BLOOD TRANSFUSIONS

BLOOD
• Blood is considered as river of life, fluid of life, fluid of
growth, fluid of health.
• Average human has 5 liters of blood i.e. 8% of total body
weight.
• It is a transporting fluid.
• It carries vital substances to all parts of body.

blood and blood transfusions

 Overview
• It is a procedure in which a patient receives a blood
product through an intravenous line.
• It is the introduction of blood components into the
venous circulation.
• Process of transferring blood-based products from one
person into the circulatory system of another.
History of blood transfusions
Cont.,.,
• Before The Nobel Prize awarded, Karl Landsteiner
discovered the ABO human blood groups in 1901, it was
thought that all blood was the same.
• This misunderstanding led to fatal blood transfusions
and many death.
Cont.,.,
• Prof. Karl Landsteiner discovered that blood
clumping was an immunological reaction
• Karl Landsteiner's work made it possible to
determine blood types
• For this discovery he was awarded the Nobel
Prize in Physiology or Medicine in 1930.

blood and blood transfusions

 FACTS….
• 450ml of blood can save as many as three lives.
• Every two seconds, someone in India needs blood.
• One out of every three of us will need blood in our
life time.
• Even with all of today’s modern technology, there is
no substitute for blood.
Someone has to give blood
in order for someone to receive
blood.
Cont.,.,
•A person can donate blood every 90 days (3
months).
• Body recovers the Blood very quickly:
• Blood plasma volume– within 24 - 48 hours
• Red Blood Cells – in about 3 weeks
• Platelets & White Blood Cells – within minutes
 Purposes
•To replace losses of: Circulating volume Oxygen carrying
capacity .
•To restore: Metabolic homeostasis.
•To replenish: Normal RBC’s (e.g.. Refractory anemia's,
Thalassemias, Sickle cell anemia's etc)
•In cancer patients like ALL; AML; with / or after
Chemotherapy drugs.
• For emergency surgery, heart surgery.
 Different blood groups
•There are more than 20 genetically determined
blood group systems known today.

• The AB0 and Rhesus (Rh) systems are the most

important ones used for blood transfusions.

• Not all blood groups are compatible with each

other. Mixing incompatible blood groups leads to
blood clumping or agglutination, which is dangerous
for individuals.
ABO blood grouping system

• Blood group A If you belong to

the blood group A, you have A
antigens on the surface of your
RBCs and B antibodies in your
blood plasma.

• Blood group B If you belong to

the blood group B, you have B
antigens on the surface of your
RBCs and A antibodies in your
blood plasma.

blood and blood transfusions 12

 Blood group O
If you belong to the blood group
O (null), you have neither A or B
antigens on the surface of your
RBCs but you have both A and B
antibodies in your blood plasma.

blood and blood transfusions 13

Possible Blood group Genotypes

Parent A B O
Allele
A AA AB AO

B AB BB BO

O AO BO OO

blood and blood transfusions 14

The ABO blood groups

• The most important thing is in assuring a safe blood

transfusion.

• The table shows the four ABO phenotypes ("blood groups")

present in the human population and the genotypes that give rise
to them.
Blood Antigens
Antibodies in Serum Genotypes
Group on RBCs

A A Anti-B AA or AO
B B Anti-A BB or BO
AB A and B Neither AB
O Neither Anti-A and anti-B OO
blood and blood transfusions 15
Blood Antigens Antibodies Can give Can
Group blood to receive
blood from

AB A and B None AB AB, A, B, O

A A B A and AB A and O

B B A B and AB B and O

O None A and B AB, A, B, O O

blood and blood transfusions 16

 Rh Antigen
•Rh antigens are transmembrane proteins with many loops exposed
at the surface of red blood cells.

• They appear to be used for the transport of carbon dioxide and/or

ammonia across the plasma membrane.

• They are named for the rhesus monkey in which they were first
discovered.

• RBCs that are "Rh positive“ Must express the antigen designated as
D.

