Source: People's Daily Health Client Lin Long Xu Tingting
Read the executive summary:
According to the Chinese Academy of Sciences, less than five out of a thousand people in Asia have Rh-negative blood, but a "less" word falling on every sick panda blood family is doubling pressure and the reason for the "difficulty". Jia Dacheng, head of the emergency science popularization team of the Health Communication Working Committee of the Chinese Medical Doctor Association, told reporters that it is recommended that measures of "national blood group check" can be taken to establish a blood group database in blood centers across the country, and establish a special database for Rh-negative blood group groups, which can be prepared at any time.
"It wasn't until the moment I fell ill that I knew that only panda blood could save lives"... This is the voice of the panda blood crowd and the patient's family.
According to 2020 data from the Website of the Chinese Academy of Sciences, the population of Rh-negative blood (commonly known as "panda blood") in Asia is less than five thousandths. A number of experts suggested to reporters that the blood type can be checked by the whole people, a blood group database can be established in blood centers around the country, and a special database can be established for Rh-negative blood group groups.
Volunteers donate blood to patients who desperately need panda blood. Rare blood type Yonghe Rescue Team courtesy of the image
Five thousandths of a way to live
Jingjing (pseudonym), who has worked in Beijing for more than ten years, still misses her father, who was still around more than a month ago. Three years ago, Jingjing's father was unfortunately diagnosed with pancreatic cancer. To their family's surprise, during the preoperative examination, they learned a new term--- panda blood.
Jingjing recalled to reporters: "At that time, my father's physical condition was quite considerable, and he used the method of autologous blood transfusion to maintain it. "Until December 2021, her father had reached advanced stage pancreatic cancer and was in far less physical condition than he had been three years ago." My father was very anemic before the operation, and he lost a lot of blood during the operation, and he still needed a lot of blood transfusion after the operation. It is no longer possible to wait for the hospital to coordinate blood transfer for 2 to 3 days. ”
The deterioration of his condition and severe anemia made Jingjing's father unfortunately leave. At this time, Jingjing felt that for her father, finding panda blood and timely treatment, both of which are possible to save her father's life.
According to popular Science China data, in addition to the classification of A, B, O, AB blood types in the ABO blood group system, there are negative and positive blood types in the Rh blood group system, but more than 99% of people in the mainland are Rh-positive blood. In the Rh-negative blood population, the ratio of blood types A, B, O, and AB is 3:3:3:1. The chance of Rh-negative blood in patients with clinical surgery is 5 to 7/1000.
But a "less" word falling on every sick panda blood family is a multiplier pressure, and it is the reason for the "difficulty". "When this type of individual is in urgent need of blood transfusion in the clinic, it is often impossible to find a blood transfusion matching RhD blood type for a short period of time, which may pose a threat to the safety of patients' lives." Liao Zhaoping, a physician in the Department of Blood Transfusion of the Second Affiliated Hospital of Zhejiang University School of Medicine, told reporters.
Wei Xia (pseudonym), from Beijing, remembers that in the past two months, he had been running to treat his mother's acute myeloid leukemia, and his physical condition had also been in a hurry with his mother. Knowing that his mother was in urgent need of Rh-negative blood for surgery, his first reaction was to check his blood type, "Also Rh-negative type A blood!" ”
Before he could breathe a sigh of relief, the doctor told him that although the blood type was the same, the mother-child relationship could not be directly transfused, which would produce a dangerous rejection reaction. With the doctor's reply, Wei Xia anxiously made various contacts, making phone calls, searching the Internet, asking acquaintances...
Wu Junyuan, deputy chief physician of the emergency department of Beijing Chaoyang Hospital, told reporters that patients like this who need emergency Rh-negative blood transfusion will only see one or two cases in the emergency department a year. The number of panda blood population is small, there are fewer patients who need emergency blood transfusion, in the specialty is not urgent elective surgery, the patient's physical condition allows, the hospital generally adopts the "autologous blood transfusion" method, draws an appropriate amount of blood for the patient before surgery, and then transfuses it back into the patient's body when the operation is needed.
One concomitant conundrum after another
"There is no blood in the hospital, and it is too slow to contact the blood bank to adjust the blood." This is the biggest problem for the panda blood crowd who are in urgent need of blood transfusions like Wei Xia's mother. Prepare blood independently, seek help from social resources, and become one of the few channels for panda blood groups.
