It’s criminal to transfuse blood at home, say experts

Blood transfusion experts and hepatologists have strongly warned that performing blood transfusions at home or outside medically regulated environments is unsafe and a criminal offence in the country.

They noted that such practices could lead to blood transfusion complications and the transmission of blood-borne infections such as Hepatitis B and C and Human Immunodeficiency Virus.

In separate interviews with PUNCH Healthwise, the haematologist and hepatologist condemned the activities of quack and unlicensed medical practitioners who collected blood from donors and transfused them to the recipients without the required screening.

The hepatologist noted that there have been clinically reported cases of Hepatitis infection through blood transfusion done at home.

According to the Centres for Disease Control and Prevention, there is an increased chance of being infected with Hepatitis C through transfusion of unscreened blood as well as through tattoos, piercing, sharing injection drug use equipment or engaging in unprotected sexual activity with infected persons.

The World Health Organisation states that the Hepatitis C virus is blood-borne and most infections occur through unsafe injection practices, unscreened blood transfusions, unsafe healthcare and sexual practices that lead to blood exposure.

To further drive public awareness, advocacy, education and action towards eliminating viral hepatitis, the WHO set aside July 28 every year to commemorate World Hepatitis Day.

Further expatiating on the possible side effects of blood transfusions, the American Cancer Society, listed allergic reactions such as itching, fever, trouble breathing, swelling in the face, lips or tongue and dizziness.

The National Blood Service Commission is authorised with the regulation of the supply of safe and quality accessible blood for all Nigerians.

According to the National Blood Safety Standards for Blood Establishments in Nigeria, August 2021, blood establishments must ensure that blood, blood components and services are carried out under controlled conditions.

It further stated that “blood shall be collected from healthy, voluntary non-remunerated donors identified by the Blood Establishment to be at low-risk for transfusion transmissible infections.

“Blood group serology and testing for infectious diseases shall be carried out on a specimen collected at the time of donation, on every unit of whole blood or apheresis unit collected.”

Also, the website of the Lagos State Health Facility Monitoring and Accreditation Agency, states, “It is an offence to transfuse blood without Lagos State Logo.”

Speaking with PUNCH Healthwise, a professor of Haematology and Blood Transfusion at the Lagos State University Teaching Hospital, Ikeja, Akinbami Abduljaleel, asserted that is unsafe and a criminal offence to transfuse blood outside of a hospital or medical-controlled environment.

He, however, clarified that blood transfusion could be done in an ambulance by trained medical personnel.

The don explained that conducting blood transfusions at home, whether by untrained or trained personnel, was discouraged due to the possible reactions from the recipient that would require some equipment in the hospital.

“Blood transfusion is a criminal offence in Lagos and Nigeria. The reason it is discouraged is the possibility of having a reaction that will require some equipment like oxygen that may not be available at home.

“Blood transfusion is a tissue transplant because you are receiving donated tissue, (blood is a tissue) from a donor so there could be adverse reaction and rejection of the tissue by the recipient. This can be fatal if you don’t have the equipment needed to support the reaction. So whether by trained personnel or not, it’s better done in a hospital setting or ambulance where if there’s a need to suction, if the patient goes into cardiac or respiratory arrest, you have a suctioning machine. Also, if the person needs oxygen you can quickly give oxygen, which may not be available at home,” Abduljaleel said.

The haematologist stated that recipients of blood transfusion at home, especially those who received them at the hands of untrained and unlicensed practitioners were at risk of transfusion transmissible infections and complications.

He added that they were also at risk of blood-borne infections such as HIV, Hepatitis B and C, syphilis and malaria.

“Before blood is certified fit for transfusion we screen them for these infections. We also screen the blood donors for HIV, HBV, HCV and syphilis in Lagos State with a good screening kit called Enzyme-Linked Immunosorbent Assay (ELISA) and after the screening we put a logo to certify the pint of blood fit. The Lagos State Blood Transfusion Service is responsible for coordinating donation and collection of blood,” the don said.

The blood transfusion expert further asserted that before blood transfusion can be considered safe, it must be crossmatched and compatible with the recipient’s blood group.

“If you give a group incompatible blood, the body of the recipient will reject it and may even cause immediate death of the recipient. So there are immediate complications of blood transfusion and there are late complications so it is possible to put up the blood and the person develops fever and rigour (severe chills with violent shivering) and dies in the next one or two minutes of receiving the blood. That is why it is not safe to give blood at home,” he said.

The professor of haematology continued, “It’s an act of parliament passed in  2001 by Lagos State House of Assembly that any blood unit that must be used in private or public facilities and hospitals must carry that logo which will be got after the screening in accredited centres. It is a criminal offence to use unscreened blood. It happens, some quacks will just bleed someone without going through screening and then transfuse immediately but if such a person is caught, they will be made to face the law.”

Also, a Consultant Physician and a Gastroenterologist, Dr Abubakar Maiyaki, stated that blood transfusion at home was rampant in the rural areas.

He added that the donors and the blood were not screened or tested for infectious diseases before it was transfused to the recipients.

The Associate Professor and Head of the Department of Internal Medicine at the Usmanu Danfodiyo University and Teaching Hospital Sokoto, Sokoto State, noted that health workers who engaged in such practices also transfused blood indiscriminately at the slightest mention of persistent illness.

Maiyaki said, “In the villages, you still see people transfusing blood without having it tested and screened for infections. This is being done seriously in the villages. You see health workers who would hear a patient say, ‘Oh, I’m sick, come and transfuse me’ and will do so.”

The General Secretary for the Society for Gastroenterology and Hepatology in Nigeria, also said, “Recently, someone in Sokoto who I admitted was telling me, he had been transfused with blood three times at home, with unscreened blood! This patient eventually died of Hepatocellular Cancer of the liver from Hepatitis B.”

The hepatologist warned against the practice, stating that unscreened blood could carry blood-borne infectious diseases such as hepatitis.

He noted that recipients of such blood would suffer the consequences of long-term infection with the virus and possible death.