2nd Edition 

Practice of Safe Blood Transfusion


By Dr. (Prof.) R. N. Makroo,
M.B.B.S.; D.I.B.T., M.D. Director & Sr. Consultant,
Transfusion Medicine, Molecular Biology & Transplant Immunology


A one stop source of in-depth and detailed information on the subject of Transfusion Medicine






Dr. Promila Gupta
MBBS, M.S.(Ophtal.) Director General of Health Services
GOVERNMENT OF INDIA Directorate General of Health Services
446, A-Wing, Nirman Bhawan, New Delhi – 110108


Dr. Jagdish Prasad (Director General of Health Service)
Government of India Ministry of Health &
Family Welfare Directorate General of Health Service
Nirman Bhawan, New Delhi-110108


Dr. Surinder Singh, MBBS. M.D. Director
Ministry of Health & Family Welfare, Government of India
A-32, Sector - 62 (Institutional Area) NOIDA - 201309 (U.P.) – INDIA
Phones: 0120 - 2400022, 2400072, Fax: 0120 - 2403014, 2400074
E-mail: Website:



Dr. V. G. Somani
Joint Drugs Controller (India)
Central Drugs Standard Control Organization Ministry of Health & Family Welfare,
DGHS Government of India FDA Bhawan, Kotla Road, New Delhi-02






Dr. (Prof.) R. N. Makroo
President Indian Society of Transfusion Medicine, New Delhi


Transfusion Medicine is an ever evolving and dynamic branch of medical sciences. It came into existence with the landmark discovery of ABO blood groups by Karl Landsteiner in 1900. With significant contributions from Levine and Stetson describing the hemolytic disease of the newborn in 1938, Carl Walter developing of the plastic bags for component preparation in 1950, and the understanding of practical application of apheresis in the 1970’s; we have come a long way. Immunohematology and Regenerative Medicine have cropped up as important branches of Transfusion Medicine, wherein the understanding of cell membranes, genes, and molecular biology, combined with fundamental knowledge of the immune system is extrapolated into laboratory bench serology to make safe blood and blood components available for patients.

Having being associated with the Indian transfusion arena for over 4 decades, I have seen it blossom from a tiny seedling into a fruit bearing tree. In all these years I have always felt the need for a standard textbook from authors in this part of the globe that embodies relevant knowledge and experiences. The 1st edition of Principles and Practice Transfusion Medicine was an endeavor towards providing transfusionists and clinicians an insight into the fascinating world of transfusion. Now, the second edition of this book gives an update on recent advances and evolving concepts of blood transfusion. As I conceptualized this book, deliberate attempts have been made to keep the text simple and lucid. Most of the information has been provided in a reader friendly format. Questions for Self Assessment have been incorporated at the end of each chapter for the benefit of the readers. The book lays emphasis on “Blood Safety” and provides an in depth analysis of methods that can be employed to ensure a safe blood supply. The importance of appropriate and rational use of blood & blood products has been highlighted. The book is suitable for medical graduate and post graduation students, medical laboratory technicians, and even independent and distance learning courses for Blood Bank officers.

I am also thankful to all my colleagues and friends for their never ending inspiration and support, especially to Dr Soma Agrawal & Dr Mohit Chowdhry for their tireless efforts and invaluable assistance in penning and editing this book all through. I am grateful to my family who has always stood beside me in thick and thin.
I dedicate this book to my parents who always have and will continue to shower their blessings on me.
Dr. (Prof.) R. N. Makroo


CHAPTER 1 Historical Overview of Transfusion Medicine
CHAPTER 2 Physiology of Blood
CHAPTER 3 Basic Principles of Immunohaematology
CHAPTER 4 Blood Collection and Processing
CHAPTER 5 Preservation and Storage of Blood
CHAPTER 6 Blood Component Preparation and Therapy
CHAPTER 7 Apheresis (Haemapheresis)
CHAPTER 8 ABO Blood Group System
CHAPTER 9 The Rh Blood Group System
CHAPTER 10 Other Blood Group System
CHAPTER 11 Antiglobulin Test
CHAPTER 12 Antibody Screening and Identification
CHAPTER 13 Compatibility Testing (Pre Transfusion Testing)
CHAPTER 14 Transfusion Practice in Clinical Medicine
CHAPTER 15 Plasma Fractionation and Plasma Protein Solution (PPS)
CHAPTER 16 Transfusion Transmitted Diseases
CHAPTER 17 Blood Transfusion Reactions
CHAPTER 18 Haemolytic Disease of Foetus and New Born (HDFN)
CHAPTER 19 Quality Assurance In Blood Transfusion Services
CHAPTER 20 Cellular Therapies
CHAPTER 21 Special Methods
CHAPTER 22 Legislation on Blood and Blood Products
CHAPTER 23 Standards for Blood Banks & Accreditation
CHAPTER 24 Nucleic Acid Testing (NAT)
CHAPTER 25 Major Histocompatibility Complex
CHAPTER 26 Haemovigilance





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