Treatment

Treatment

• Receives the donors for blood donation with a warm welcome and act as a bridge between the hospital staff and the technical staff of the blood bank.
• Well-trained staff does donor screening, while Donor privacy and confidentiality is maintained at all times.
• Pretest counseling to defer high-risk donors is undertaken.
• Blood bags with pre storage leukoreduction filter are used that provide 3-4 logLeukoreduced blood. The advantages of leucoreduction include:
  1. Prevention of Febrile Non Hemolytic Transfusion Reactions (FNHTR)
  2. Prevention of HLA allo-immunization
  3. Reduction in transmission of lymphotropic viruses such as EBV, CMV and HTLV-I & II.
  4. Prevention of immunomodulation

• The bags also contain a sample pouch, which diverts first 15-30 ml of blood that is used for testing. This has significantly reduced bacterial contamination of blood products.
• The sterile connecting device has made it possible for us to provide blood components in parts for fulfilling pediatric transfusion requirements. The various components prepared in our BLOOD COMPONENT PREPARATION LABORATORY include:
  1. Leukoreduced Packed Red Cells (3-4 log leukoreduction)
  2. Random Donor Platelets and Fresh Frozen Plasma
  3. Cryoprecipitate
  4. AHG poor plasma
  5. Washed RBCs
  6. Irradiated RBCs

• The IMMUNOHAEMATOLOGY LABORATORY is a reference centre providing advanced Immunohaematology work-ups, not only for in-house patients but also to patients from other hospitals.
• Tests performed at our laboratory include:
  1. Donor: Blood grouping (ABO & Rh), Rh phenotyping and Immune antibody screening
  2. Patients: Grouping, antibody screening, antibody identification and extended antigen typing if required.
  3. Cross matching
  4. Advanced work up such as auto/alloadsorption& elution for solving of difficult cases.
  5. Direct & Indirect Antiglobulin tests
  6. Coombs titre

• The INFECTIOUS MARKER LABORATORY, besides the five mandatory tests also performs testing of hepatitis B core antibody on all the donated blood units and the units that are found positive are discarded.
• NUCLEIC ACID TESTING (NAT) LABORATORY: Individual Donor (ID)-NAT testing based on Transcription Mediated Amplification by ProcleixUltrio Assay is done on all the donated blood units. This has reduced the window period of HIV-I, HBV & HCV considerably and is a step forward in our quest for zero risk blood.

• APHERESIS AND OTHER SPECIAL PROCEDURES:
  1. THE APHERESIS LABORATORY is functional 24 hours, all days. It is equipped with fully automated cell separators, which are flexible to produce various components.
  2. The various procedures undertaken include:
  3. Plateletpheresis
  4. Plasmapheresis
  5. Granulocytapheresis

• Besides these the department also performs special procedures such as:
  1. Therapeutic Plasma Exchange
  2. Peripheral Blood Stem Cell (PBSC) collection: Autologous and Allogenic
  3. Red Cell Exchange

• Voluntary blood donation program The Department has initiated an in-house voluntary blood donation program wherein a list of hospital employees willing to donate voluntarily is maintained. This also includes donors with rare blood groups who can be called at the Eleventh hour for blood donation. These Voluntary Blood Donors play a pivotal role in maintaining safe and adequate blood supply that forms the backbone of any Blood Transfusion Service. The Department also maintains the registration of Voluntary Blood Donors who are willing to donate blood at the IAH. These Voluntary Blood Donors are encouraged to become regular repeat remunerated Voluntary blood donors instead of just one-time voluntary blood donors. Voluntary donors at our hospital are also provided with certain special incentives. As per the departmental policy that all donors who have donated 4 times in a year or at least in 2 years are entitled for an Executive Apollo Health Check up. This is to ensure that our voluntary donors remain in good health at all times.
• Thalassemia initiative The Department of Transfusion Medicine at Indraprastha Apollo Hospitals, New Delhi is catering to the transfusion needs of approximately 75 Thalassemic patients. We are providing NAT tested, 3 to 4 logleukoreduced blood for these patients. In addition we perform regular screening for any irregular red cell antibodies and the extended blood group phenotyping of these patients, helping us in providing the safest possible blood for them.