"I have also inquired about the channels of blood trading, but the state has explicitly banned it." Even knowing that it was impossible, Wei Xia tried to contact all channels to save his life. Since the implementation of the Blood Donation Law of the People's Republic of China, the mainland's medical and clinical use of blood has been all derived from unpaid blood donation. According to the notice of the National Health Commission, before the end of March 2018, mutual aid blood donation will be cancelled nationwide.
Professor Wang Ben of the Second Affiliated Hospital of Zhejiang University School of Medicine told reporters that in the mainland, as far as I know, the panda blood population will establish mutual aid platforms such as online communities, and if a patient needs surgery, in addition to the necessary blood source preparation through the blood center, they will also make point-to-point preparations through the above mutual aid platforms and mutual assistance in the same city.
"We have formed a consortium with public welfare teams in Dalian, Shaanxi, Shandong, Guizhou, Changshu, Guangxi and other places, calling on volunteers to regularly participate in unpaid blood donation, and accept private requests for help to donate blood to help patients, and a total of 430 volunteers in the team will participate in public welfare rescue and participate in unpaid blood donation in 2021." Jiang Yonghe, founder of the rare blood type Yonghe Rescue Team, told reporters.
Wei Xia was one of the lucky few who contacted a public welfare organization and got life-saving blood. However, what Wei Xia didn't know was that getting blood might not save his life.
"Anyone who needs to cross-match before a blood transfusion may not be able to transfuse even if the blood types are exactly the same. Panda blood is a very small group of people, and it will be more difficult for them to find matching blood," Wu Junyuan told reporters. Cross-matching is a method of mixing the serum and red blood cells of the donor and the recipient to observe whether agglutination response occurs. In other words, in order to transfuse blood, in addition to blood of the same blood type, it is also necessary to have blood that can be accepted by the patient's body.
"There was a blood donor who didn't donate blood because he stayed up late the night before and the aminotransferase was high. The donated blood has indeed reached the blood bank, but it will take two or three days to test it before it can be given to our patients. Jingjing said helplessly that blood must be tested before and after donation, even if the rh-negative blood volunteer has gone to the hospital's nearest Tongzhou blood donation truck to donate blood, her father can only continue to wait.
Wu Junyuan told reporters that what makes hospitals and doctors feel embarrassed is the storage time and utilization of blood, platelets are generally stored in the hospital for no more than 24 hours, and suspended red blood cells can be stored for several days, but the time is not long. Most of the clinical blood is still linked to the blood bank to adjust blood, Rh-negative blood emergency transfusion is relatively rare, if the blood in the hospital storage of these days no patients need blood transfusion, then the time can not be used for a long time.
Little-known blood type
"I used to donate blood, but I didn't know I would be, and I didn't think my family would be." Wei Xia described to reporters his first impression of panda blood. Little known is another difficulty faced by the panda blood population.
Xiao Fu (pseudonym) from Henan told reporters that her father-in-law was Rh-negative blood type A, which their family only knew when their father-in-law was admitted to the hospital. "It was originally ischemia, and after the blood was found, his pancreatic cancer had metastasized and spread," Xiaofu recalled, when she had gone to the hospital to open the hospitalization list, but because of the slow blood matching process of rare blood types, the operation that could have been hospitalized for a few days was delayed for nearly a month. Later, the father-in-law was operated, and the operation was not carried out thoroughly, and the condition was still delayed. Xiao Fu said, "After learning that my father-in-law belonged to the panda blood group, the family still did not specifically check the blood type."
Some netizens launched a discussion about "why many people in China do not know their blood type". Some people in the comments said that although the blood type is a kind of identity classification and recognition, it is not like the height and body shape, and it is impossible to intuitively "draw conclusions by looking in the mirror"; some people say that "I have not experienced surgery for decades, nor have I donated blood, so I have no opportunity and motivation to know"; and some people have issued the question of "why not check the household registration book", and the reply is "there is a blood type column, but my account is blank" or "My account book is not"...
