NEW DELHI: If you need blood transfusion, it’s better to get a voluntary donor than depend entirely on hospital stock. That’s because blood collected through replacement donations have a high rate of infection.
A retrospective study conducted at Guru Tegh Bahadur Hospital, which is the regional blood transfusion centre for east Delhi, has confirmed it. Data published in the latest issue of Indian Journal of Medical Research shows the centre received 2.2 lakh units of blood in six years, from January 2008 to December 2014.
Nearly 75% of the blood was collected through voluntary donations (VD) while the rest of it was through replacement donations (RD). Simply put, RD refers to blood donated by a relative or friend in lieu of blood transfused to a patient from the hospital stock.
When these blood samples were tested for infections, doctors found transfusion-transmitted infection rates very high in case of RD as compared to VD — a concern raised by many experts in the past.
In 2014, for example, 81 units of blood collected at GTB Hospital tested positive for HIV. Of these, 76 were RDs. Prevalence of hepatitis B, hepatitis C, syphilis and malaria was also found to be four to five times higher in case of RD as compared to VD (see graphic).
“Patients often arrange for professional donors if they cannot find someone from among family and friends. They conceal medical history, which makes it difficult to rule out infection,” said a doctor.
GTB doctors have stressed on the need to increase public awareness about VD and its benefits. Also, they have called for meticulous donor screening and use of highly sensitive techniques for detection of transfusion-transmitted infections to prevent the spread of diseases.
National Blood Bank Policy 2002 also calls for phasing out of RDs. But an RTI reply accessed by TOI showed the practice of seeking RDs was prevalent across the country. It also revealed that Delhi hospitals collected nearly a million units as RDs in five years from 2012-13 to 2016-17, which is the third highest across all states.
At 20.15 lakh, Uttar Pradesh had the highest rate of blood collection through RD, followed by Karnataka (9.88 lakh).
Dr Vijay Kumar from the geriatric division of AIIMS said hospitals seek RDs because there is a scarcity of VDs and hospitals have to maintain their stocks.
“There is an urgent need for a registry of VDs and giving them incentives. We must do away with this practice of RDs because it is fraught with risks and causes avoidable stress to a patient’s family,” Kumar said.
Delhi has 69 blood banks of which 34 are run by private hospitals, 11 by Delhi government hospitals, nine by central government hospitals, eight by voluntary organisations and three by municipal corporations. There are four private blood banks.
Dr Bharat Singh, who heads Delhi State Blood Transfusion Cell, said RDs are higher in private hospitals as compared to government hospitals and blood banks. “DSBTC can only recommend or suggest hospitals to seek more blood through donation. We do not have staff or infrastructure to organise camps for VD,” he said. Singh is one of the authors of the study.