Blockchain in Blood Donation (Part 56)
Welcome to the 56th part of the 100-part series on Blockchain.
Blood is the most precious gift one human being can give to another — it is indeed the gift of life. Since there is no synthetic blood available so far, somebody has to give his own blood to make it available for needy patients. Hence it is not incorrect to assume that blood transfusion is an indispensable component of health care. It contributes to saving millions of lives each year in both routine and emergency situations.
Blood transfusion makes it feasible to conduct increasingly complex medical and surgical procedures like organ transplants, chemotherapy, etc., which in turn, dramatically improves the expectancy and quality of life of patients suffering from a variety of acute and chronic conditions. Unfortunately, many patients still die or suffer because they don’t have access to safe blood transfusions.
Challenges in blood transfusion
The timely availability of safe blood is essential in all health facilities where blood transfusion is performed, but in many developing countries, there is a big mismatch between the demand and the availability of blood, and this shortage of blood forces the cancellation of many critical surgeries, risking the lives of many patients. Some of the key issues contributing to this problem are as follows:
(i) The primary reason for this issue is the lack of blood donors who regularly participate in the blood donation process. One of the reasons that many people don’t donate their blood regularly is the lack of transparency in how their donated blood is used later on. Imagine a scenario where a donor knows that his blood saved the life of a person; he would be more willing to donate his blood regularly versus a scenario where he doesn’t know what happened to his blood once he donated it.
(ii) On one hand, we have a shortage of blood donations, while on the other hand, a considerable number of the donations made go straight to the bin and are never used. The reason behind this is the short shelf life of blood. Blood has a shelf life period of 42 days. Hence the donated blood must be transfused within 42 days of its donation. In simple words, there is a need for an efficient system that can help to map the donations with the needy recipients so that the donations don’t go waste and people don’t lose their lives unnecessarily.
(iii) Apart from this, unsafe blood transfusions or contaminated blood transfusions account for HIV infections, other viral infections, and Syphilis infections in the patients receiving this contaminated blood. Moreover, this problem is highly prevalent in developing nations where there is less accountability and traceability of blood.
All of these problems in the current blood donation ecosystem exist because of the complex journey of blood from a donor to a receiver, which in turn, makes it difficult to track the blood.
Blockchain-based blood donation system
Blockchain can be a great solution for these issues existing in the current blood donation ecosystem. Now let’s understand how Blockchain can be implemented in the blood donation and transfusion process to make it more robust and transparent.
(i) In a Blockchain-powered blood donation ecosystem, when a donor goes for blood donation, his essential details, like age, identity proof, weight, medical history, etc., will be recorded on the distributed ledger. The blood collected from the donor will then be labeled with a unique identification number. This number can be scanned and tracked to find the donor.
(ii) In the next step, all of the blood collected from the donation venue will be transported to the blood center, where the donations will be sorted and registered on the Blockchain.
(iii) The donations will then be sent to the manufacturing area. In the manufacturing area, the donated blood is spun in a device known as a centrifuge, which separates the blood into transfusable components like red cells, platelets, and plasma. Each component is packaged as a “unit,” — which is a standard amount that doctors use while transfusing a patient. And each of these components has its own functions and advantages. For example
· A patient suffering from iron deficiency or anemia may receive red blood cells to increase his hemoglobin and iron levels, which in turn helps to increase the amount of oxygen in his body
· A patient whose body is unable to make enough platelets due to illness or chemotherapy may get platelet transfusions to stay healthy
· And plasma transfusions are used for patients with liver failure, severe infections, and serious burns
(iv) Before blood transfusion to a patient, nearly a dozen tests are performed on donated blood to establish the blood type and presence of any infectious disease like hepatitis, HIV, syphilis, Zika Virus, etc. Under the law, no blood can be released for transfusion without passing the required tests. But currently, in many developing countries, this is not practiced properly, and blood is released for transfusion without all the necessary tests done. Sadly, in the current system, there is no full-proof way for a doctor or a patient to know whether the blood has passed all the required tests. But once Blockchain is implemented, all of this data will be recorded on the digital ledger and will be linked back to the individual donor’s identification number labeled with at the donation center. This data will also be accessible to medical professionals looking for a specific blood type. With this system in place, the required blood type can be found quickly and almost in real-time, thus, saving lives by preventing delays in the critical treatments.
(v) Currently, once the blood has been tested and is deemed suitable for transfusion, it is stored as per the recommended conditions, which are as follows:
· Red blood cells are stored in refrigerators at a temperature of 6°C for up to 42 days.
· Platelets are stored at room temperature in agitators, required for stirring platelets for up to five days
· Plasma is frozen and stored in freezers for up to one year
Because different blood components have different shelf lives, it’s imperative that the labels on them match the individual donor and can be linked back to the donor at any given time. The blood is now ready for distribution to hospitals and to patients whose lives will be saved or sustained by this generous gift.
(vi) The donated blood meets its purpose when it finally reaches the right patient typically within the valid shelf life of the blood. Patients who require transfusion as part of their clinical management have the right to know that they are receiving safe blood. Blockchain technology, once implemented, can provide complete transaction history of every bottle of blood and can empower the patient to verify details of the blood being transfused to him/her.
(vii) The blood transfusion information of a specific unit of blood to a particular patient will also be recorded on the Blockchain in an immutable manner. With this complete end-to-end visibility, an automatic push notification can be sent to the donor when his blood is used to save another human’s life. Thus motivating more volunteers to donate blood more frequently as they will have the assurance that their donated blood is saving many precious lives.
Scalability concerns
(i) Blockchain used will be permissioned Blockchain. The entire information of the donor, blood group, components of blood, tests conducted, storage and transportation, doctors, etc., will be stored on IPFS, and its hash will be stored on the smart contract. All the stakeholders in the network can access the data based on the permissions they have been granted. IPFS has been explained in detail in Part 18.
(ii) To make the Blockchain scalable for its use in blood donation and other healthcare applications, layer 1 (discussed in Part 15) and layer 2 (discussed in Part 16) scaling solutions will be required to be implemented.
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