• A person with Rh- blood does not have Rh antibodies

naturally in the blood plasma
Cont.,.,
 According to above blood grouping
systems, you can belong to either of
following 8 blood groups:

blood and blood transfusions 18

• A person with Rh- blood can develop Rh antibodies
in the blood plasma if he or she receives blood from
a person with Rh+ blood, whose Rh antigens can
trigger the production of Rh antibodies.

• A person with Rh+ blood can receive blood from a

person with Rh- blood without any problems.

blood and blood transfusions 19

Laboratory Determination of the ABO
System
Cont.,.,
Cont.,.,

blood and blood transfusions 22

Cont.,.,
Cont.,.,
• Rh+ can receive blood from: Rh+ and Rh-
• Rh- can receive blood from: Rh- only.
Blood Transfusion Administration

25
 Sampling Procedure
Step 1:
 Ask the patient to tell you their:
Full Name + Date of Birth.
• Check this information against
the patient’s ID wristband.
• Be extra vigilant when checking
the identity of the unconscious /
compromised patient,
 Labelling the venous blood sample

• Information to include:-
• Full name
• Date of birth
• Hospital number
• Gender
• Date
• Signature of person who has taken the
sample
• At the bedside
• By the person taking the sample
Cont.,.,
Step 2:
 Check the patient’s ID wristband against
documentation
e.g., case notes or request form for:
• First name
• Surname
• Date of birth
• Hospital number

blood and blood transfusions 28

PRE-TRANSFUSION RESPONSIBILITIES

• Assess laboratory values.

• Verify the medical prescription.
Cont.,.,
• Assess the client’s vital signs, urine output, skin color
and history of transfusion reactions.

blood and blood transfusions 30

Cont.,.,
• Obtain venous access. Use a central catheter or at least
a 20-gauge needle, if possible.
Cont.,.,
 Only bleed one patient at a time using
Aseptic non touch technique.
 Do NOT use pre-labeled tubes.
 Label the sample tube beside the
patient.
 Send the sample to the laboratory in the
most appropriate way for the clinical
situation, i.e. routine / emergency.
 Remember emergency requests must
always be phoned through to the
Transfusion Laboratory.
blood and blood transfusions 33
IV Blood/ Blood Component
Chart

blood and blood transfusions 34

 Pre-administration checks

• Personal checks:
 Wear personal protective equipment.

• Equipment checks:
 Personal protective equipment is available and is clean
and sterile.
 A correctly completed prescription chart.
 Observation chart.
 Giving set.
 Disposable bags.
 Trolley.

blood and blood transfusions 35

Pre-administration Procedure

• Step 1: Check the blood component has

been prescribed.
• Step 2: Undertake baseline observations.
• Step 3: Undertake visual inspection.

LEAKS
DISCOLOURATION
CLUMPING

EXPIRY DATE
Cont.,.,

• Step 3: Check the

compatibility/traceability label
with the blood bag label.

Any discrepancies
DO NOT
TRANSFUSE !
Blood Component Bedside Check Procedure

SURNAME

FIRST NAME(s)

HOSPITAL NUMBER

D.O.B.BLOOD GROUP
(Patient and Unit)

DONOR NUMBER

EXPIRY DATE

Special Requirements

blood and blood transfusions 38

Cont.,.,

• Remain with the patient during the first 15-30 minutes of

the infusion.
• Infuse the blood product at the prescribed rate.
• Monitor vital signs.
Warming Blood

• STORED BLOOD IS COLD 4*C

• PATIENTS UNDERGOING SURGERY WILL
ALREADY BE LOSING BODY HEAT DUE TO
WOUND OR CAVITY EXPOSURE
• LARGE VOLUMES OF COLD BLOOD MAY
INDUCE HYPOTHERMIA OR CARDIAC
ARYTHMIA
Cont.,.,
• AT INFUSION RATES>100ML/MINUTE, COLD BLOOD MAY BE A
CONTRIBUTING FACTOR IN CARDIAC ARREST. HOWEVER,
KEEPING THE PATIENT WARM IS PROBABLY MORE
IMPORTANT THAN WARMING THE INFUSEDBLOOD !
• WARMED BLOOD IS MOST COMMONLY REQUIRED IN
LARGEVOLUME RAPID TRANSFUSIONS & EXCHANGE
TRANSFUSION IN INFANTS.
• BLOOD SHOULD ONLY BE WARMED IN A BLOOD WARMER
THAT HAVE A VISIBLE THERMOMETER AND AN AUDIBLE
WARNING ALARM AND SHOULD BE PROPERLY MAINTAINED.

