24 April 2004	Saturday	03 Rabi-ul-Awwal 1425

KARACHI, April 23: So unsafe is the locally available blood that many well-meaning doctors have discontinued recommending transfusion to patients whose lives are not threatened in the short term.

This was stated by two office-bearers of the Pakistan Medical Association (PMA) on Friday during a press briefing at which a set of guidelines for safe transfusion of blood were made public. The guidelines have been formulated by a committee specially constituted for the purpose.

Talking to journalists, the PMA's office-bearers and two experts demanded of the authorities that the guidelines be adopted by them as their own and also that the same be implemented as soon as possible.

The four doctors - namely Dr Shershah Syed, Dr Qaiser Sajjad, Dr Farrukh Hassan and Dr Tahir Shamsi - were of the opinion that only the government departments could ensure satisfactory implementation of the guidelines.

Some of their recommendations are: Blood banks should only receive blood on exchange and from volunteer donors; all donors be screened for syphilis, HIV, Hepatitis B and C, malaria and Haemoglobin before the collection of blood; before transfusion proper blood grouping and cross-matching be ensured by competent health workers; all blood banks be supervized by qualified pathologists, preferably haematologists; no blood bank should be allowed to operate without the provision of electricity round-the-clock; all blood banks should store blood in special refrigerators and stored blood should be destroyed or incinerated after the date of expiry; whole and fresh blood only be dispensed under appropriate conditions; blood components be prepared under good quality control conditions; and, blood and blood components be transported in thermopole packs from the bank to any other place.

The use of blood components should be encouraged as much as possible, the four doctors told the journalists present. One pint or bag of blood could be utilized by several patients provided the blood components were produced under the recommended conditions, they pointed out.

The basic premise for the medical profession was that no harm should come to the people who seek advice or help from doctors. "It is important, therefore, that the blood available for transfusion should be absolutely untainted," remarked Dr Farrukh Hassan.

Dr Shershah Syed informed the journalists that in small towns like Kandiaro, up to 20 blood banks operated not all of which met the minimum quality control standards permissible. "Similarly, dozens of laboratories in Malir and Saudabad are dispensing blood of dubious quality."

Answering a question, the four doctors said less than 50 per cent of the blood available for transfusion in the country came from blood banks which did not follow good laboratory practices. However, situation in Karachi was better where up to 80 per cent of the blood transfused was processed or stored by good quality blood banks.

The four were of the view that the Blood Transfusion Authority in Punjab was better placed to control the menace of unsafe blood than the ones in the other provinces. "But if the Sindh Blood Transfusion Authority is also run by competent and meritorious officers and workers, situation could improve tremendously."

Dr Qaiser Sajjad said there was a need to educate doctors, even specialists, about the various issues in blood transfusion. "Blood transfusion as a separate subject, or even as a major topic, is not taught at the MBBS level."

Dr Tahir Shamsi stated that a good quality blood bank could be established with a minimum investment of Rs4 million, indicating that any facility built at a lower cost was not equipped to handle blood in a satisfactory manner.