On April 25, 1937 Dr Bernard Fantus at Cook County Hospital in Chicago coined the word “Blood Bank” for the blood preservation laboratory equipped with the system of deposit and withdrawal. But blood banks had been established even before the nomenclature was coined. Blood transfusion service does not exist in isolation. It is an integral and indispensable part of the health care system. Today no hospital can function effectively without blood. Blood has to be provided to the patient in need in right time and right quantity. A stock has to be maintained. Only well planned and efficiently managed blood banks can meet the requirement of health care service.
An Ideal blood bank has the following functions
The first task of any blood bank is blood donor motivation, recruitment. and retention. Without blood all other functions of blood bank become non-existent. Only the blood banks depending on voluntary donors motivated through education of self-exclusion can ensure safe blood transfusion by preventing transfusion transmissible infections. There should be steady supply of blood from voluntary blood donors throughout the year. There should not be any flush or lean season. Hence blood donor motivation in a scientific, systematic and sustained way is a demanding task. Some of the blood banks wrongly depend totally upon the ‘family donor’ or replacement donor system. There are, however, several reason why such blood banking system is unsatisfactory and dangerous. It may not be possible for the patients’ family to find a suitable family donor. Some may feel obliged to donate even if they know that they have some health condition which prohibits donation of blood. Moreover, since this blood is meant for a particular patient, it is not easily made available to other patients, who may have a greater need. It is not possible, therefore, to utilise family donations effectively for running a blood bank with adequate stock of blood, ensuring its availability at right time of right group.
In addition, this system may ultimately lead to professional blood selling system in disguise, has the potential to corrupt the personnel working in the blood bank. Since these are the people who have first access to the family, there is great temptation to accept pay offs for referring the family to the professional seller syndicate. Corruption of this kind thus introduces further dangers for the patient by subverting the professional integrity of the transfusion service staff. Systems of this kind are undesirable and should not be allowed to develop. The solution is to create a viable, ethical voluntary blood programme which succeeds in providing the required services. Paid donor system cannot succeed if something better is already in place.
Blood banks, therefore, must have their own donor motivation, recruitment and retention programme, or may entrust one or more respectable voluntary organisations with the responsibility of undertaking. the job for them.
There are four different models of blood banking service which have been tried successfully. These are:
In India there are three types of blood banking service:
Government blood banks run on tax payers money from the public exchequer and therefore, they donot have to depend on total cost recovery from the patients. Non-profit making blood banks have to be funded from different sources including cost recovery from the patients. Commercial blood banks trade in human misery. Often their blood banking practices are unethical. Commercial blood banks have a high price for blood to meet the salary bills and the profit of the owners. Ideally, there should be a National Blood Transfusion Service (BTS) based on the existing model of National Health Service (NHS) in the United Kingdom (Britain).