Department of Transfusion Medicine

The Department of Transfusion Medicine at Gleneagles Hospital, Mumbai have one of the most advanced facilities in India. They contain Blood Transfusion wards for the donor to donate blood, and the blood banks to safely store the blood until needed. The department consists of highly skilled professionals who understand the special needs of the patients and provide excellent care. We are one of the largest Transfusion Medicine departments with many years of experience in this field, performing Blood Transfusions for patients every day.

The Transfusion Medicine department is well furnished with the latest technology machines to provide you with the best of service and care. Utmost care is taken while performing the Blood Transfusion procedure so that the blood-borne infections are prevented. With an established and well-equipped lab, with the latest technological equipment for the diagnosis and treatment of patients, we aim to provide the best care in India.
Division units add another level of service for the patients are:

• Thrombin and factor VIII blood collection
• Blood Transfusion Procedure
• Blood Component Separation
• Collection of fibrinogen concentrate
• Plasminogen collection

Diagnosis And Treatment Of Diseases

Transfusion of blood is also termed – Transfusion Medicine and is employed to increase the level of blood, blood cells or blood components in an individual. Gleneagles Hospital, Mumbai houses an accredited blood bank that aids the collection, storage and transfer of blood components. Blood loss can occur either during surgical procedures or due to accidents, and in some cases due to certain diseases. The department of transfusion medicine provides the required blood or blood components for patients in need. The Department of Transfusion Medicine caters to the following conditions and diseases.

• Anemia
  You get tired during your routine activities and feel drained of energy by end of the day. You have undergone some medical tests that said you were anemic. Several supplements since then have not been able to provide relief or improve the blood picture. Your anemia needs further characterization and unless studied in detail, may not be possible to treat well. All anemias are not alike though may cause similar symptoms.
  What is normocytic anemia?
  Normocytic anemia is an abnormality of blood wherein the numbers of red cells is reduced and their shape and structure is normal. There is thus a fall in the red cell mass to levels below those expected for normal people of the same age and gender. This is unlike the small red cells seen in anemia due to iron deficiency and large red blood cells seen in anemia due to deficiency of vitamin B12. Normocytic anemia may be an initial manifestation of any type of anemia.
  Normocytic anemia is a common type of anemia seen in elderly.
  What causes normocytic anemia?
  Normocytic anemia may be present since birth, i.e. it can be congenital. When acquired later in life, it may be caused by a disease or an infection. It is usually seen in course of long term diseases like cancers, kidney diseases, rheumatoid arthritis, a disease in which there is inflammation of small joints in the body, etc. Normocytic anemia is caused when there is an inadequate production of red cells, excess of fluid in blood leading to dilution, or an increased destruction of red cells. Inadequate destruction can be due to some bone marrow disorders. Increased dilution of blood can be seen in pregnancy or when excess of fluids are infused when trying to treat other conditions.
  Normocytic anemia may also develop as an adverse effect to consumption of some medicines.
  How is normocytic anemia treated?
  Normocytic anemia is best treated by correcting the underlying cause. It resolves as other medical conditions are treated. If normocytic anemia is being caused by some other drugs that you are taking, you will need to stop taking the drug and use other alternative drugs as advised by your doctor. If caused by deficiency of iron, you will need iron supplements in form of pills or syrups. You may be advised to also take a vitamin supplement. When normocytic anemia is severe and causing distressing symptoms, you may need some injections of erythropoietin.This is a hormone produced by the body that stimulates the bone marrow to produce more and more red cells. It is available as a recombinant form for injections. It is safe to use this injection though it may cause pain at injection site and increase in blood pressure in some patients.
  Anemia is treatable provided it is understood what is the type and cause for anemia. Reconfirm yours if you have one and see it disappear after a proper treatment.
  What are the signs of normocytic anemia?
  Normocytic anemia is a silent entity. It has a slow onset and may only cause fatigue or tiredness that may be low grade and difficult to explain. One may turn pale and loose lusture of skin. The nails loose the pink color and turn white. The inner surfaces of lower eyelids also turn pale. If normocytic anemia develops more swiftly, it can cause dizziness, fainting, shortness of breath, etc. The symptoms are similar to those seen in other anemias and differentiation of normocytic anemias from other types of anemias is difficult on basis of symptoms alone.
  How does my doctor find out that I have normocytic anemia?
  Your doctor will obtain a detailed history from you for your complaints and examine your eyes, nails, skin, and other parts of your body. Normocytic anemia is best diagnosed by studying a detailed blood picture. Your doctor may like you to undergo a complete blood count (CBC). For this a sample of blood taken from one of your vessels will be subjected to examination for the numbers and types of cells. This is done by studying the samples under a machine after using special techniques to delineate different cells in the blood. In normocytic anemia, CBC shows a lower count of normal sized red cells.
  The red blood cell indices used to characterize normocytic anemia are the mean corpuscular volume (MCV), hemoglobin and hematocrit concentrations. Hemoglobin is an oxygen carrying protein in the red cells. Hematocrit signifies the percent of the total blood volume constituted by cells. MCV is a measure of the size of the red cells. A typical blood profile of normocytic anemia is characterized by a normal mean corpuscular volume (MCV) and decreased hemoglobin and hematocrit concentrations.
  You may then need to undergo detailed investigations to find out the underlying cause for normocytic anemia. Other family members may need to undergo investigations if they too have normocytic anemia.
• Aplastic Anemia
  What is Aplastic anemia? Is it life-threatening? Are there any cases of death recorded to date? Yes! Aplastic Anaemia can be moderate, as well as severe and life-threatening at times. Marie Curie, a famous pioneer in the field of radioactivity, was a victim of Aplastic Anaemia. She died of aplastic anaemia after working with unprotected radioactive materials for over a prolonged period.
  Your bone marrow is responsible for manufacturing enough blood cells to replenish the older blood cells. In Aplastic Anaemia, your body’s bone marrow becomes incapable of producing enough blood cells. So, there will be lower counts of all three blood cells–red blood cells, white blood cells and blood platelets.
  Symptoms

