Pre-surgery concern about blood - interesting

I'm getting ready for yet another hip replacement on Jan. 9. The interesting thing is that I asked the blood donor bank (United Blood Services) today, an important question regarding getting blood during surgery from donors who may be infected with a number of potential maladies.

The answer from the tech was that although remote, the chance is STILL there for the HVC and HIV viruses to be in the supply! Therefore, as a precaution, I will be a "autologous" donor. That means I will give my own blood to myself starting this Friday and for the next four weeks at one pint per week. I suggest anyone having surgery do the same.

Since I never did drugs (okay okay, some pot), the doctor who first diagnosed me with HVC in 1994 is convinced it was from a blood transfusion prior to 1992. That's when there were no difinitive tests for HVC in the blood supply.

Numerous friends of mine (and probably yours) have had surgeries without ever thinking of being their own blood donors. This is a piece of information I thought I would post after the shock I received that there "may" be tainted blood that goes into your body. Not to scare anyoner, but better think about it...better think about it...

Magnum

[koala68]

That's a good point. I don't think supply can ever be 100% safe. Much better off today than 10 years ago with all the scandals, but there will be always a risk.
For instance, there is a window of time between infection and screening where tests are usually not sensitive enough to detect viruses. Not sure for HCV but for HIV it is several weeks if not months! I guess, if a person were to donate blood in that time frame, he might still be able to contaminate but the blood bank won't necessarily discover it then.
Other than that, human errors are still possible (swapping samples, etc) and some unknown diseases for which a test doesn't exist yet might be present with some donors. (HepC&HIV only have tests for a few years).
Does it mean we should not get any transfusion in a life threatening situation or major surgery? Certainly not. Blood banks are much more safer today. But doing your own transfusion when you know you are going to need it later is certainly a good idea.
It make me think that Interferon+Ribavirin can sometime lead to severe anemia which can be relieved by ordering a blood transfusion in the most severe cases.
Has anyone arranged to be his own blood donor for this purpose? Although the vast majority of people on treatment won't ever need this, I am wondering how much it would cost to do this.

[Kalio1]

That is very true Magnum, you make a very good point.

I have read the chance of contracing HIV through the blood supply today is 1 in 100,000. It is a very fragile virus compared to HCV. HCV is very durable. I do not know what the risk factor of contracting HCV through the blood supply actually is today nor can you locate stats for it, but I'd imagine it would be higher than HIV due to it's durability.
Th medical community is in denial about these risks and our riak of contracting HCV in clinical settings during relatively benign procedures. I wish something could be done to address and correct the issue.

Good luck with the hip surgery Magnum, you sure have been through the ringer!

[sallyo]

One of my responsibilties where I work (at a major hospital) is operation of a machine called a cell saver.  It is usually not used unless there is potential for serious bleeding during a procedure.  It is used usually for surgeries involving a lot of vascular like  aneurysms, heart re vascularizations, some orthopedic (hips mostly) and radical prostatectomies.
    This procedure alows blood loss while in the O.R. to be collected, processed and returned to the patient. Since it is their own, it does not need to be tested, typed or crossed.  In some cases of course, additional bank blood needs to be used.
     Autologous blood (self blood) can be given ahead of time if there is no emergency and is a good thing.  I do know that it is more expensive to do so and I'm not sure of insurance payment. Another thing which is a little more expensive that can be done if you have the time is called directed blood.  This is blood collected ahead of time by some one other than yourself provided there is a match.  For instance if you don't have time to collected your own (since it expires at some point, or your count is too low) a friend or spouse can donate it and then you will at least know where it came from
  That being said, you can ask about it but I feel our blood banks screen pretty well.  The windows for contamination do exist but I think the tests now are pretty sensitive,  I myself have received quite a bit of "bank blood" due to riba induced anemia and have just closed my eyes and let it happen.  Some things you just have to do.  Refuseing blood altogether can be dangerous.  You might just express to your doc that you choose not to recive it unless absolutely necessary and maybe he will be more conservative with his decision.  Be well

[NYgirl]

My PCP said the exact same thing when I was crazy to figure out where I'd gotten this (you know in the BEGINNING).

It freaked me out pretty good. If you know in advance maybe you can bank blood.

The chances are so so so slight - but I know my personal luck.

[Pdilly]

Good point....we are all in the same boat regardless of how we got in it and it really does not matter.

[sallyo]

I really don't know how the blood bank tests.  Maybe they already do those tests.  If it is an additional test there may be a time factor between getting results and expiration.  Sorry I can't really answer that.  The blood I work with never leaves the room the patient is in.

[Forseegood]

i don't think anybody deserves "blame" for this disease...I was a kid when I experimented with shooting drusgs, the whole thing freaked me out, and I walked away from that....but there are those who are addicts (chemical and other reasons) and they got hooked, are they to "blame"?...at any rate, no one knew that this disease was in the background, now they do but then we didn't...people go through f'd up things, whatever...but no one is to "blame" for contracting a disease, whatever way they got it...

And once you have it, you have it, it's like being pregnant, we are all in the same boat...the only people I blame are those who are quasi-indifferent to our suffering, and are in a very good position to do us some good, like the govt for instance...better to put our tax revenues to help people who are victims of all types of diseases, then to fund nonscensical wars at billions per month...can you imagine if that money were re-directed to research for wiping out disease? Sorry if I got political there...

[jmjm530]

Stupid question maybe but since you work in the field...

Why couldn't one just order additional testing on the blood that will be used for a transfusion? For example, if the concern was Hep C, then you could have the blood re-tested both for antibodies as well as a sensitive TMA. I would imagine this would be a good double-check in case some bad blood fell through the cracks.

-- Jim

[crsrph]

another stupid question on this cell saver machine i take it that all componets that come in contact with blood are disposable ?

[sallyo]

The cell saver machine itself of course is not disposable, but all of the software is disposable, a closed circuit and latex free.  The only real source of contamination, if set up properly is if the surgeon were to drop it off of the sterile feild.  That rarely happens but if it does, it is discarded and reset.
    The surgeon holds a double lumen suction tube that is fed by an anti-coagulent (keeps the blood from clotting) The blood is suctioned into a centrafuge (SP) where it is spun at a high rate.  The red cells are heavier than the other blood components so they sink to the bottom.  The plasma, anticoagulant and anything else like antibiotics are washed off with normal saline and then the red blood cells are sent (via closed circuit to a re-infusion bag.  The bag is handed off to anesthesia and returned to the patient through an existing line ( usually a central line)
   I know that is more information than you asked for but I got on a role. lol
  BTW the only thing that can not be washed in general are bacteria and virus.  Even prostate surgery in which some urine might be collected can be washed as long as there is no pre existing UTI as urine normally sterile.

[crsrph]

thanks for the info found it interesting