Трансфузиолог

Трансфузиолог – the doctor whose specialization are diseases of blood and plasma of the person.

Transfusiology quite young section of medicine which studies questions of mixing of the biological and replacing them liquids (blood, its components, a lymph).

A founder of this direction is the doctor William Garvey who at the beginning of the 17th century in England made the first attempt of hemotransfusion on the basis of the opening about blood circulation in a human body. Already by the end of the 18th century in America the first transfusion of blood from the person to the person was carried out, and a referral of medicine was got by the name transfusiology ("transfusio" – transfusion, "-a log" – I report, I speak, I tell).

Where doctors of transfusiology work

Doctors of transfusiology are demanded in various large medical clinics, medical research institutes, and also in many military medical institutions. Today transfusiology actively practice in departments of hemotransfusion, offices of transfusion therapy, departments of transfusiology and in departments of gravitational surgery of blood.

For functioning of this medical direction the service of blood which main objective is not only preparation and storage of blood and its separate components, and also development of methods of inspection of donors is created.

Also doctors of transfusiology work in such latest directions of medicine as selection, preparation and storage of stem cells that does this profession very perspective because of rapid development of this direction of medicine.

One more area of work of transfuziolog is extracorporal haemo correction which is directed to modification of components of blood out of the patient's organism. The purpose of the doctor of a transfuziolog in this direction is change of properties of blood or removal of pathological substances which cause or support a disease.

Extracorporal haemo correction is carried out transfuziology by means of a plasma exchange which quite widely is applied and consists today parts of plasma with the toxins dissolved in it, the end products of a metabolism and fragments of molecules showing physiological aggression at a distance.

Doctors of transfusiology develop also more difficult clinical technologies which are actively developing recently, for example, the selection sorption of specific proteins.

Main areas of work of the doctor of a transfuziolog

It is possible to allocate two main areas of work of transfuziolog:

• The doctor who deals with issues of preparation and inspection of blood. The main place of its work is blood transfusion stations;
• Clinical трансфузиолог, working directly in medical institutions and providing transfusion therapy.

Both directions demand from the doctor in addition to professional knowledge and skills the increased attentiveness, responsibility and ability to concentrate in practice as often the patient's life depends on work of the doctor of a transfuziolog.

The doctor трансфузиолог, working in medical institutions, has to be able to carry out different types of a hemotransfusion:

• Autohemotrasfusion at which the patient at the same time acts as both the donor, and the recipient of blood, and also its components;
• The intraoperative reinfusion based on blood sampling which streamed in a cavity (a small pelvis, chest, belly) during operation with the subsequent washing of erythrocytes and their return to a blood channel;
• Indirect hemotransfusion at which in the course of transfusion preservatives and stabilizers are used that gives the chance to prepare a large number of components of blood for long storage;
• Direct hemotransfusion at which without stabilization and conservation there is direct hemotransfusion from the donor to the recipient;
• Exchange hemotransfusion at which infusion of donor blood with blood sampling of the recipient is at the same time carried out. Such method is most often used at such states and diseases as a massive intravascular hemolysis, hemolitic jaundice of newborns and at a serious poisoning.

At hemotransfusion the doctor transfuziology various complications quite often develop, namely:

• The syndrome of a tissue incompatibility connected with reaction of an organism of the recipient to the entered foreign protein that, as a rule, occurs at incompatibility of blood of the donor and recipient on one of immune systems;
• The syndrome of massive hemotransfusions arising usually at the large volume of the transfused blood;
• The syndrome of homological blood which is characterized by disturbance of transcapillary exchange and microcirculation, happening because of the increased viscosity of blood and obstruction of capillaries microunits of thrombocytes and erythrocytes;
• Transmission syndrome which is characterized by transfer of infections and other disease-producing factors from the donor to the recipient.

The main danger which constantly face transfusiology is connected first of all with infectious diseases. In spite of the fact that the biological material received from donors carefully is checked, many infections have long stage of latency. Development of new and more effective methods of inspection of donors of a transfuziologama which would exclude transmission of infection and also implementation of modern methods of an inactivation of the contagiums circulating in blood is one of the most priority tasks in this direction of medicine.

One of the recent world trends in transfusiology is the gradual refusal of transfusion to recipients of plasma which is received from blood of female donors in which the antileukocytic antibodies causing acute respiratory insufficiency quite often circulate. These tendencies also have to be considered during the work of the doctor of a transfuziolog.

How to receive a profession of the doctor of a transfuziolog

The profession of the doctor of a transfuziolog is quite popular among young specialists in connection with prospects of development of the direction connected with stem cells today. For receiving primary specialization in transfusiology it is necessary to have the higher medical education after which it is necessary to pass an internship or an internship in a therapy, surgery or anesthesiology resuscitation.

As the transfusiology is dynamically developing science in which discoveries are made today and information as about therapeutic, and possible side effect of hemotransfusion and its components is constantly updated, the doctor трансфузиолог has to watch this new knowledge.