Facts You Must Know About Blood Transfusion
Authored by Dr.Pawan Kumar Singh
Most of us may experience the transfusion of blood as a donor or as a recipient at some stage in our lives. Hence it is important to be aware of the blood transfusion procedure to be better equipped in case of a situation where we have to experience it ourselves at some point in our lives. Blood transfusion is a process in which blood products are transfused into the body intravenously to replace lost components of blood such as blood plasma, red blood cells, white blood cells, blood platelets. It refers to the administration of donated blood to patients who need blood. Blood transfusion is needed when a person’s own blood level falls below the normal range due to any of the following reasons: • Blood loss during accident/surgery • Underlying medical condition like cancer Abnormal levels of any of the following blood component may create the need for transfusion: • RBCs
Platelets • Plasma • Cryoprecipitate Who can donate blood to whom? Any healthy adult (18+ years), can donate blood; but it can only be given to the person to whom it is compatible. The compatibility is determined mostly by the blood group of the donor and the recipient. So, it is important to know the criteria which decide the compatibility of the donor and the recipient. Types of Blood group and criteria for transfusion Types of blood groups are A, B, AB, or O, it can be either Rh-positive or Rh-negative. That means, if you have type B blood it may be either B positive or B negative. So it is also important to match this Rh-factor (+/-) and the blood type of donor and recipient for successful blood transfusion. In the case, it is not matching then transfusion should be avoided, because if transfused, antibodies of the recipient’s body may attack the new blood cells from transfusion and may lead to severe complications. There are some exceptions to matching of the blood group: • Universal Donor (O-blood group): Can donate to anyone • Universal Recipient (AB-blood group): Can receive blood from all types of blood group (A, B, AB and O) Along with the blood type, it is also important to receive blood group with matching Rh-factor. If the recipient has Rh-positive blood, he/she can get Rh-positive or Rh-negative blood of a compatible type. But if the recipient has Rh-negative blood, she/he can only get the Rh-negative blood. However in emergency Rh-positive blood can be given to Rh-negative persons especially in the elderly case. What are the potential benefits of a blood transfusion? Insufficient level of blood in the body may lead to serious health complications. Transfusion of desired blood components at the right time provides the following benefits: • RBCs carry oxygen and circulate it to vital parts of the body. • Platelets/cryoprecipitate controls bleeding. • Plasma controls bleeding and replace deficient blood factors. •
When is a blood transfusion needed? • Red blood cells transfusion: Is needed when a patient who has insufficient RBCs due to blood loss during surgery, in an accident, or RBCs have been destroyed due to any disease. • Platelet transfusions: Is required when a patient is at risk due to excessive bleeding with low platelet count. • Plasma transfusions: As plasma is composed of albumin, immunoglobulin’s, and clotting factors, it is transfused in to the patients who require these components. ·What tests are done on the blood before transfusion? Blood donated is always tested to detect the following: • Infections: o Hepatitis B and C o Malaria
HIV/AIDS o Syphilis • Blood group: o ABO group o Rh type • Cross-match test: To check RBCs for compatibility reactions in a donor’s and recipient’s blood. What are the risks of being transfused? If transfused according to protocol, blood transfusion is often very safe. Exceptionally, it may lead to the following health issues: • Bacterial infection • Anaphylaxis, a serious allergic reaction. • Hemolytic reaction due to destruction of donor’s or recipients’ red blood cells. • Viral infections • Itchy rashes • Chills and fever o
Are there any alternatives? As on today, there is no alternative to blood transfusion. However, if your own blood level has not dropped down and can’t be treated, the doctor may prescribe some medication to help your body make its own blood. Anticoagulant drugs: If the cause of dropped blood level is excess bleeding, then it can be prevented and stopped using certain medications. What to expect during the transfusion? • The blood pressure, pulse, and temperature will be checked • The blood will be injected in your body through veins. • Again the blood pressure, pulse and temperature will be checked during the transfusion after 15 minutes and repeated when the blood transfusion is done. • Blood should be transfused within 30 minutes from the receipt of the blood from the blood bank and then it should be completed within 4 hours. However in certain situations it can be prolonged. What should be done post-transfusion? After the transfusion, proper rest is advised. Over-exertion for at least two days post transfusion is best avoided. Reach out to your doctor immediately if any of the following symptoms are seen after the blood transfusion: • Excessive bleeding • Abnormal pain at the IV site • Severe back pain or chest pain • Fever and chills • Nausea • Vomiting
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Itchy rashes Headache Dizziness Cold Increased heartbeat Difficulty in breathing Wheezing Abnormally dark or reddish urine Yellowing of the skin and / or eyes
Note: • Blood transfusion or blood components are only given when the benefits outweigh the risks. • If you refuse to have a transfusion when needed, it’s risky for your health. • Ask as many questions as you need to ensure you are making the right choice.