• Molecular biology and transplant immunology During the past decade the pace of discovery, invention and innovation in Genetics has accelerated dramatically, more so in the Molecular Genetics arena. The Apollo Group, in line with its commitment of providing world class services second to none, not only has a cutting edge technology in the Genetic services but also has an equally highly committed human resource comprising of skilled doctors and Scientists to man these services. Molecular Diagnostics has increased our understanding of oncology and we are no longer treating cancer patients empirically but are able to assist the oncologist in prognosis as well as finding Minimal Residual Disease. Today Molecular diagnostics has reached a stage where it also plays a significant role in investigating recurrent abortions, genetic anomalies and HLA tissue typing for Organ transplantation, both solid organ and Bone Marrow transplants.
• Services provided by immunology & molecular biology
  • Prenatal & Postnatal Diagnosis
    • Chromosomal Analysis (GTG Banding) – Abortus Material (Product of Conception)
    • Amniotic Fluid -FISH Ploidy for Chromosome 21,18,13,X and Y (5 probes analysis)
    • Amniotic Fluid -Karyotyping-GTG banding
    • CVS cell culture for routine karyotyping
    • CVS-Complete Chromosomal Analysis (Karyotyping GTG Banding+ Ploidy analysis for Chromosome 21,18,13,X and Y by FISH
    • CVS-FISH Ploidy for Chromosome 21,18,13,X and Y (5 probes analysis)
  • Cytogenetics
    • Stress Cytogenetics for Aplastic Anaemia
    • Chromosomal Analysis (GTG Banding) -Peripheral Blood
    • Chromosomal Analysis (GTG Banding) -Bone Marrow
    • Couple Karyotype from peripheral blood samples
  • Fluorescence in situ Hybridization (FiSH) for Hematological malignancies
    • FISH FOR 1q25,LSI19q13/LSI19p13
    • Her 2 Neu Gene Amplification by FISH with on Paraffin Embedded tissue Sections
    • FISH FOR CEP XY (MRD ASSESSMENT) for Bone marrow transplant assessment
    • AML FISH panel
    • FISH FOR ALL PANEL (ANY 3 FISH PROBES) TEL/AML, MLL, t(9;22), INV 16
    • FISH for CLL panel
    • FISH for AML panel
    • FISH FOR CEP-12
    • AML1/ETO t(8;21) translocation (FISH)
    • FISH FOR CML patients LSI BCR/ABL t(9;22) f
    • N-myc FISH for neuroblastoma
    • FISH FOR LSI D7S486(7q31)CEP-7q LSI 1p36/LSI
    • FISH for MDS PANEL del(5q), del (7q)
    • FISH FOR MULTIPLE MYLEMOMA t(11;14), t(14;18), 13q(del), p53(17p13)
  • HLA typing for Kidney, Liver and Bone Marrow Transplant
    • HLA CLASS -I A,B,C / PCR-SSP/SSOP
    • HLA CLASS-II DQ/DR/PCR-SSP/SSOP
    • HLA LYMPHOCYTE CROSSMATCH&HLA TYPING(DONOR&PATIENT)
    • HLA LYMPOCYTE CROSS MATCH NIH METHODS
    • BONE MARROW TRANSPLANT HLA TYPING
    • HLA B-27, HLA B-51, HLA B-17, HLA-B 15 (SSP- PCR)
    • PANEL REACTIVE ANTIBODY TEST
    • DONOR SPECIFIC ANTIBODY TEST
  • Infectious Marker Screening
    • HBV- Quantification(PCR)
    • HBV-Qualitative(PCR)
    • HCV-Quantitative(PCR)
    • HCV- Qualitative(PCR)
    • HCV genotype
    • HIV-Viral Load
    • MRD ASSESSMENT (Q-RT-PCR FOR BCR-ABL GENE)
    • HIV Proviral DNA
    • HIV Genotypic Drug Resistance
  • Molecular Genetics
    • BETA Thallasemia – 5 COMMON MUTATIONS – CHILD & PARENTS
    • THAL – MUTATIONS + XMN POLYMORPHISM
    • THALASSEMIA – (8) UNCOMMON MUTATIONS
    • THALASSEMIA – 2nd PRENATAL DIAGNOSIS
    • THALASSEMIA – ALPHA – DELETIONS (3.7 & 4.2 KB)
    • THALASSEMIA – ALPHA,BETA & GAMMA GENE ANALYSIS
    • THALASSEMIA – PRENATAL DIAGNOSIS
    • THROMBOPHILIA PROFILE(FAC V+MTHFR+PROTHROMBIM GENE)