Blood Transfusion: An overview

blood transfusion

Blood transfusion is a common and lifesaving medical procedure that is used to replace lost blood due to any injury, surgery, or illness. They can also be used to treat certain medical conditions such as anemia, which is a condition in which the body does not have enough red blood cells to carry oxygen to the body’s tissues.

Blood transfusion involves the transfer of blood or blood products from one person (the donor) to another person (the recipient). The donor can be a individuals whom you know, such as your friends or family members.

Also the blood can come from blood banks where the blood is collected from donors, typed, separated into different components, stored, and prepared for transfusion to recipients.

During a blood transfusion, blood or blood products are transferred into a person’s bloodstream through an IV.

Blood transfusion

Donor and Recipient role in blood transfusion

In a blood transfusion, the donor is the person who gives the blood and the recipient is the person who receives the blood.

1. Donor

  • Blood donors must be in good health and meet certain eligibility criteria set by the blood bank or blood collection organization.
  • Blood donors must pass a health screening and provide information about their medical history to ensure that their blood is safe to use.
  • Blood donors may be volunteers or may be paid for their donation.
  • Blood donors can give whole blood, or a specific component such as red blood cells, plasma, or platelets.

2. Recipients

  • Blood recipients usually require a transfusion because they have a medical condition that affects their ability to produce or maintain an adequate supply of blood cells.
  • Blood recipients must be a match for the blood they are receiving, meaning that the blood must be compatible with their blood type and other factors.
  • Blood recipients are closely monitored during and after the transfusion to ensure that there are no adverse reactions or complications.
Donor and recipient

Types of blood or blood products used in blood transfusion

There are several types of blood products that can be used for transfusion, including:

  • Red blood cells (RBCs): These are the most commonly transfused blood product and are used to treat anemia or blood loss.
  • Fresh frozen plasma (FFP): This is the liquid portion of blood that contains clotting factors. It is used to treat bleeding disorders or to replenish clotting factors in patients on blood thinners.
  • Platelets: These are small cells in the blood that help with clotting. They are used to treat patients with low platelet counts (thrombocytopenia) or to prevent bleeding in patients undergoing certain medical procedures.
  • Cryoprecipitate: This is a blood product derived from FFP that contains high levels of clotting factors. It is used to treat bleeding disorders or to replenish clotting factors in patients on blood thinners.
  • Whole blood: This is blood that has not been separated into its different components. It is rarely used in transfusions, but may be used in emergency situations to quickly replace blood loss.

It is important to note that the type of blood or blood product should only be given under the direction of a physician and after careful screening and testing to ensure the compatibility with the recipient.

Blood transfusion – Indications and Contraindications

1. Indications

  • Anemia or low red blood cell count due to bleeding, chronic disease, or surgery.
  • Blood loss from injury or trauma.
  • Hemophilia or other bleeding disorders that affect blood clotting.
  • Thrombocytopenia or low platelet count that can lead to excessive bleeding.
  • Certain types of cancer or bone marrow disorders that affect blood production..
  • Transfusion of plasma, platelets, or cryoprecipitate to replace clotting factors in patients with bleeding disorders or those on blood thinners.
  • Some surgeries, such as open-heart surgery or organ transplant, may require a blood transfusion as a part of the procedure.

2. Contraindications

  • Blood type incompatibility between the donor and the recipient.
  • Positive test results for certain infectious diseases such as HIV, Hepatitis B and C, or syphilis.
  • Severe allergic reactions to blood products or components in the past.
  • Some types of cancer such as leukemia, lymphoma, or multiple myeloma.
  • Autoimmune diseases such as lupus or rheumatoid arthritis.
  • Person with blood clotting disorders.
  • Acute hemolytic reactions.
  • Blood pressure elevation or heart related problems.
  • Some other medical conditions that may be contraindicated for blood transfusion as per the opinion of the treating physician.

Precautions and points considered before Blood transfusion

Before a blood transfusion can take place, the blood must be screened for various diseases and conditions. This is done to ensure the safety of the blood, and to prevent the transmission of infections such as HIV, hepatitis, and syphilis.

Blood donors must meet certain criteria, such as being in good health, and must pass a screening process that includes a physical examination, blood tests, and some questionnaire.

The transfusion process is typically done in a hospital or medical facility and is performed by a trained healthcare professional. The procedure is generally considered safe, however, like any medical procedure, there is a small risk of complications. Some of the possible risks associated with blood transfusions include infection, adverse reactions to the blood, or an allergic reaction.

Blood transfusion reactions and side effects

There are several potential blood transfusion complications that can occur due to blood transfusion. It can happen at the time of blood transfusion or post completion of the blood transfusion. Some of the most common blood transfusion adverse effects include:

1. Allergic reactions :

Some individuals may have an allergic reaction to the blood or blood products they receive during a transfusion.

The severity of allergic reactions can range from moderate (urticarial) to fatal (anaphylactic).

Hives or pruritus are the characteristics of urticarial allergic responses. Patients who experience allergic transfusion responses have developed a sensitivity to the donor unit’s antigens. The resulting reaction is dose-dependent. 1 to 3 percent of transfusions result in allergic transfusion responses.

Similar to urticarial reactions, patients with anaphylactic transfusion reactions may initially appear with hives, but these patients differ  in that they also suffer from hypotension, bronchospasm, difficult breathing, and gastrointestinal symptoms.

According to estimates, this kind of reactions happen in one in 20,000 to 50,000 transfusions.

2. Febrile non-hemolytic transfusion reactions (FNHTR):

These reactions occur when the patient develops a fever (raised body temperature) within 24 hours after a transfusion; but there is no evidence of red blood cell destruction. It may involve rigors, chills, and discomfort.

3. Hemolytic reactions:

These reactions occur when the patient’s immune system recognizes the donated blood as foreign and begins to destroy it. Symptoms can include fever, chills, low blood pressure, and jaundice.

4. Transfusion-related acute lung injury (TRALI):

This reaction can occur when the transfused blood contains antibodies that attack the patient’s lung tissue.

It is a noncardiogenic (do not involve heart) pulmonary edema causing acute hypoxemia (low levels of oxygen in blood) that occurs within six hours of a transfusion and has a clear temporal relationship to the transfusion.

Symptoms include difficulty breathing, low blood pressure, and chest pain.

5.Infection:

Although blood donors are screened for various infections, there is still a small risk of transmitting an infection through a blood transfusion.

6. Transfusion-associated circulatory overload

A fast transfusion of a blood volume that is more rapid than what the recipient’s circulatory system can handle can lead to transfusion-associated circulatory overload. It has no connection to an antibody-mediated response.

Signs and symptoms, such as increased heart rate, coughing, breathlessness, high blood pressure, high central venous pressure can be seen in such cases.
Chest radiography frequently reveals cardiomegaly (an enlarged heart) and pulmonary edoema.

7. Iron overload:

In cases of frequent blood transfusions, the patient may accumulate excess iron in their body. This can lead to organ damage, particularly in the liver and heart.

Conclusion

In conclusion, blood transfusions are important and crucial medical procedure that can save lives and improve the health of those suffering from blood loss or other conditions such as anemia.

Overall, this procedure is considered safe as, it is well-regulated, with strict guidelines in place to ensure the safety of the blood. However, as with any medical procedure, there is a small risk of complications.

Patients should discuss any concerns they may have with their doctor before undergoing this procedure and report any symptoms they experience during or after the procedure.

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