Wu Junyuan suggested that everyone should make precautions, understand their body, and minimize exercise that may cause bleeding disorders. Especially for people with rare blood types such as Rh-negative blood, if they are engaged in high-risk industries such as high-altitude work, or athletes who need to exercise strenuously, they should know their blood type and avoid the surprise caused by emergencies.
Liao Zhaoping suggested that at present, most of the discoveries of Rh-negative blood personnel are found in the process of unpaid blood donation or in the process of diagnosis and treatment and health examination in medical institutions, and the importance of their clinical blood may not be paid attention to due to insufficient publicity, which will cause potential difficulties for subsequent blood use. It is recommended that the blood center register the screened Rh-negative blood personnel, and publicize their unpaid blood donation, so as to develop into a fixed unpaid blood donation team; medical institutions will publicize and inform the clinical blood and unpaid blood donation policies for the screened Rh-negative blood personnel.
The whole people check blood type and establish a database
"Panda blood is very scarce and precious, and once a person with an Rh-negative blood type needs a blood transfusion on their own, it is sometimes difficult to find a suitable blood type." Jia Dacheng, head of the emergency science popularization team of the Health Communication Working Committee of the Chinese Medical Doctor Association, told reporters.
Jia Dacheng suggested that measures of "national blood group check" can be taken to establish a blood group database in blood centers across the country, and to establish a special database for Rh-negative blood group groups, which can be prepared at any time. In addition, networking of hospitals with blood centres and the identification of blood groups after the birth of newborns and the entry of blood group databases can be taken. In addition, you can add a blood type to the medical insurance card and driver's license, and you can also consider adding blood type information to the ID card, but only public security personnel can view it.
According to Article 10 of the "Technical Specifications for Clinical Blood Transfusion" promulgated by the former Ministry of Health, for patients with Rh (D) negative and other rare blood types, self-transfusion and homotype transfusion should be used. Article 15 shows that when emergency rescue patients are given emergency blood transfusions, Rh blood group examinations can be dispensed with, which means that in an emergency, some panda blood group patients can transfuse Rh-positive blood for the first time. However, when a patient receives Rh-positive blood for the second time, a hemolytic reaction occurs, and it will have a certain impact on female fertility.
On March 21, 2020, a study published in the top international journal Science Advances showed that the successful development of "universal panda blood" was jointly completed by Tang Ruikang, a professor in the Department of Chemistry of Zhejiang University, and Wang Ben, associate professor of the Second Affiliated Hospital of Zhejiang University School of Medicine/Institute of Translational Medicine.
According to Professor Wang Ben, clinical trials of universal panda blood are still being actively planned. "We expect to complete preclinical tests and clinical trials within 3-5 years under the condition of smooth funding and manpower support, and truly allow patients in panda blood populations to use universal panda blood after 5 years." Wang Ben said.
Wang Ben suggested that a database of individual blood type categories in the population from birth should be established, and each individual should be allowed to fill in more scenarios like gender. At the same time, the blood group system of the population is established through the big data platform, and the emergency help and response system is established through the Internet.
Liao Zhaoping suggested that a long-term mechanism for unpaid blood donation be established. Comprehensively and systematically publicize the "Blood Donation Law" in a more in-depth manner, improve citizens' consciousness of unpaid blood donation, and establish a fixed unpaid blood donation team; actively publicize the rights enjoyed by unpaid blood donors, improve the policy care of unpaid blood donors; reduce the clinical blood costs of unpaid blood donors and their relatives, and establish a convenient blood fee reduction system. Standardize the rational use of blood in clinical practice. Strictly grasp the guidelines for blood transfusion, and actively promote new concepts and technologies for rational and economical use of blood. Increase the translation of basic blood research into clinical applications. By preparing universal "O-type red blood cells", sufficient blood resources are provided.
Weekly campaigns for unpaid blood donations. Rare blood type Yonghe Rescue Team courtesy of the image.
After finding out that her father was panda blood, Jingjing's family also went to check the blood type and experienced a life-and-death separation from her father, jingjing only hoped that in the future, if the family urgently needed blood transfusions, she could become a beneficiary of help.
Wei Xia, who has panda blood, regrets that he cannot donate blood to his mother, and also hopes to help more panda blood people who are in urgent need of blood transfusions. "I can do whatever I want if needed". After a pause of a few seconds, Wei Xia said firmly again, "Now, I think I can." ”