In present therapeutic trial on blood transfusion, 16 cattle positive for haemoprotozoan infection and having Hb<5 gm/dl and HCT<15 per cent were included.
Divers (2005) opined that serious haemorrhagic or haemolytic disorder and euvolemic cattle with Hb<5 gm/dl (approximately 15 per cent HCT) should be considered at risk for having inadequate oxygen carrying capacity and tissue hypoxia.
Balcomb and Foster (2014) recommended whole blood transfusion when the HCT decreases to <15 per cent- 20 per cent in cases of acute blood loss or <10 per cent to 15 per cent in cases of chronic anaemia. A haematocrit value of 12% or less following an acute episode of anaemia is considered as “critical”. Myocardial oxygenation is compromised at Hb < 5 g/dl (HCT 15 per cent), increasing the risk of tissue hypoxia.
Briggs (2014) reported that blood transfusion in cattle is indicated on priority when there is severe anaemia with HCT< 10 per cent to save the life as well as in moderate anaemia with HCT< 15 per cent to hasten the recovery. Earlier
Hunt and Wood (1999) suggested that cattle having less than 12 per cent HCT with clinical signs of a significant anaemia should be considered at risk for having inadequate oxygen carrying capacity and tissue hypoxia and requires immediate blood transfusion. Several clinicians attempted to identify a reliable, consistent threshold for initiation of a blood transfusion termed as the transfusion trigger. Haematocrit value (HCT) and haemoglobin (Hb) concentration are important transfusion indicators in haemolytic disorders but should not be considered as the sole transfusion trigger measurement. Euvolemic humans with Hb concentrations < 7 gm/dl are generally considered in need of transfusion. Because normal HCT concentrations are higher in humans than cattle, this trigger value may be lower in cattle
(Herbert et al., 2005). A far more important indicator for transfusion is the presence of tachycardia or an ever-accelerating heart rate >110 beats/minute in bovine.
The comparative efficacy of standard treatment without blood transfusion (group A) and with blood transfusion therapy (group B) was evaluated in 16 clinical cases of severe haemolytic anaemia (Hb <5 gm/dl) due to haemoprotozoan diseases in cattle based on recovery rate, recovery period and improvement in haemato-biochemical parameters. The clinical signs such as appetite, water intake, haematuria, mucous membranes (Fig 1, 2) and body condition (Fig 3, 4) were improved rapidly in group B as compared to group A. In transfused animals (group B), appetite and water intake improved immediately after transfusion. Recumbent animals stood up during or immediately after whole blood transfusion (Fig 5, 6). Similar observations were recorded by
Pradhan et al., (1993) who performed whole blood transfusion in cattle (Hb<6 gm/dl) suffering from haemoprotozoan infections.
Saritha et al., (2016) also performed whole blood transfusion in a calf having anaemia (3 gm/dl) due to iron deficiency and parasitism and uneventful recovery was recorded.
Kachhawa et al., (2016) also observed good improvement in theileriosis affected calves treated with standard treatment and single blood transfusion.
The physiological values of body temperature, pulse rate, respiratory rate and ruminal motility (Table 1) showed highly significant (P<0.01) changes and restored progressively to normal after standard treatment along with whole blood transfusion (group B) as compared to group A cattle (Table 1). Similarly,
Kachhawa et al., (2016) observed significant decrease in body temperature, heart rate and respiratory rate after treatment with whole blood transfusion. The clinical improvement noticed may be due to restoration of oxygen carrying capacity owing to replenishment of cellular components (
Prathaban, 1986;
Divers, 2005;
Kachhawa et al., 2016; Chand et al., 2017).
The haematological values improved in both groups (Table 1 and 2) but the comparative analysis of values revealed highly significant increase in Hb and HCT values in group B as compared to group A during the course of treatment. At 12 hours of treatment in group A, the Hb and HCT values reduced by 0.24 gm/dl and 0.18 per cent, whereas in group B the same values increased by 0.45 gm/dl and 1.39 per cent, respectively indicating beneficial effects of whole blood transfusion therapy. This suggested that administration of 1050 ml of blood to adult cow resulted in net increase in HCT by 1.39 per cent. Similarly,
Soldan (1999) mentioned that the administration of 1000 ml blood to adult anaemic cow raised HCT by approximately 0.75 per cent.
