References
Current issues in veterinary transfusion medicine
Abstract
Human and veterinary transfusion medicine is an area where there has been ongoing research and new developments. The way in which blood and transfusion products have been used has been questioned resulting in changes in their use and storage. In transfusion medicine, not only the research methods, but sometimes the application of the product itself, has raised ethical and moral questions, which has in part led to major differences between UK and US transfusion practices. Within the UK there is a rapidly growing demand for banked blood products and an increasing use in practice of both banked products and emergency whole blood donations. Registered veterinary nurses (RVNs) are now able to undertake further qualifications in emergency and critical care which includes the use of blood products. It is of vital importance for the RVN to keep up to date with current thinking on transfusion medicine and to ensure that transfusion guidelines and protocols within their work-place are up to date and evidence based.
Since the first dog to dog blood transfusion in 1665, transfusion medicine has evolved greatly, with many practices using volunteer donors or having their own blood bank in house (Branquinho et al, 2011). Since 2007 canine blood component products such as packed red blood cells (PBRCs), fresh frozen plasma, frozen plasma, cryo-precipitate and cryo-supernatant have been commercially available in the UK from the Pet Blood Bank UK (PBBUK) (Barnett, 2012). Historically whole blood transfusions were used in cases of hypoxic anaemia or hypovolaemic trauma (Tobin, 2011), but with the advent of component product availability, and with new evidence-based research, the applications for blood and blood products has evolved. Transfusion products are now regularly used in patients with clotting factor deficiencies, septic peritonitis, vasculitis and protein losing enteropathies and nephropathies (Boag and Walton, 2011a). Recent papers published herald the discovery of two new canine blood groups; Kai 1 and Kai 2 (Euler et al, 2016a). Current research is also ongoing for red blood cell (RBC) storage lesions and the ensuing implications to practice, xenotransfusions (Euler et al, 2016b), autologous transfusions with or without cell salvaging devices (Kellett-Gregory et al, 2013), leukoreduction (Kisielewicz and Self, 2014) and canine species-specific albumin transfusions (Craft and Powell, 2012). Goulet et al have studied the prevalence of the Dal blood group in certain canine breeds (Goulet et al, 2017) and Bebar et al (2014) have written of the identification of Von Willebrand disease (VWD) in a cat, which may well be of relevance in the future. Research in these areas closely follows that of research in human transfusion medicine and are areas which have been subject to controversy recently (Kisielewicz and Self, 2014). In human medicine advances have been made such as freeze dried plasma for use in the military field (Pusateri et al, 2016). With veterinary medicine traditionally following in the footsteps of human medicine it is reasonable to consider that similar developments in the veterinary field may be a possibility in the near future.
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