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Blood and Organ Donation in the time of COVID19

 

Donation of tissues and organs of human origin such as human blood, blood components, bone marrow, cornea, heart, liver or kidney is noble deed that very often saves lives. The need for the donors is always much greater than the number of people who can actually donate. There is a huge requirement for donated blood every day across the world even when there isn’t a pandemic. Unfortunately, COVID19 pandemic has resulted in fewer blood and organ donations. Emergency surgeries, emergency cesarean sections, organ transplants, and blood needs of people with trauma, special diseases, cancers don’t stop because of a global emergency. Donated whole blood perishes within a month. Besides, preventive measures such as lockdown further curtail donor transportation. Hence regular donation of blood is the need of the hour to maintain enough reserves to meet the requirements.

Who needs regular blood transfusion and a special therapy to survive?

A lot of special disorders and cancer patients need regular blood transfusion. For example, considering India as the Thalassemia capital of the world, every year, more than ten thousand children are born with ‘Thalassemia major’ the severe form of this genetically determined condition. It is estimated that every month almost one lakh patients undergo blood transfusion to battle this ailment and more than two lakh units of blood is required in India for the treatment of Thalassemia patients.

Is COVID19 test necessary for the donors?

Previously, many studies found that SARS-CoV (causing SARS) virus genetic material could be detected in the plasma of the patients even though it is a respiratory disease. Although SARS-CoV-2 virus (causing COVID19) is transmitted from human to human via droplets, uncertainties about the presence of the virus in the blood and bodily fluids of an asymptomatic donor may be considered a potential threat to the safety of the recipient. Therefore, test for COVID19 (both RTPCR and Serological tests) of the donors (deceased or living) and recipients before any organ or blood donation is very crucial and has been mandated by ICMR (Indian Council of Medical Research). Living donor transplants is recommended for only urgent cases only, as admitting a healthy donor in a hospital exposes them to SARS-CoV2 contact risk.

Lipid-enveloped RNA viruses such as SARS-CoV2 must be removed or inactivated before providing blood and blood components for transfusion. Regular screening procedures for donors showing clinical symptoms of COVID19 and the established processes of virus inactivation and removal during blood component manufacturing should mitigate SARS-CoV2 transmission through blood components. Please follow up with a local blood bank to know more details about the effect of COVID19 on blood components therapy.

Complete data on transplant recipients with COVID-19 are still lacking. However, based on data from influenza and SARS, if infection occurs, progression to pneumonia may be more common in the immunocompromised population, including transplant recipients.