FAQ's on Transfusion Medicine Department at Indraprastha APollo Hospitals Delhi, India

Q- Who can donate blood?

·         A blood donor must be in good health.

·         Age between 18 to 60 years.

·         Weight about 50 kg or more

·         Haemoglobin level at least 12.5 g/dl

·         It is safe to donate blood every three months.

·         Persons with high risk behaviour for having AIDS and who had jaundice (Hepatitis B or C) should exclude themselves from blood donation.

Q- Prerequisites for hla typing sample

Ans- Prior appointment in advance is required. Recent photograph of the donor and patient affixed on the form should be duly attested by the treating Physician. The form should be filled appropriately and Thumb Impression/Signature of the donor and the patient should be taken. The sample would be collected in the presence of Consultant, Transplant Immunology and Molecular Biology in Apollo Hospital.

SAMPLE: Patient and Donor Blood sample in 2 EDTA vial.

Turn-around Time (TAT): 3 day

Q- Prerequisites for HLA B 27, HLA B5, B51, HLA B15 HLA B17 Sample

·         SAMPLE: Patient Blood sample in 2 EDTA vial.

·         Turn-around Time (TAT): 5 days

Q- Prerequisites for blood/bone marrow sample for karyotyping

Ans- The blood/bone marrow sample needs to be sent in a heparin vial (3-4 ml sample) along with the patients clinical history and diagnosis

Turn-around Time (TAT): 10 days

Q- Prerequisites for amniotic fluid/placenta/poc for karyotyping

·         AMNIOTIC FLUID: 15 ml in Falcon Tube

·         PLACENTA/POC: 5 ml in RPMI media in Sterile Container

·         CVS: 25-50 mg CVS tissue in RPMI media in sterile container

·         TAT: 3-4 weeks

Q- Prerequisites for couple karyotyping for recurrent abortions

·         2 heparin vials of the Couple: 4 ml each

·         Turn-around Time (TAT): 10 days

Q- Prerequisites for chromosome breakage studies

·         2 Heparin Vials: 3-4 ml

·         Turn-around Time (TAT): 2 weeks

Q- Prerequisites for fish

Ans- Leukemia/Genetic disorder: Blood/ Bone Marrow sample in heparin vial (3-4 ml)

Q- For Prenatal Cases:

·         Amniotic Fluid approx. 10 ml

·         Chorionic Villous Sample/Products Of Conception/ Placenta sample: 25-50 mg in RPMI

·         Turn-around Time (TAT): 4-5 days

Q- Prerequisites for fish-her2 NEu

·         Biopsy Paraffin Block / Polylysine coated tissue slides with 1 H& E slide

·         Turn-around Time (TAT): 7 days after receiving the slides

Q- Prerequisites for infectious marker testing

Ans- For HIV sample consent form duly signed by the primary physician and patient is required.

·         2 EDTA vials

·         Turn-around Time (TAT): 1 week

Facilities of Transfusion Medicine at Indraprastha Apollo Hospitals Delhi, India

·         The Blood component preparation Laboratory is a state of the art laboratory that is well equipped with latest instruments. The sterile connecting device has made it possible for us to provide blood components in parts for fulfilling pediatric transfusion requirements.

·         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. Our laboratory is equipped with the fully automated platform Galileo from Immucor for Immunohaematology work up of donors & patients. Besides the fully automated system, the laboratory also utilizes the gel technology by DIAMED.

·         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.

·         The ELISA based tests are performed on a fully automated walk away system EVOLIS. Latest third/fourth generation kits are used for testing. The laboratory also undertakes Western Blot testing for both donors and patients who are found positive for HIV by ELISA

·         Individual Donor (ID)-NAT testing based on Transcription Mediated Amplification by ProcleixUltrio Assay in the NAT LABORATORY.

·         THE APHERESIS LABORATORY is equipped with fully automated cell separators, which are flexible to produce various components.

Treatment & Services in Transfusion Medicine Department at Indraprastha Apollo Hospitals Delhi, India

·         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 counselling 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)

Blood Transfusion Medicine Department at indraprastha Apollo Hospitals Delhi, India

Blood Transfusion Services (BTS) is the vital part of modern health care system without which efficient medical care is impossible. It is a complex organization requiring careful designing and management.

The aim of a Blood Transfusion Service (BTS) is to provide effective blood and blood products, which are as safe as possible, and adequate to meet the patients need.

The department uses state-of-art technology and stringent quality control protocols to ensure timely supply of the safest possible blood and blood components. The department boasts of Nuclear Amplification Technology (NAT) Laboratory which very few centres in the country currently use.

FAQ's on Physiotherapy Department at Indraprastha Apollo Hospitals Delhi, India

Q- Do I need a doctor's referral for physiotherapy treatment?

Ans- No, however we do recommend that you contact your physician/surgeon as you may require a medical referral (referral by a medical practitioner) to authorise re-imbursement of treatment charges.

Q- What is electrotherapy?

Ans- Electrotherapy is the use of electricity in order to produce different types of energy waves. These waves are then used to effect tissues by reducing swelling, pain and muscle spasm and by strengthening muscles. This results in the promotion of healing.

Q- How quickly will I be seen for my first appointment?

Ans- We will always endeavour to offer you an appointment on the same day or within 24 hours.

Q- How long does a treatment session last?

Ans- Each treatment session lasts approximately half an hour.

Q- Should I bring my X-rays with me?

Ans- Yes and any other relevant medical information you may have.

Q- How many treatments will I need?

Ans- There is no pre-determined number of treatments for a specific condition. However following your initial assessment, your physiotherapist will discuss and agree a treatment plan with you. This may include advice regarding the approximate number of treatments you may require. Individual's response to treatment varies.