specially processed and most often frozen. They use thromboconcentrate, erythrocyte mass, plasma, leukocyte concentrate.
Depending on the place of injection of blood components, there are the following types of transfusions (infusions):
- Intravenous (through a vein).
- Intra-arterial (through an artery).
- Intraosseous (into the body of the patient's bones).
- Intracardiac (into the left ventricle directly into the heart or by puncture through the skin).
- Intrauterine (with Rh-conflict pregnancy, a puncture is made to the fetus in the womb).
When a blood transfusion is needed
Despite the achievements and extensive clinical experience of transfusions, this procedure is considered a major transplant operation and cannot guarantee completeabsence of complications and risks in the long term.
However, there are clear indications for transfusion:
1. Absolute indications (without donated blood, the risk of death of the patient is high, there are no contraindications):
- severe blood loss;
- shock after injury;
- terminal state (death of all tissues on the rise).
2. Indications are relative (without blood transfusion, the patient can live, and it is only part of the treatment. The doctor and the 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;
- spreading intravascular coagulation syndrome;
- blood loss over 30%;
- untreated bleeding disorder;
- hemophilia, cirrhosis, acute hepatitis causing insufficient blood clotting;
- blood cancer and some other cancers;
- severe poisoning;
- sepsis.
When should blood be transfused?
Severe diseases of the cardiovascular system, 2nd and 3rd stages of circulatory failure, atherosclerosis, cerebral hemorrhage, tuberculosis during an exacerbation, a tendency to form blood clots, bronchial asthma, rheumatism, allergies, pulmonary edema - all These are direct contraindications to transfusion. Any transfusiology center will refuse admission to a patient with such diseases and recommend looking for other, lessrisky 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 clarifying 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 tests are made for the compatibility of the recipient and blood components to be transfused. About 15 milliliters of the component is injected into the patient's vein and the body's reaction is monitored.
If everything went well, the paramedic prepares packages with components (heats or defrosts), and the patient signs the necessary documents. The blood is transfused according to the transfusion method 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 tests are performed.
What kind of blood is used for transfusion
Of course, the main source of blood for its further processing and obtaining components are donors. But there are other sources as well.
Utilnaya is primarily blood from the umbilical cord and placenta. It is collected after the birth of a child. The umbilical cord is cut, and the remaining blood is poured into special flasks under sterile conditions. After each birth, an average of 200 ml is collected. Due to the rapid development of science, nowrecommend keeping it in special jars for your children. It is expected that doctors will soon be able to treat a huge number of diseases with the help of umbilical cord blood.
Cadaverous - the blood of practically he althy and suddenly deceased people (as a result of catastrophes and accidents, myocardial infarction, electric shock, cerebral hemorrhage, acute heart failure, etc.). The collection 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 blood of the patient to him. It is also possible in case of injuries of the abdominal cavity and extensive internal bleeding to collect the blood that has poured out into the body cavity and, after cleansing, inject it into the patient again. This procedure is safer, as the possibility of rejection is excluded.
Donation
Every hospital in our country constantly needs donated blood. The so-called donor days are passing, there are personnel donors, active donors and even honored donors, but nevertheless, the resources are sorely lacking.
Every relatively he althy citizen of our country between the ages of 18 and 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. Before delivery, a free examination is carried out (including for syphilis, hepatitis and HIV). Most volunteers donate their blood for free, but there are also financial incentives. All donors are required to receive breakfast and lunch on the day of blood donation or financial compensation for lunch, as well as an additional day off. Blood can be donated every eight weeks, up to five times a year.
Research Institute of Hematology and Transfusiology
Blood transfusion is a procedure available in many hospitals today. But in Russia, the Russian Research Institute of Hematology and Transfusiology of the FMBA, which is considered the leading central scientific and medical institution of the country, operates. It is located in St. Petersburg at the address: 2nd Sovetskaya street, house 16.
Research Institute of Transfusiology provides all types of the most modern medical care related to blood problems and concomitant diseases. Within its walls, they treat oncological diseases, store stem cells, collect and store organs and tissues of the human body. Also, the research institute has organized departments of orthopedics and traumatology, radiology, radiology, surgery, and various types of laboratory diagnostics.