Hunt and wood (1999) reported that in small animals 2.2 ml/kg of blood elevated HCT by 1 per cent having donor HCT> 40 per cent. Whereas 3 ml blood per kg body weight of recipient is required to get comparable increase in HCT as bovine donors have lower HCT than 40 per cent. On 21
st day of treatment in Group A, Hb and HCT values were increased by 2.44 gm/dl and 6.42 per cent, whereas in-group B the same values increased by 4.10 gm/dl and 10.36 per cent, respectively suggesting significant restoration in Group B cows as compared to Group A cows.
Kachhawa et al., (2016) recorded significant improvement in Hb, HCT, total erythrocyte count and total leukocyte count after treatment with single blood transfusion in
Theileria affected calves having anaemia (<6 gm/dl). In both groups, the improvement in Hb, HCT and TEC values may be attributed to cessation of intravascular haemolysis and oral supplementation of haematinics. However, the marked improvement in Hb, HCT and TEC values in group B could be attributed to replenishment of RBC’s through whole blood transfusion.
Highly significant (P<0.01) increase in total plasma proteins, albumin, globulin and highly significant (p<0.01) decrease plasma total bilirubin, direct bilirubin, indirect bilirubin, urea nitrogen, creatinine showed rapid improvement in transfused (group B) cows as compared to group A. The present observations corroborate the findings of
Kachhawa et al., (2016) who observed significant (P<0.01) improvement in total protein, albumin and globulin values after treatment with single blood transfusion in Theileria affected calves. These findings indicated restoration of liver and kidney function due to cessation of intravascular haemolysis.
The survival rate was significantly higher in group B cattle received standard treatment along with whole blood transfusion (100 per cent) as compared to group A cattle (62.5 per cent). This could be attributed to improvement in oxygen carrying capacity of blood due to replenishment of RBC’s owing to blood transfusion. It can also be concluded from present study that even transfusion of small quantity of blood in critically anaemic patient is lifesaving. Further, it was surprising to note that 62.5 per cent critically anaemic cattle survived without blood transfusion. These findings support the opinion of
Divers (2005) who reported that ruminants that have very low hematocrits but appear relatively comfortable and have adjusted to their anaemic condition may survive without transfusion.
In current study no adverse reaction to blood transfusion was noticed in any of the transfused animals, although out of 8 recipients, 7 were crossbred cows and one was Deoni male whereas among 8 donors 7 were Deoni cattle and one Red Kandhari cattle including 2 male and 6 females. These observations suggests that first transfusion is safe in cattle irrespective of breed and sex. However,
Soldan (1999) mentioned that donor and recipient from the same breed reduces the risk of a transfusion reaction.
Major and minor cross-matching of blood from all 8 donors and recipients revealed no signs of incompatibility. Before transfusion cross-matching of recipient and donor blood should be carried out to minimize the risk of transfusion reaction
(Choudhary et al., 2017). Cross- matching is similar to blood typing, except that specific antisera are not used and consists of a major and minor part. The major cross-matching involves the cross-matching of donor RBCs with recipient serum, whereas, the minor matching is the cross- matching of recipient RBCs with donor serum. The major cross match detects antibodies previously present in recipient serum and
vice versa in minor cross match. However,
Smith (2002) opined that generally first transfusion is safe in cattle even if done without cross-matching due to absence of naturally occurring alloantibodies.
Divers (2005) also mentioned that cross-matching is not required for first transfusion in cattle because of the likelihood of a reaction during first transfusion is low in cattle. It is possible that J positive donor cells transfused into J negative recipients might cause reaction on first transfusion because cows with J-negative antigen on the RBCs may have J antibodies.
Stormant (1982) stated as anideal donor cow should have J-negative RBCs, but cattle have minimal agglutinating antibody and cross-matching is of little benefit in predicting a transfusion reaction in cattle. Blood typing and examination of plasma for alloantibodies of both, donor and recipient are ideally required before transfusion but this is not feasible in cattle. Cross-matching is performed to safeguard against any transfusion reaction but it is not 100 per cent safe. The cross-matching detects only antibodies to red blood cells and not to white blood cells and platelets, therefore immunogenic transfusion reactions can occur even after cross-matching
(Chand et al., 2017). Hunt and Wood (1999) reported that bovine blood has 13 major types of blood group systems. Of these, anti-J isoantibodies are the most important. In ruminants, these isoantibodies are present in very low quantities in serum. Thus, initial blood transfusions can be done without matching blood types and without serious threat of fatal reaction. Compatibility tests should only be necessary if the animal is known to have been previously transfused.
