Blood Transfusion

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Introduction

Introduction

A blood transfusion is when you're given blood from someone else (a donor). It's a very safe procedure that can be life-saving.

Why it's done

Some of the main reasons for needing a blood transfusion are:

A blood transfusion can replace blood you've lost, or just replace the liquid or cells found in blood (such as red blood cells, plasma or cells called platelets).

Ask your doctor or nurse why they think you might need a transfusion if you're not sure.

What happens

Before having a blood transfusion, the procedure will be explained to you and you'll be asked to sign a consent form.

A sample of your blood will also be taken to check your blood group. You'll only be given blood that's safe for someone with your blood group.

During a blood transfusion:

  1. You sit or lie down in a chair or bed.
  2. A needle is inserted into a vein in your arm or hand.
  3. The needle is connected to a tube and a bag of blood.
  4. The blood runs through the tube into your vein.

It can take up to 4 hours to receive 1 bag of blood, but it's usually faster than this.

You can normally go home soon after, unless you are seriously unwell or needed a lot of blood.

How you might feel during and after

You might feel a sharp prick when the needle is first inserted into your vein, but you shouldn't feel anything during the transfusion.

You'll be checked regularly while receiving the blood. Tell a member of staff if you feel unwell or uncomfortable.

Some people develop a temperature, chills or a rash. This is usually treated with paracetamol or by slowing down the transfusion.

Your arm or hand may ache and have a bruise for a few days after.

Contact your GP if you feel unwell within 24 hours of having a blood transfusion, especially if you have difficulty breathing or pain in your chest or back.

Risks

Blood transfusions are common and very safe procedures.

All donor blood is checked before it's used to make sure it doesn't contain serious infections such as hepatitis or HIV.

There is a very small risk of complications such as:

  • an allergic reaction to the donor blood
  • a problem with your heart, lungs or immune system (the body's defence against illness and infection)

The risks will be explained before having a transfusion, unless this isn't possible - for example, if you need an emergency transfusion. Speak to your doctor or nurse if you have any concerns.

Alternatives

A blood transfusion will only be recommended if it's needed and other treatments won't help.

If it's possible that you'll need a transfusion - for example, if you're due to have surgery or you have anaemia - you may sometimes be given medicine to:

  • lower your risk of bleeding, such as tranexamic acid
  • boost your number of red blood cells, such as iron tablets or injections

These can reduce your chances of needing a blood transfusion.

Giving blood afterwards

Currently, you can't give blood if you've had a blood transfusion.

This is a precautionary measure to reduce the risk of a serious condition called variant CJD (vCJD) being passed on by donors.

Find out more about who can give blood on the NHS Blood and Transplant website.



Why a blood transfusion is necessary

Why a blood transfusion is necessary

There are several different types of blood transfusion. Whether you need one depends on a number of factors.

These include:

  • your health
  • your medical history
  • the type of operation you're having
  • the seriousness of your condition

An average-sized adult has about five litres of blood in total. Small amounts of blood loss (up to 1.5 litres) can be replaced with a salt solution, which your body replaces with new red blood cells over the following weeks.

The different types of blood transfusions are described below.

Red blood cell transfusions

The main reason for a red blood cell transfusion is to treat anaemia. Anaemia occurs when the body doesn't have enough red, oxygen-carrying blood cells, which means the body's tissues and cells aren't getting enough oxygen.

Anaemia can develop as a result of severe blood loss - for example, as a complication during childbirth or as a result of injury or surgery. Anaemia can also be caused by:

  • health conditions in which red blood cells are produced at a reduced rate - for example, in anaemia due to lack of iron, vitamin B12 or folate (usually treated without the need for blood transfusion), and some types of cancers, such as acute myeloid leukaemia and lymphoma
  • health conditions that disrupt the normal production of red blood cells - such as sickle cell anaemia and thalassaemia
  • conditions or factors that lead to red blood cells being destroyed - for example, in some types of infections such as malaria, the use of certain medicines, toxins such as alcohol or lead poisoning, or as a result of the immune system mistakenly attacking healthy red blood cells

If you're told that you might need a blood transfusion, you should ask why it's necessary and whether there are alternative treatments. You have the right to refuse a blood transfusion, but you need to fully understand the outcome of this before doing so. Some medical treatments or operations can't be safely carried out without a blood transfusion.