blood and blood transfusions 41

 Monitoring of Patient
 Base line observations – Temperature, pulse and blood
pressure.
 Further observations (as above) at 15 minutes.
 A set of observations at the end of transfusion.
 More frequently if the patient is unwell, unobservable,
unconscious or a child.
• Ensure the venflon is secure, patent and there are no
signs of inflammation
• Give the patient the call bell .
• Patients should remain in a clinical area for the duration
of the transfusion.
• Review the patients fluid balance and medication.
 Good Documentation
Minimum Transfusion Dataset: the following should be
documented in the notes
• Reason for transfusion.
• Current blood results.
• Component type and amount to be prescribed.
• Anticipated outcome.
• Any reported transfusion adverse events/reactions.
• Review following the transfusion including how
much blood has been transfused.

blood and blood transfusions 43

 Reporting Incidents/Transfusion Reactions
• Stop the Transfusion and seek Medical Input and inform the
Transfusion Laboratory staff.

• Replace the unit and giving set with Normal Saline 0.9%.

• Send the discontinued unit with giving set attached back to

transfusion capped off at the end with a white venflon cap – and any
previous transfused bags sealed with the blue plugs all in biohazard
bags.

• Documentation (complete the checklist).

• Complete a Trust Incident form.

blood and blood transfusions 45
TYPES OF TRANSFUSION
• Based on time of transfusion:
• Fresh whole blood transfusion.
• Stored CPD Blood.

• Based on composition :
• Whole blood.
• Blood fraction.

• Based on the donor:

• Autologous blood transfusion.
• Blood from diff donor.
Whole Blood
• Storage
• 4° for up to 35 days
• Indications
• Massive Blood Loss/Trauma/Exchange Transfusion
• Considerations
• Use filter as platelets and coagulation factors will not
be active after 3-5 days
• Donor and recipient must be ABO identical
RBC Concentrate
• Storage
• 4° for up to 42 days, can be frozen
• Indications
• Many indications—ie anemia, hypoxia, etc.
• Considerations
• Recipient must not have antibodies to donor RBC’s
(note: patients can develop antibodies over time)
• Usual dose 10 cc/kg (will increase Hgb by 2.5 gm/dl)
• Usually transfuse over 2-4 hours (slower for chronic
anemia
Platelets
• Storage
• Up to 5 days at 20-24°
• Indications
• Thrombocytopenia, Plt <15,000
• Bleeding and Plt <50,000
• Invasive procedure and Plt <50,000
• Considerations
• Contain Leukocytes and cytokines
• 1 unit/10 kg of body weight increases Plt count by 50,000
• Donor and Recipient must be ABO identical
Plasma and FFP
• Contents—Coagulation Factors (1 unit/ml)
• Storage
• Comes in 200ml bags.
• FFP--12 months at –18 degrees or colder
• Indications:
• Coagulation Factor deficiency, fibrinogen
replacement, DIC, liver disease, exchange
transfusion, massive transfusion
• Considerations:
• Plasma should be recipient RBC ABO
compatible
• In children, should also be Rh compatible
• Account for time to thaw
• Usual dose is 20 cc/kg to raise coagulation
factors approx 20%
Cryoprecipitate

