Nigeria must adopt modern blood management systems, says expert

The Zonal Director of the National Blood Service Agency (NBSA), South West Zonal Centre, Ibadan, Dr Oladapo Aworanti, has urged Nigerian healthcare practitioners to embrace modern, evidence-based transfusion practices to reduce preventable deaths linked to blood shortages and unsafe transfusions.

Aworanti made the call while delivering a lecture titled “New Concepts in Blood Transfusion Practice” at the June Continuing Medical Education (CME) programme of the Association of Nigerian Private Medical Practitioners (ANPMP) in Ibadan.

The Consultant Haematologist described blood transfusion as the “vein-to-vein transfer of blood or blood components from a donor to a recipient”, stressing that despite its lifesaving importance, it remains a procedure “always associated with some level of risk”.

According to him, errors at any stage of the transfusion chain—particularly during blood grouping, sample identification, or compatibility testing—can result in life-threatening complications.

Aworanti expressed concern over Nigeria’s persistent blood deficit, noting that demand continues to far exceed supply.

He cited estimates showing that Nigeria requires about 1.5 million units of blood annually but collects only about 500,000 units, describing the shortfall as “dangerously wide”.

“Less than one in three patients who require blood transfusion in Nigeria actually receive it,” he said, adding that children account for about 65 per cent of transfusion needs across Africa.

He further noted that voluntary, non-remunerated blood donation remains extremely low in Nigeria, with a significant proportion of donations still coming from family replacement and paid donors.

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Highlighting one of the key innovations in modern transfusion practice, Dr Aworanti advocated the adoption of Patient Blood Management (PBM), which he described as an evidence-based, multidisciplinary approach that seeks to improve patient outcomes by preserving and optimising a patient’s own blood rather than relying heavily on donor transfusions.

He explained that PBM is built on three pillars: optimising red blood cell production, minimising blood loss during medical and surgical procedures, and improving patients’ physiological tolerance to anaemia.

According to him, contemporary medical practice now favours restrictive transfusion thresholds based on a patient’s age and clinical condition, rather than routine liberal transfusion.

Aworanti also warned against unsafe transfusion practices still prevalent in some healthcare facilities, including transfusions carried out without proper baseline evaluation, reliance on rapid test kits alone, and the division of blood units among multiple patients.

Such practices, he said, significantly increase the risk of transfusion reactions and the transmission of infections.

“Blood must be treated as a scarce and highly regulated resource. Any deviation from standards puts lives at risk,” he warned.

The haematologist also highlighted evolving transfusion options for patients such as Jehovah’s Witnesses, who traditionally decline donor blood on religious grounds.

He noted that the growing acceptance of autologous procedures—in which a patient’s own blood is collected, stored, and later reinfused under controlled conditions—provides an alternative pathway that respects patients’ beliefs while supporting clinical care.

Aworanti further underscored the increasing role of automation and artificial intelligence in transfusion medicine, including blood inventory forecasting, compatibility matching, and monitoring transfusion reactions.

He added that advanced technologies such as pathogen-reduction systems and blood substitutes are gaining traction globally, although their availability in Nigeria remains limited.

The NBSA director, however, called for stronger public enlightenment campaigns and greater institutional support for voluntary blood donation, urging stakeholders to prioritise donor recruitment, retention, and education.

“The future of safe transfusion depends on voluntary donors and strict adherence to standards,” he said.