BENGALURU: With technological advances, more safety procedures have been introduced in ensuring safe blood donation. A landmark decision adopted by the state government was to introduce nucleic acid testing (NAT). In 2011, it set up a NAT facility at Bowring and Lady Curzon Hospital here, where samples from all over the state are sent for testing.
The test can detect a virus in smaller window periods even before antibodies are detected by traditional serology screening methods. This prevents the spread of HIV/AIDS and hepatitis.
The state has 200 blood banks of which 160 are private where NAT is not mandatory. This is a debate that has come up time and again. One factor that deters private facilities from sending samples for testing is the cost.
The Karnataka Blood Transfusion Council has fixed the cost for NAT at Rs 1,002.25 for non-government blood banks although the National Blood Transfusion Council has fixed the cost at Rs 1,200 for the same. Whatever be the cost, it adds to the overall cost of the blood component.
Another factor is the scale. Dr Shivaram Chandrashekar, blood bank in-charge at Manipal Hospital, said, “While the government can test one lakh blood samples and give NAT-tested blood to its patients free of cost, private blood banks can test only 800 to 1,000 samples in a month. NAT will double the cost of everything else that is done in the blood bank -- grouping, antibody screening, cross-matching, cost of the bag, ELISA testing, etc. It will double the cost of blood.” Manipal Hospital provides for NAT testing of blood.
Bowring and Lady Curzon Hospital receives around one lakh samples every year for NAT testing. Dr K S Manjunath, medical superintendent of the hospital, said, “Even if it is Rs 1,000 extra, it is okay. Families spend that much for a movie in a multiplex. NAT helps in screening life-altering diseases.”
“Why can’t we have indigenous technologies to bring down the cost of the blood components from Rs 1,500 to Rs 400 or Rs 500?” asks Dr Shivaram.
Only two companies sell ID NAT (individual nucleic acid testing) technology and mini-pool NAT (when blood samples are pooled and tested instead of individually) technology. Grifols (formerly Novartis Diagnostics) is the only healthcare company in India that provides ID-NAT in partnership with Hemogenomics.
While all government hospitals from across the state, including specialty hospitals like NIMHANS and Kidwai Memorial Institute of Oncology, send their blood units for NAT testing to Bowring, the premier heart institute Jayadeva does not send its blood units for NAT testing. They cite logistics as a problem.
Dr C N Manjunath, director, Jayadeva Institute of Cardiovascular Sciences, said, “We have 13-15 open heart surgeries every day. We did a scientific analysis of 100 blood samples using NAT and fourth generation ELISA (traditional serology testing). The results are the same. We can’t wait for a day for the NAT results to come.”