Family Health Magazine
FAMILY MEDICINE
Blood Transfusions
Questions and answers about blood products
A transfusion is the injection of a blood product through a needle inserted into a patient’s vein. Many blood products are made by Canadian Blood Services (CBS) from human blood donated by volunteers across Canada. Commonly transfused blood products are red cells, platelets and plasma.
Why are transfusions needed?
Blood and blood products are given to patients who have specific medical needs. Patients are encouraged to ask their doctor questions about transfusions. Blood and its products are chosen to replace what has been lost because of disease, injury or due to surgery. Remember, receiving blood products when they are needed can save a life.
What can be transfused?
- Red blood cells carry oxygen from the lungs to the body’s vital organs such as the heart. A red cell transfusion may be necessary to prevent organ damage caused by a lack of oxygen. Currently there is no proven substitute for blood if it is needed quickly.
- Platelets are blood cells the body requires to form a blood clot and prevent or stop bleeding at the site of an injury. A platelet transfusion may be needed if a person’s platelets are at a low level or if they are not working properly.
- Plasma is the clear liquid part of the blood. There are many dissolved substances in the plasma, and clotting proteins are among the most important. A plasma transfusion may be needed to prevent or to help stop bleeding that has started because levels of clotting factors are too low.
- Blood products can be made from plasma. Plasma may be further separated into a number of blood products that can be used to help blood clot, prevent infection or preserve blood volume.
What are the risks of transfusion?
The risks of transfusion range from common minor reactions to very rare but life-threatening reactions or problems. Severe reactions might be caused by transmission of infection or transfusion of incorrect blood. Reactions and problems include:
- Allergic reaction is common and usually mild. Some patients experience itching or a rash. Most allergic reactions are easily treated by a doctor. Severe allergic reactions, such as breathing problems, are rare.
- Fever reaction is uncommon and usually occurs during or shortly after a transfusion. Symptoms may include fever, chills or flushing. People who have had a fever reaction with a transfusion in the past should tell their doctor. Steps can be taken to prevent a similar reaction from happening again.
- Hemolytic reaction, a serious and sometimes life threatening reaction occurs when a patient’s blood destroys transfused blood cells. It can result in kidney failure. Fortunately, such reactions are rare. Hemolytic reaction is usually caused by transfusion of an incorrect blood product. Blood is carefully tested for blood type by the Transfusion Services Laboratory and identified by the health care worker at the bedside, to ensure it is the correct blood product for the patient.
- Infection has been made less likely thanks to several processes Canadian Blood Services uses to ensure the greatest possible safety. Canada’s blood supply comes from volunteer donors. In addition to a questionnaire, donors are screened and individually interviewed by Canadian Blood Services nursing staff before each donation. Every donation is tested for hepatitis, HIV (the virus that causes AIDS), and other infectious agents. As of July 2003, testing has included West Nile Virus. While testing reduces the chance of catching an infection from a blood transfusion, this risk cannot be completely eliminated. Patients are urged to discuss the risk of infection with their doctor.
What are the risks of not having a transfusion?
Red blood cells carry oxygen in the blood to vital organs such as the brain and heart. A decrease in oxygen could result in damage these organs. Platelets and plasma help blood to clot. Without these cells, excessive bleeding can result, causing a dangerous loss of red blood cells. The point at which transfusion becomes necessary varies from case to case.
Are there choices other than a blood transfusion?
In certain circumstances, medication can be used to help avoid the need for blood or blood products. A patient should ask their doctor about this possibility. Iron and certain vitamin supplements, such as folic acid or vitamin B12 injections, may be helpful. A synthetic blood-forming hormone, called erythropoietin, may also help in very special circumstances.
Can I use my own blood or blood from someone in my family?
- Autologous donation is the collection of a patient’s blood for use by that person in a future transfusion. Blood collected before surgery can be stored for up to 35 days. The surgeon helps the patient make this decision. Travel to a larger centre may be necessary for autologous donation.
- Directed donation is the process where a specific donor’s blood is assigned to a specific patient. Patients with rare blood types, bone marrow transplant patients and minor children may qualify to receive blood from this program. Directed donation is not routinely available. The doctor can arrange a directed donation if it is considered appropriate.
Can I go online and find more information about blood transfusions?
Information on the benefits and risks of blood transfusions is updated often. Current information related to transfusion risks, including the risk of transfusion-related West Nile Virus infection, can be found on several web sites.
Canadian Blood Services
www.bloodservices.ca
Calgary Health Region
www.calgaryhealthregion.ca (use search for “blood transfusion”)
Pat Letendre Consulting - Transfusion Complications
www.patletendre.com/tm-reading-complications.html
Alberta Clinical Practice Guideline Program
www.albertadoctors.org (use search for “blood transfusion”)
Alberta Health and Wellness
www.health.gov.ab.ca
www.cha.ab.ca
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specifid medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physican promptly. Copyright 2006, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 2S6 [FM_FHb04]