• Description
• Precipitate formed/collected when FFP is
thawed at 4°
• Storage
• After collection, refrozen and stored up to 1
year at -18°
• Indication
• Fibrinogen deficiency or dysfibrinogenemia
• vonWillebrands Disease
• Factor VIII or XIII deficiency
• DIC (not used alone)
• Considerations
• ABO compatible preferred (but not limiting)
• Usual dose is 1 unit/5-10 kg of recipient body
weight
Granulocyte Transfusions
• Prepared at the time for immediate transfusion
(no storage available)
• Indications – severe neutropenia assoc with
infection that has failed antibiotic therapy, and
recovery of BM is expected
• Donor is given G-CSF and steroids or
Hetastarch
• Complications
• Severe allergic reactions
• Can irradiate granulocytes for GVHD prevention
 Leukocyte Reduction Filters
• Used for prevention of transfusion reactions.
• Filter used with RBC’s, Platelets, FFP,
Cryoprecipitate.
• Other plasma proteins (albumin, colloid
expanders, factors, etc.) do not need filters—
NEVER use filters with stem cell/bone marrow
infusions.
• May reduce RBC’s by 5-10%.
• Does not prevent Graft Verses Host Disease
(GVHD).
RBC Transfusions Preparations
• Type:
• Typing of RBC’s for ABO and Rh are
determined for both donor and recipient
• Screen:
• Screen RBC’s for atypical antibodies
• Approx 1-2% of patients have
antibodies
• Crossmatch:
• Donor cells and recipient serum are
mixed and evaluated for agglutination
 RBC Transfusion Administration
• Dose
• Supplied in 250ml bags.
• Usual dose of 10 cc/kg infused over 2-4 hours
• Maximum dose 15-20 cc/kg can be given to hemodynamically
stable patient
• Procedure
• May need Premedication (Tylenol and/or Benadryl)
• Filter use—routinely leukodepleted
• Monitoring—VS q 15 minutes, clinical status
• Do NOT mix with medications
• Complications
• Rapid infusion may result in Pulmonary edema
• Transfusion Reaction
Platelet Transfusions Preparations
• ABO antigens are present on
platelets
• ABO compatible platelets are ideal
• This is not limiting if Platelets indicated
and type specific not available
• Rh antigens are not present on
platelets
• Note: a few RBC’s in Platelet unit may
sensitize the Rh- patient
 Platelet Transfusions Administration
• Dose
• May be given as single units or as apheresis units
• Usual dose is approx 4 units/m2—in children using 1-2
apheresis units is ideal
• 1 apheresis unit contains 6-8 Plt units (packs) from a
single donor
• Procedure
• Should be administered over 20-40 minutes
• Filter use
• Premedicate if hx of Transfusion Reaction
• Complications—Transfusion Reaction
 Autologous Blood Transfusions
• Collection/infusion of client’s own blood
Four types:
• Preoperative autologous blood donation
• Acute normovolemic hemodilution
• Intra-operative autologous transfusion
• Postoperative blood salvage

blood and blood transfusions 59

 Preoperative autologous blood donation
• Collecting whole blood from the client, dividing it into
components and storing it for later use
• Can be collected weekly as long as client’s H&H are
within safe range
• Can be stored up to 40 days; up to 10 years for rare
blood types.
 Intra-operative autologous transfusion & Post
operative blood salvage
• Recovery/reinfusion of client’s own blood from operative field
or bleeding wound.
• Special devices collect, filter, drain blood into transfusion bag
• Used for trauma or surgical patients with severe blood loss
• Blood must be reinfused within 6 hours.
TRANSFUSION REACTIONS
Observing / Monitoring the Patient During a Blood / Blood
Component Transfusion is part of safe transfusion