Platelets

A platelet transfusion is used to treat people who have very low levels of platelet cells in their blood. This is known as thrombocytopenia.

If you have thrombocytopenia, you're at risk of excessive bleeding, either through a minor accident, cut or graze, or as a result of surgery or dental work.

Causes of thrombocytopenia that may require treatment with a platelet transfusion include:

  • cancers - such as leukaemia or lymphoma
  • chemotherapy or bone marrow transplantation - which reduces the production of platelets
  • chronic liver disease or cirrhosis (scarring of the liver, which has many causes, including alcohol abuse)
  • sepsis or severe infection - this can cause abnormal clotting and low platelets

Plasma

Plasma is the fluid in the blood containing proteins that help the blood to clot. A transfusion of plasma may be needed if there's severe bleeding, such as after surgery, trauma or childbirth. A transfusion may also be needed in conditions (such as liver disease) that affect the production of clotting proteins.

Granulocytes

Granulocytes are a type of white blood cell that help to fight infection. Granulocyte transfusions aren't commonly used, but may be needed if there's a severe infection that's not responding to antibiotics after chemotherapy or bone marrow transplantation.

Surgical operations

Surgeons always try to carry out surgery to minimise the amount of blood lost. In recent years, this has become easier, due to the increasing use of keyhole surgery (laparoscopic surgery), where only small cuts are made in the body.

However, some types of surgical operations and procedures have a higher risk of blood loss; therefore, a blood transfusion is more likely to be needed.

It may be possible to use a procedure called intra-operative cell salvage. It collects your blood that's lost during the surgery, and it can be returned back to you. Ask your doctor or nurse if intra-operative cell salvage is appropriate for the type of surgery you're having.

It's no longer possible to routinely collect your own blood in advance of your surgery.

 



'I was losing blood faster than it could be transfused'

'I was losing blood faster than it could be transfused'

Motorsport fanatic, Mike Austin, 34, will never forget the summer of 2006. While on his way to work on his much-loved motorbike, he collided with a car.

"The impact of the crash trapped my leg between my bike and the car," says Mike. "My body was slumped over and I knew my leg was in a bad way, but I didn't feel any pain."

An ambulance arrived and paramedics spent more than 45 minutes trying to stabilise Mike before he could be taken to hospital. The crash had almost destroyed his leg - the skin and muscle had been torn away, the bones were shattered and his femoral artery had been badly damaged.

"The paramedics chatted to me at the side of the road for what seemed like five minutes before I was on my way to hospital. As soon as I arrived at A&E, blood was pumped into each arm, and another bag was attached to my neck. I was losing blood faster than it could be transfused. I was still conscious, but the doctors couldn't find a pulse. My chances of survival were very slim."

Mike was taken to theatre, where surgeons tried to save his leg. During the operation, the entire volume of his blood had to be replaced four times. Two days later, doctors told him that his leg would have to be amputated.

"By then, the pain had become so bad that I was glad it was going to be done. Blood was clotting in my leg, which was poisoning the rest of my body. I really thought I might not make it to the operating table - I felt like I was drifting away.

"When I woke up from my operation I could still barely move, but there was a major improvement in my condition."

After months of operations, involving a total of 33 units of blood products, Mike is looking positively to the future and is hoping to ride motorbikes again.

"I'm still working hard with my physio. I hope to get into a position where I can be fitted with a flexible knee limb, although this is some way off at the moment.

"Before something like this happens it's easy to go through life blinkered, but now I'm glad to be alive and I appreciate every day. Without blood donors, I definitely wouldn't be here."

'I always tell myself there are plenty of people out there worse off'

'I always tell myself there are plenty of people out there worse off'

Nisa Karia, 30, has needed blood transfusions for most of her life, and she's received more than 1,300 units of blood so far.

Nisa was diagnosed with thalassaemia major when she was just five. This rare blood disorder means that she can't produce normal haemoglobin for her red blood cells, so she relies on donated blood to survive.

"Growing up needing transfusions was hard, but it was just part of life. I always tell myself there are plenty of people out there who are worse off," she says.

Although Nisa needs blood transfusions every three weeks, her blood disorder hasn't stopped her realising her dream of working in London's fashion industry, after graduating from Leeds University.

"Thanks to the wonderful people who give blood, I lead a full and active life. I'm also looking forward to getting married next year."