Blood Transfusion is not the safest form of treatment and must be avoided as far as possible . Body has its own mechanism to recover and heal and it must be given a chance before administering any transfusion. Experts in blood transfusion science always claim that about 90 % transfusion in India can be avoided. This month we have a similar experience to share with the world where some sensible decision making could have avoided a series of events. (In order to protect the privacy of the patient, the real names have been held back)
Mrs Laxmi, a 50 year old woman suffering from hysterectomy ( a condition where a woman looses excess of blood during her menstruation cycle) was admitted to a renowned Hospital in Bangalore. Her hemoglobin level was down to 4 but the reason to worry was that her blood group was Bombay positive blood group ( the rarest blood group with a frequency of 1 in 17000) . But as said earlier; body has its own mechanism to fight back and so was the case with Mrs Laxmi too. Her Hemoglobin level was showing signs of improvement and increasing gradually thereby naturally avoiding the need for any blood transfusion. Stuck in a situation where there was not a single eligible donor for this blood group at that moment in the entire state of Karnataka , it was a reason to cheer for Sankalp volunteers. But the treating doctor was not willing to wait till the time she patient would recover to an extent that surgery could be undertaken without the need of any transfusion . The emergency team of Sankalp seeing the condition suggested the doctor to administer Erythropoetin injection which would naturally pump up the Hb level ( Erythropoetin is an injection that can brought from any medical center upon a doctor's prescription , which is used to pump up the Hb without transfusion of blood) . But what was shocking was that when the doctor simply refused the idea of injecting erythropoetin on the grounds that they were not specialized in trying this injection and more over they shall discharge the patient if blood was not made available to them. Isn't this interesting and shocking when a doctor claims that he not specialized in monitoring an injection!
The doctor kept his word and discharged the patient . The poor lady was admitted to a bigger hospital in the hope that things would be better there. The doctor here too expressed that blood transfusion is necessary.The good news was that the Hb had increased to 8.5 . Does this not justify our claim that we should wait as Hb count increased from 4 to 8.5 in a matter of few days ? The reason to wonder was why are people reluctant in trying erythropoetin injection when it is safer than blood transfusion? This is a question not answered till now as the doctor in this bigger and better hospital too was not ready to try it out ; may be even they where not specialized in monitoring injection!
At approximately the same time there was hope of getting blood, 1 unit of Bombay negative blood was available in one of the renowned blood banks. Hoping that the doctor would be pleased this time , this valuable information was communicated to the doctor without any delay. But the response was another disappointment to Sankalp volunteers . The medical officer was not willing to take risk and so this unit of blood which was readily available could not be transfused . But all these years we had learnt from various Blood Transfusion experts that a Rh negative blood can be transfused to a Rh positive patient without any risk and honestly speaking the same has been applied in numerous cases so far all over the world. The doctor not only failed to act sensible and responsible, but also did not substantiate the claim as to why transfusion of that unit must be avoided. But as organisation working for blood emergencies we wonder and ask ourselves one simple question ; given a situation where the patient has the rarest blood group under the sun , is it justified to waste that one unit of blood which was already available in blood bank?
Nevertheless, Sankalp had no other option left but than to get donation done and go ahead with the surgery. By god's grace , 2 donor were eligible to donate by this time , and finally both of them donated and the surgery was carried out successfully . Interestingly, the Bombay negative unit which was already available in the blood bank was transfused to a thalassemic kid who needs blood transfusion every month, who is a Bombay positive patient without any risk !