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More blood, more life? Reflections on World Blood Donor Day – 2011

The Indian Journal of Medical Research
Medknow Publications
Publication Date
  • Editorial
  • Medicine


Previously commemorated by the International Federation of Blood Donor Organisations (IFBDO), the World Blood Donor Day has now been adopted by the World Health Organization (WHO) to recognise the contribution of blood donors to world health. Public recognition of blood donors is a strong motivator for donation1. In itself, it may be considered as an incentive and an example of ‘impure’ altruism2, sitting somewhat uneasily in the landscape of ‘voluntary, unpaid’ blood donation which appears to be, at the expense of any alternative, the sole donation route accepted by the WHO. It is fitting that blood donors are recognised, because blood-derived therapies continue to be a life-saving medical intervention in many instances. It is important, however, to reflect on the current state of the field of haemotherapy, if the role of donors is to be properly recognised. The past fifty years have seen blood transfusion shift in status in the established Western economies, from a modest medical technology to an alleged speciality ‘Transfusion Medicine’ (TM). TM may be viewed as a paradigm as described by Kuhn3, characterised by an unquestioned acceptance of its basic tenets yet containing tensions which may eventually lead to its replacement. Perhaps, the most significant component of the TM paradigm, in terms of these tensions, is the detachment, despite the term ‘Transfusion Medicine’, of transfusion from the direct medical interphase. TM has been replaced by a manufacturing construct, in which blood is viewed as a raw material for the extraction of various fresh components for immediate transfusion, principally red cells. The primary event which caused this replacement in the Western world was the discovery in 1964, that cryoprecipitate made in blood banks could provide an effective treatment for haemophilia4. This led to a rapid conversion of whole blood units to >95 per cent red cells, as more and more plasma was generated for cryoprecipitate. Thus the needs of a tiny, vulnerable but, suddenly, eminently treatable p

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