Tóm tắt
Background: The transfusion service in developing countries is bedeviled with the challenges of perennial shortage of allogeneic blood and the need for safe blood. The perceived risk of transfusion-transmitted disease led to the incorporation of autologous blood transfusion (ABT) as an integral component of elective surgical protocol in many institutions in the 1980s. The improvement of viral safety of allogeneic blood products following the introduction of molecular techniques has led to a decline in the use of autologous blood use. Therefore a literature search was performed to examine current evidences and motivate the utilization of autologous blood in developing countries to increase blood availability and safety
Materials and methods: A literature search on autologous blood donation and transfusion was carried out using PubMed, high wire press and google scholar. Article from 1991 to 2016 on the provision of autologous blood with its challenges, merits and demerits were reviewed.
Results: Provision of adequate units of blood is not a major issue in developed countries. With the advent of nucleic acid testing, the risk of HIV, HCV, HBV infections with receiving transfusion of allogeneic blood is considerably small. The cost incurred by the execution of autologous blood transfusion service in the developing countries is less than in the developed countries. The majority of the population in developing countries do not have access to adequate blood supply and the risks of transfusion transmitted viruses is much higher than in developed countries
Conclusion: The Hospital Transfusion Committee should encourage surgeons to offer autologous blood donation/transfusion to patients who are fit. Guideline should also be developed to establish criteria for perioperative blood donation and there should be a policy in place that allows crossover of autologous blood units to homologous blood units which will convert the autologous blood wastage reported from the studies in developed countries to gain for patients in poor resource countries.
Keyword: Autologous, allogeneic, blood, shortage, developing countries
Résumé
Contexte: Le service de transfusion dans les pays en voie de développement est confronté aux défis de la pénurie perpétuelle de sang allogénique et au besoin de sang sain et sauf. Le risque perçu de maladie transmissible par transfusion a conduit à l’incorporation de transfusion sanguine autologue (TSA) en tant que composante intégrale du protocole chirurgical électif dans de nombreuses institutions dans les années 80. L’amélioration de la sécurité virale des produits sanguins allogéniques suite à l’introduction de techniques moléculaires a entraîné une diminution dans
l’utilisation de sang autologue. Par conséquent, une recherche documentaire a été effectuée pour examiner les preuves actuelles et motiver l’utilisation du sang autologue dans les pays envoie de développement pour accroître la disponibilité et la sécurité du sang.
Matériaux et méthodes: Une recherche de la littérature sur le don et la transfusion de sang autologue a été effectuée à l’aide de Pub Med, de la presse à fil haut et du GoogleScolaire. Article de 1991 à 2016 sur la fourniture de sang autologue avec ses défis, mérites et démérites ont été examinés.
Résultats: La fourniture d’unités adéquates de sang n’est pas un problème majeur dans les pays développés. Avec l’avènement des tests d’acide nucléique, le risque d’infection par le VIH, VHC, VHB avec transfusion de sang allogénique est considérablement réduit. Le coût engagé par l’exécution du service de transfusion sanguine autologue dans les pays en voie dedéveloppement est inférieur à celui des pays développés. La majorité de la population dans les pays envoie de développement n’a pas accès à un approvisionnement sanguin adéquat et les risques de virus transmissibles par transfusion sont beaucoup plus élevés que dans les pays développés.
Conclusion: Le Comité de Transfusion Hospitalière devrait inciter les chirurgiens à offrir une donation ou transfusion autologue de sang aux patients qui sont en forme. Une ligne directrice devrait également être élaborée selon les critères établis pour le don de sang peropératoire et il devrait y avoir une politique qui permette le passage des unités de sang autologues aux unités de sang homologues qui convertiront le gaspillage de sang autologue rapporté par les études dans les pays développés pour gagner aux patients des pays à ressources appauvrie.
Mot-clé: Autologue, allogénique, sang, pénurie, pays envoie de développement
Correspondence: Dr. F.A. Fasola, Department of Haematology, College of Medicine, University of Ibadan, Ibadan, Nigeria,. Email: folukefasola@yahoo.com
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