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Health: I'd rather have my own blood, please: Making a donation in advance of an operation can be difficult, says Virginia Ironside

Virginia Ironside
Tuesday 07 December 1993 00:02 GMT
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When Elizabeth Buxton was told that her 13-year-old daughter, Lucy, had to have her tonsils out, she was unconcerned. It was a routine operation and there was nothing to fear, despite the fact that when Mrs Buxton herself had had her tonsils out as a child she had haemorrhaged and needed a transfusion. Blood is always on hand during operations, so there was no problem.

Or was there? She then discovered that when the daughter of Lucy's godmother had had the same operation, the surgeon had suggested that the child donate her own blood in advance.

Why? asked Mrs Buxton. Surely in Britain our donated blood, particularly as it is voluntarily given, is the finest and safest in the world?

It is. But donated blood is only safe up to a point. Blood is screened for syphilis, for hepatitis B and C, and for HIV. However, it is not screened for the virus HTLV1, which can lead to leukaemia after an incubation period of 20 years. The risk is so small it is almost theoretical, but it exists.

With HIV, people are questioned about their lifestyle to eliminate risky donors, but antibodies against the virus may not show up for several months after infection (with hepatitis, this period is even longer). Through this window of risk, infected blood could reach the system.

Mrs Buxton considered asking Lucy to donate her own blood before the operation, but because her daughter was ill and because she shared the same blood group, she decided to donate her own.

The problem was finding anyone to take it. 'The first surgeon I went to see in Harley Street flatly refused,' says Mrs Buxton. 'The second said there was no reason for it.'

Close to the date of her daughter's operation she talked to a paediatrician friend. 'She confessed that she would never allow a member of her family to be given a blood transfusion from anyone other than themselves or the family. When she had a Caesarean she refused to sign any consent forms until a member of her family had donated blood. She fired me up to try again. I went back to my GP, who rang three laboratories without success, even though I was paying.'

Finally she was put in touch with Dr Lesley Kay, a consultant haematologist who is a member of the Special Interest Group on Autologous Blood Transfusions of the British Blood Transfusion Society and who was able to arrange for her to donate blood. It was not used because the operation went smoothly. But Mrs Buxton is adamant she would never allow herself or her children to be operated on without first providing 'autologous' blood; that is, blood given yourself before an operation.

Dr Kay says: 'There are many advantages to people donating autologous blood. In pilot studies it has been shown that after the expense of setting up a service, autologous blood donating is cost-effective, and patients given such blood seem to get better quicker than those given other blood.'

So why did Mrs Buxton find it so difficult to donate blood for her daughter? 'While some surgeons are keen, many are still resistant to change,' Dr Kay says. 'Certainly if I or my family faced an operation, I would much prefer autologous blood to be made available.'

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