Tachycardia Hyper /
Hypotension Headache
Pyrexia

Rigors
Urticaria -
Itchy rash
Haemoglobinuria Collapse

Chest, abdominal,
Nausea / muscle, bone or loin
vomiting pain

Generally feeling
unwell
Breathlessness / Flushing
Restlessness
coughing
Agitation
Confusion
 Transfusion-associated graft-versus-host
disease (TA-GVHD)
• Donor T-cells attack host tissues.
• Symptoms occur within 1-2 weeks.
• Thrombocytopenia.
• Anorexia.
• Nausea.
• Vomiting.
• Chronic hepatitis.
• Weight loss.
• Recurrent infection.
 DISSEMINATED
INTRAVASCULARCOAGULATION(DIC)
• DIC is the abnormal activation of the coagulation and
fibrinolytic systems,resulting in the consumption of
coagulation factors and platelets.
• DIC may develop during the course of massive blood
transfusion, although its cause is less likely to be due to
the transfusion itself than related to the underlying
reasons for transfusion, such as:
• Hypovolemic shock.
• Trauma.
• Obstetric complications.
 Management of DIC
• Treatment of DIC should be directed at correcting the
underlying cause and at correction of the coagulation
problems as they arise.
 BLOOD BANKS
• Blood banks collect, test, and store blood.
• Autologous transfusion - If surgery is scheduled months
in advance, patients may be able to donate their own
blood and have it stored.
BLOOD STORAGE:
• Blood products must be stored at 4C +- 2C.
• Stored blood has a shelf life of 3 weeks.
• After a storage time of 24-72 hr RBCs have reduced
capability to release oxygen to tissues.
• If the patient needs massive transfusions its better to
give blood that’s less than 7 days old.
Bio-Safety & Waste Management In
Relation to Blood Transfusion

blood and blood transfusions 74

 Classification of waste in the Blood Transfusion
Service

• Different types of waste are generated in a BTS. The

amount of waste generated depends on the scale of
activities the BTS carries out. Waste is classified based
on the level of hazard it presents; It can be: hazardous
and non‐hazardous.
Hazardous waste:
• Hazardous waste is any waste that poses a substantial
or potential threat to human health or the environment.
• The threat may be due to the quantity or concentration of
the waste, or to its physical, chemical, radioactive,
genotoxic or infectious characteristics. About 15‐25% of
HCW generated in a HCF is likely to be hazardous.
Non‐hazardous waste:

• Non‐hazardous waste is generally material that is not

contaminated with blood or other body fluids, or
chemicals. About 75‐85% of waste generated in a HCF
is non‐hazardous and includes items such as packaging,
boxes and wrappings.
• This type of waste should be managed separately from
hazardous waste.
Infectious waste:

• Infectious hazardous waste is any used, contaminated,

soiled or discarded material, device or equipment that
has the potential to transmit infectious agents. This
includes sharps, non‐sharps and effluents. Any material
contaminated with blood should be considered
potentially infectious and should be handled according to
standard precautions.
• Infectious sharps: Items that can cause direct injury,
such as cuts or puncture wounds, are considered as
sharps. They include needles, lancet blades and broken
glassware and ceramics (e.g. glass slides,
• pipettes, test tubes and tiles).
blood and blood transfusions 78
Cont.,.,
• Used sharps are considered to be highly hazardous
waste and, if contaminated with blood, they carry a high
risk of transmission of blood‐borne pathogens, due to
their ability to penetrate soft parts and enter vascular
tissues.
• Infectious non‐sharps: Non‐sharp infectious waste
includes all items such as plastics (used blood units),
non‐plastic materials and glassware contaminated with
blood or other body fluids.
Cont.,.,
• Infectious effluents: Effluents are liquid waste generated
during BTS activities such as testing of samples and
processing of blood units. These are also considered
hazardous due to their infectious potential.
Non‐infectious waste:

• Non‐infectious hazardous waste is any discarded

material that poses a hazard but does not have the
potential to transmit infectious agents, e.g. chemical
waste.
• Chemical waste: This includes any discarded solid, liquid
and gaseous chemicals used during disinfecting
procedures or cleaning processes that may pose health
and environmental hazards (e.g. carcinogens, irritants,
toxic, inflammable and corrosive chemicals).
• Chemical waste should be disposed of in accordance
with manufacturer’s instructions.
General roles of staff who handle wastes
• Attend staff training and refresher courses.
• Follow all SOPs on waste management.
• Segregate HCW at source.
• Properly dispose of HCW in appropriate containers.
• Label and attach HCW tags to each waste container.
• Ensure containers are no more than ¾ full when another
one is selected.
• Properly seal each container.
• Secure intermediate storage at workplace before
transportation to centralized storage.
• Report all accidents and incidents promptly.
 Role of a nurse
• Assess the risks posed by HCW and provide a safe
working environment for staff.
• Ensure that staff members are aware of the need to
manage HCW appropriately, and are properly trained
and supervised.
• Provide staff with adequate equipment and appropriate
protective personal equipment (PPE), based on the
anticipated risk involved in the handling process.
• Develop guidelines and standard operating procedures
for managing HCW that meet the requirements for
infection control and occupational health and safety
(OH&S).
blood and blood transfusions 83
Cont.,.,
• All waste that is generated within the BTS should always follow an
appropriate and well‐defined process from its point of generation
until its final disposal; this is referred to as the “cradle‐to‐grave”
concept.
• The process of dealing with HCW consists of the following steps:
 Waste minimization
 Waste segregation
 Waste collection
 Waste storage
 Waste transportation
 Waste treatment
 Waste disposal.
Waste minimization:

