Blood transfusion doesn't work for first 12 hours

by dmouse 26 Replies latest watchtower medical

• 

  LDH

  TD,

  That's exactly what I was going to say re:the efficiency. Nicely stated.

  It is worth remembering also that the haemoglobin of stored, citrated red cells is not fully available for the transfer of oxygen to the tissues for some 24 hours after transfusion (Valtis & Kennedy (1954) Lancet, 1, 119); rapid blood transfusion must therefore be regarded primarily as a mere volume expander in the initial stages.

  Are you telling me that the WT in 1980 quoted a publication from 1972, which quoted a publication from 1954? Once you know their literary tricks and re-read the publications applying the same standards that any qualified research journal would, it falls apart.

  Scully, thank you for referring to The Appearance of the Dreaded Ellipsis. A phrase aptly coined by our own Jankyn, and now having it's own thread.

  Lurkers, search for a thread with this title and "The Appearance of the Dreaded Brackets."

  Lisa
• 

  Scully

  Lisa,

  The article in Anaesthesia is from 1975... even worse than if it were 1972. The brochure Jehovah's Witnesses and the Question of Blood was published in 1977 (according to my copy of the CD-ROM... oops did I say that? )

  The other verrrrrry interestingk thing about this article in Anaesthesia is that it is an editorial, and there is NO AUTHOR'S NAME ATTRIBUTED TO THE CONTENT. I'm quite surprised that the reference to the 1954 article in the Lancet got under the radar on this one. It's just very poor academic practice to use reference material that is so out of date.

  Although I can see why the WTS and JWs would think nothing of using a 20 year old or even a 50 year old reference to support their doctrine; after all, their own "reference manual" has parts that are between 5000 and 2000 years old.
• 

  Scully

  Oh, and here are the links to the threads that Lisa was referring to:

  The appearance of the dreaded ellipsis [. . .] posted by LDH

  The appearance of the dreaded [] brackets... posted by AuldSoul
• 

  LittleToe

  It makes interesting reading in the cold light of day, doesn't it?
• 

  Marvin Shilmer

  Reading this thread of discussion compels me to reproduce a section of Bruce Spiess’ article Risks of transfusion: outcome focus. (Transfusion, Volume 44, December 2004 Supplement) From Spiess:

  “RBC transfusions today are largely dependent on the use of RBCs stored at 4 degrees C in the blood bank. Fresh blood is rarely available but it should be noted that it can be obtained in some centers if desired. As RBCs are stored and aged they undergo a number of physiologic changes. The RBCs are largely using anaerobic glyocolisis to maintain cellular integrity. As such the blood rapidly becomes acidotic and by Day 28 of storage it can have a very low pH value. Potassium leaks out of the cells and it can rise in the plasma to levels of 78 meq per L or higher. The intracellular adenosine diphosphate is relatively well maintained but the intracellular 2,3- diphosphoglyceratae (2,3-DPG) levels plummet within 24 hours of harvest. The shift in available 2,3-DPG causes the Hb in stored cells to profoundly bind and hold oxygen. Therefore, when initially transfused, stored RBCs take up oxygen with tremendous affinity. They, however, do not release the oxygen to tissues. It has been estimated that stored RBCs take oxygen from circulating plasma, other normal RBCs, and even from tissue myoglobin. A recent prospective study of oxygen delivery to tissues in patients after cardiac surgery found that the transfusion of 1 or 2 units of RBCs did nothing to improve oxygen delivery to striated muscle. The shift to 100 percent O2 breathing, however, radically increased tissue oxygen delivery. So the idea that one is transfusing RBCs to increase oxygen-carrying capacity may not be realistic. That oxygen-carrying capacity, however, may be doing nothing or worsening the release of oxygen to the tissues that it is targeted to help.

  “Blood utilized in the US has an average life of 19 to 21 days at transfusion. In Europe the average unit transfused is younger by about 5 days. Blood is considered “fresh” if its shelf life is younger than 5 days old. Once transfused the cellular dysfunctions of RBCs begin to be repaired as the cells undergo metabolism. The potassium is reabsorbed and the 2,3-DPG is replenished. But the return to normal physiology can take between 5 and 24 hours to restore. Of note is the fact that at 42-days-old only about 70 percent of cells are even capable of surviving for 24 hours once transfused. Therefore, 30 percent are ghosts or merely cellular debris. Those cells that are still alive are swollen and unable to behave normally in the microcirculation.”

  Marvin Shilmer
• 

  google_mE

  KID-A -- I recall the society claiming once that "personality" traits of the donor could be transmitted to the recipient during a blood transfusion. I remember my mother believing this crap and also

  that personality traits were transferred by organ donations as well.

  I wondered where my mom came up with this idea, because a few years ago we were having lunch and the topic came up that if a person had a heart transplant from a murderer, the person receiving the heart could become a murderer. LOL I thought she was joking at first. Pretty sad. -mE PS - After searching the CD-ROM, the article is "How is your heart?" from the w71 3/1
• 

  Midget-Sasquatch

  I wouldn't have thought I'd find myself saying this , but it does look like the WTS has some basis for concern on this one point. Even if normal tissue oxygenation wouldn't return till 12 hours later though, I'd dare say that the transfused patient will be much better off afterward.

  Does anyone know if the higher acidity within the RBCs and the drop in active DPG are simply the usual pH effects on enzyme conformation or are other reagents/steps involved? If its just the former, couldn't treating the RBCs with some buffering solution prior to transfusion help to return their intracellular pH to physiologically normal values? And along with that DPG with active conformations?