The common symptoms that are associated with Aplastic Anaemia include:

• Tiredness
• Bleeding in gums
• Severe headache
• Rashes on the skin
• Shortness of breath
• Frequent infections
• Dizziness or vertigo
• Bleeding from nose
• Rapid or slow pulse rate
   

Aplastic Anaemia may attack you suddenly or may progress slowly taking weeks or months. It can be acute or chronic. However, it can be life-threatening at times.
 

Risk factors

The common risk factors for Aplastic Anaemia include:

• Exposure to heavy ionizing radiations
• Exposure to toxic chemical substances
• Due to any Autoimmune Disorders or a viral infection
• Usage of drugs such as antibiotics, or Anti-rheumatoid
• Pregnancy, your Immune System attacks your Immune System when you are pregnant, this can be referred to as an autoimmune cause
   

Causes

The major cause of Aplastic Anaemia is unknown. However, it can be caused due to any underlying autoimmune disorder in which the white blood cells are affected.
 

Diagnosis

• To count the types of blood cells (red blood cells, white blood cells, platelets, and reticulocytes) circulating in the blood, your doctor would order for blood tests. Two or three of the cell counts is a strong evidence of aplastic anemia.
• To confirm the diagnosis, your doctor would order for more specific tests such as a Bone Marrow Biopsy. For this procedure, your doctor removes a sample of bone marrow from the large bone. The sample collected is then examined to rule out any other underlying causes. In the case of aplastic anemia, your bone marrow biopsy shows a fewer to normal blood cells and an increased amount of fat.
   

Treatment

If Aplastic Anaemia is mild without any bothersome symptoms, you may not require treatment.
But in the case of severe loss of blood cells, your symptoms would be prominent. At this instance, your doctor would order for blood and platelets transfusions. There may also be a situation where in spite of blood transfusions, you may still have very low blood cell count. This is considered to be a life-threatening condition.
 

Stem cell transplantation or bone marrow transplantation is recommended for the people under the age of 40 years. It works well when the donor has exactly matched brother or sister. This is called a matched sibling donor.
Immune suppressors are used to lowering your body’s immune mechanisms. This prevents your immune system from attacking your bone marrow, making bone marrow stem cells to grow, which is helpful in raising the blood counts.
Iron chelation, is a beneficial treatment if you have iron overload. Too much of iron in your body may affect red blood transfusion. So, iron chelation would be appropriate.
 