 Minimize waste through the “3R” principle.

 Reduction.
 Re‐use.
 Recycling.
Waste segregation:

• Collect and segregate waste at the site of generation.

• Use three different kinds of clearly identifiable
color‐coded waste containers to separately collect
sharps, infectious and non‐hazardous waste. Strong
leak‐proof and puncture‐proof buckets/ containers with
lids/ covers should be used for segregated collection of
waste.
• Red for infectious waste ‐ non‐sharps; segregate
infectious solid and liquid waste
• Yellow for infectious waste –sharps (needles,
blades/ lancets)
•
blood and blood transfusions 86
Cont.,.,
• Blue for non‐hazardous waste (general waste such
as packaging)
• The size of the bucket/ container should be according to
the workload of the blood centre.
• Clearly mark the buckets containing infectious waste
with the international “biohazard” symbol.
Waste collection:

• Do NOT fill the waste containers more than three

quarters of their maximum volume before sealing them
securely, to avoid over‐filling.
• Replace the containers for waste immediately with new
ones of the same type.
• The containers for collection should be strategically
located at all points of generation.
• Wear appropriate PPE such as heavy duty pierce‐proof
gloves, goggles, aprons and protective shoes or boots
when collecting HCW.
• Waste should be collected regularly (on a daily basis) by
trained and designated staff.
Waste storage:

• Do NOT store waste for more than 24 hours in a hot or

humid climate.
• Do NOT store waste for more than 48 hours under any
conditions.
• Always store non‐hazardous HCW in a separate location
from hazardous HCW, to avoid cross‐contamination.
• Waste storage facilities should have a hard floor that is
easy to clean and disinfect, inaccessible to animals and
insects and kept locked to prevent access by
unauthorized persons.
• A schedule for regular cleaning of the storage area and
transportation carts should be in place and followed.
Waste transportation:

• If the waste treatment facility is within the blood centre,

transport the waste in closed containers and if possible
using carts or wheeled trolleys that are stable and easy
to load/unload, and easy to clean and disinfect.
• The carts used should not be used for any other
purpose.
Cont.,.,
• For off‐site transportation, ensure that the waste is safely
packed in puncture‐proof containers that are adequately
labeled.
• Ensure that a consignment note accompanies the waste
from its place of production to its site of disposal, and
that the note is duly filled out by the waste handler on
completion of the journey.
• Do NOT use vehicles designated for transportation of
waste, for transportation of other materials.
• The designated vehicle should be signposted as carrying
hazardous waste.
Waste treatment:

• In choosing a waste treatment method, evaluate the

relative risks, benefits as well as the ease of adopting
the method into the overall waste management strategy.
• Autoclaving at a temperature of 121°C for a minimum of
20 minutes is the preferred method for infectious waste
treatment. An autoclave, of a capacity that is appropriate
to the needs of the BTS, should be used.
• Place the waste to be treated into an autoclavable
polyethylene bag and open the mouth of the polythene
bag before placing it in the autoclave chamber to
facilitate mixing of hot steam with waste.
• Non‐hazardous waste does not require treatment.
Waste disposal:

• Appropriately treated waste can be sent to a secured or

municipal landfill for disposal.
• The output from the autoclave is non‐hazardous material
and can be disposed of with municipal waste.
• Non‐infectious liquid waste can be discharged directly
into the sewers.
• Non‐hazardous waste can be disposed of together with
domestic waste or municipal waste.
• Inflammable waste disposal (to avoid explosion or fire):
Hazardous chemical/ inflammable waste should be
disposed of according to manufacturer’s instructions.
Cont.,.,
• Radioactive waste disposal: Blood bank irradiators used
in the BTS for irradiation of cellular blood components
are self‐contained pieces of equipment. The use and
de‐commissioning of blood bank irradiators should be
undertaken according to manufacturers' instructions.
• Blood products that have been irradiated are not
radioactive; thus, they pose no threat to staff safety,
public health or the environment.
• Discarded or used irradiated blood products should
therefore be managed as infectious waste.
 ROLE OF NURSE IN ORGAN
DONATION RETRIVAL AND BANKING
Facts….

• Every day, 18 people in the United States die waiting for

organ transplants.

• Every 11 minutes another person's name is added to the

list of thousands who await lifesaving organ transplants.

• Currently, there are over 101,000 total patients waiting

for a transplant in the United States.
 ORBO

• Organ Retrieval Banking Organization, a nodal

centre for the country, has been set up at All India
Institute of Medical Sciences (AIIMS), New Delhi, with
a purpose of encouraging organ donations, fair and
equitable distribution and optimum utilization of
human organs.
Cont.,.,
This organization is maintaining the waiting list of
terminally ill patients requiring transplants, donor
registration, matching of recipients with donor, co-
ordination from procurement of organs to
transplantation, dissemination of information to all
concerned hospitals, organizations and individuals,
creating awareness, promotion of organ donation
and transplantation activities.
 ORGAN DONATION
 There are two ways of Organ donation:
 Living related donors:- only immediate blood
relations (brother, sister, parents & children) can
donate as per the Transplantation of Human Organ
Act 1994. Living donor can donate only few organs,
one kidney (as one kidney is capable of maintaining
the body functions), a portion of pancreas (as half of
the pancreas is adequate for sustaining pancreatic
functions) and part of the liver (as the few segments
that are donated will regenerate after a period of
time) can be donated.
 Cadaver Organ donor:- can donate all organs after
brain death.
DONOR PROFILE:

• Anyone, regardless of age, race or gender can become

an organ and tissue donor. If he/she is under the age of
18 years, then the consent of parent or legal guardian is
essential. Medical suitability for donation is determined
at the time of death.
CONSENT FOR ORGAN DONATION FOR
BRAIN DEAD PERSON:

• Donors who have during their lifetime consented for

organ donation in writing in the presence of two
witnesses (at least one of whom is a near relative,)
should carry their donor cards with them and also
express their wishes to their near and dear ones.

• In case of no such consent or donor pledge form was

filled before death, then the authority to give consent for
organ donation lies with the person lawfully in
possession of the dead body.
 TERMINAL DISEAES THAT CAN BE
CURED BY TRANSPLANT

 Heart: Heart failure.

 Lungs: Terminal lung illnesses.
 Kidneys: Kidney failure.
 Liver: Liver failure
 Pancreas: Diabetes.
 Eyes: Blindness.
 Heart valve: Valvulardisease.
 Skin: Severe burns.
 PRIORITIZATION FOR RECEIVING
TRANSPLANT

• Organs are matched to recipients on the basis of

medical suitability, urgency of transplant, duration on the
waiting list and geographical location.
ORGAN TRANSPLANT PROGRAMME
Cont.,.,
 Emphasis on Cadaver Donation.
 Aims: 1.To enhance the facilities for Organ
transplantation throughout the country; 2. To establish a
network for equitable distribution of retrieved deceased
organs and 3. To increase the availability of organs
through facilitation and attitude change.
 Involves building up human resources.
 Creation of a body for procurement, distribution of
organs at national, regional and zonal level covering the
entire country.
 Awareness:

• In order to create public awareness and educate

common-man about organ transplant and organ
donation, intensive use of print and electronic media
should be undertaken under the supervision of
ORBO. Additionally the altruistic virtues of organ
donation must also be highlighted in the promotion
campaigns with provision for registration with ORBO
for altruistic cadaver donations.