Blood transfusion is receiving blood or blood products, including red blood cells, platelets or plasma, donated by another person. Blood is stored in a plastic bag and given through a tube, which is connected to a needle inserted in the arm. The transfusion should not be painful but having a needle in your arm may be slightly uncomfortable. Each unit of blood is generally transfused over two to four hours.

Why patients need blood transfusions?

Blood and blood products are used to replace blood loss and correct abnormalities in the blood, which cannot be corrected by any other means.

Common reasons for blood transfusion include:

• Severe blood loss because of an accident or surgery
• Anaemia
• Bleeding or clotting disorders
• Supportive treatment in certain diseases and blood disorders

Your doctor will discuss with you the reason why you may need blood. However your options may be limited and refusing of blood may have life threatening consequences.

What are the steps taken to ensure that the blood is safe?

All blood units are provided by the Blood Transfusion Centre of HCMC. Donors are voluntary. Before giving blood, donors must answer detailed questions to ensure they are in good health and to rule out risk factors for diseases. Donors who have any risk factors are not allowed to donate.

Every unit is tested for infections which can be transmitted through blood, i.e.:

• Hepatitis B
• Hepatitis C
• HIV 1&2
• Syphilis
• HTLV 1&2

What are the benefits and risks of having a blood transfusion?

It is important to realize that the risks of not having a necessary blood transfusion exceed the extremely low risk of transfusion and blood is only given when the benefits exceed the risks.

The serious risks of a transfusion, although rare, include reactions to the blood or the transmission of infections. These risks are minimized by the careful selection of donors, testing and handling of the blood.

How is blood matched?

For the blood transfusion, the blood of the donor must be matched with the blood of the person receiving it as people have different blood groups. Also, before the transfusion, at the bedside, both you and the unit of blood will be carefully identified and again cross matched. This is the reason why the nurse, doctor asks you to state your name and date of birth when taking a blood sample and prior to transfusion.

What is meant by transfusion reactions?

Transfusion reaction is a rare complication of blood transfusion where the patient reacts against the transfused blood.

Your nurse will observe you carefully during transfusion particularly at the beginning. Tell your nurse immediately if you feel fever or chills during or after the transfusion. Even if you have a reaction to blood, it does not mean that there is cause for concern. As a precaution, your nurse will stop the transfusion and call a doctor. Your symptoms will be treated and the reason for the reaction investigated. All transfusion associated reactions and incidents are reported to the Blood utilization committee.

If I have a reaction, will I be able to receive subsequent transfusions?

If a patient develops a reaction to the blood transfusion, medication given prior to the next transfusion or giving a different blood product may prevent a further reaction.

Rarely some months after a transfusion, patients may develop antibodies against the transfused red cells. These antibodies will not usually make the person ill, but it will be important to know about them for future transfusions or in pregnancy. They will be discovered when the blood is tested prior the next transfusion.

Are there alternatives to having blood transfusion?

Autotransfusion is a process wherein a person receives their own blood for a transfusion, instead of banked allogeneic (separate donor) blood. There are two main kinds of autotransfusion:

o Blood can be “pre-donated” by the patient before a surgery, or
o Blood can be collected during and after the surgery using an intraoperative blood salvage device called Cell-saver. When a cell-saver is used, blood that is lost during the operation is collected into a machine. This filters and washes the blood to remove any contaminants. The blood can then be given back to the patient during the operation or afterwards. The cell saver is also a viable alternative for patients with religious objections to receiving blood transfusions. This technic cannot be used for every patient, and in the event of excessive bleeding during surgery a complementary blood transfusion will still be required.

• Erythropoietin (EPO): Erythropoietin is a naturally occurring hormone produced by the kidneys. It stimulates the body to produce more red blood cells and is used to treat anaemia. It is widely used as a transfusion alternative. It is usually given by injection between one and three times per week prior to your surgery.
• Nutritional Supplements: If your body is lacking certain vitamins or minerals, like iron, vitamin B12 or folic acid, nutritional supplements may be able to raise your haemoglobin level and reduce your need for a blood transfusion. Supplements for these nutrients are taken daily on your own or they can be administered by your doctor’s prior to your planned surgery.

If you would like more information, ask your doctor for advice.

PLEASE ENCOURAGE YOUR HEALTY RELATIVES AND FRIENDS TO BECOME BLOOD DONORS