Life style modifications

You must take sufficient amount of rest, because anemia may cause fatigue and shortness of breath. So take rest whenever you need.
You must try to avoid contact sports because of risk of bleeding associated with low platelet count.
You must keep yourself away from infected people and maintain hygienic conditions to prevent the risk of infection.

• Sickle Cell Anemia
  Sickle Cell Disease or Sickle Cell Anemia is a genetic disorder of haemoglobin, a protein in red cells that binds oxygen and enables it to be transported to all tissues in our body. Normally, the red cells are disc-shaped and very flexible. They can mould the shape to pass through very narrow blood vessels. In Sickle Cell Anemia, the red cells become crescent-shaped or sickle-shaped and rigid, hence the name, sickle cell. They do not pass through small vessels hence causing a compromised flow to some tissues. These C-shaped cells live shorter than the normal cells.

Symptoms

• Sickle Cell Anemia symptoms may be caused depending upon which part of the body gets lesser blood supply. This can lead to pain in the affected part.
• Blood vessels can be blocked in the arms, legs, chest, or abdomen.
• You may develop painful swelling of your hands and feet.
• When the blood supply to the spleen, an organ in the abdomen that protects against infections, is damaged, there may be abdominal pain and also infections.
• Blocked vessels in the brain can cause paralysis of the part controlled by the affected segment of the brain or blackouts, dizziness and fainting episodes.
• There may be slurring of speech.
• Children may show unusual behaviour and delay developmental milestones.

Treatment

• Sickle cell disease treatment is aimed at relieving pain and preventing infections. You may need antibiotics to fight infections. Folic acid and vitamin supplements can help to replace the damaged red cells in the blood. When internal organs are affected, you will need to be hospitalized and depending upon the severity of the condition, you may need to be infused with fluids, given pain control drugs, blood transfusions, and even undergo intensive care.
• An Anti-tumour drug called hydroxyurea may be used to stimulate the formation of fetal haemoglobin, a type of haemoglobin that is present in babies developing in the mother’s womb. Fetal haemoglobin prevents the sickling of cells. This reduces the frequency of painful episodes and the need for Blood Transfusions.
• Sickle Cell Anemia cannot be cured. Bone Marrow Transplant has been successful in some cases.
• Gene Therapy may be used wherein the defective gene is corrected by complex cellular techniques.
   

Pain relief

• Pain relief is an important part of Sickle Cell treatment. You can use over-the-counter painkillers to relieve the pain. Some of these are aspirin, acetaminophen, ibuprofen, and naproxen.
• You should adopt some lifestyle remedies to combat pain.
• Eat a balanced diet and take folic acid and vitamin supplements.
• Drink plenty of water to avoid dehydration.
• Reduce stress, rest and avoid extreme temperatures.
• Avoid high latitude areas and fly in aircraft with pressurized cabins.
• Exercise regularly but avoid excess of it.
• Some medicines like pseudoephedrine available over counters in cold remedies can constrict blood vessels and precipitate an attack. You will need to be cautious of self-medication.
• Protect yourself from infections.
• Make sure you have had all your vaccinations.
• Some alternate techniques like hot baths, massages, physical therapy, psychological therapy, and meditation are also helpful.
• Seek support of family, friends, and support groups.
   

Sickle Cell Crisis

• Sickle Cell Crisis is a condition in which the rigid crescent-shaped red cells block the vessels of the bones, joints, Lungs or Abdomen. This can cause pain in arms, legs, chest, back, knees, etc. that may last a few hours to several days. The pain can be dull, throbbing, stabbing, or tearing. Each episode of crisis may have varying types and intensities of pain.
• Another form of crisis is one that can results in rapid and profound Anaemia. This is because the spleen gets enlarged by trapping the abnormal red cells. This is called the Sequestration Crisis. The patient develops a large spleen and complains of fatigue, weakness, and pain in the Abdomen. Sickle cell crisis can be triggered by cold or dehydration.