Aryabhatta Sadhu: Effective Hemotherapy Beyond Transfusion
Aryabhatta Sadhu, Attending Consultant and Head of Transfusion Medicine at Fortis Hospital Shalimar Bagh, New Delhi, shared a post on LinkedIn:
”Most hospitals still treat plasma as a ‘bleeding product.’
That is clinically dangerous.
FFP is not volume expansion.
It is not nutritional support.
And it is definitely not a reflex response to abnormal coagulation reports in a non-bleeding patient.
The deeper problem is that many coagulation decisions are still being made through habit rather than haemostatic reasoning.
A mildly deranged INR before a procedure?-‘Give 4 units FFP.’
Massive transfusion with ongoing dilutional coagulopathy? – Plasma delayed until the patient is already spiralling.
Liver disease with chronically elevated INR but preserved haemostasis? – Plasma given to ‘correct numbers.’
This is not evidence-based transfusion medicine.
This is institutional pattern repetition.
The irony is that inappropriate plasma transfusion is not a harmless excess:
- TRALI risk
- TACO
- unnecessary donor exposure
- inventory strain
- delayed access for patients with actual factor deficiency states
- and a false sense of haemostatic correction
Modern transfusion medicine cannot function as a product-dispensing specialty.
It has to evolve into a consultative discipline integrating:
- clinical haemostasis
- critical care physiology
- inventory stewardship
- and systems-level decision making.
Otherwise we will continue producing blood banks instead of transfusion services.”
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