What is a blood transfusion?

A blood transfusion is a common procedure where donated blood or blood components from a volunteer donor are given through an intravenous line (IV) to a patient to replace blood and blood components that may be too low. The patient may have low blood levels due to blood loss from injury or surgery, or as a result of a certain medical disorder.

The transfusion is done with one or more of the following parts of blood: red blood cells, platelets, plasma, or cryoprecipitate.

What are the potential benefits of a blood transfusion?

If your body does not have enough of one of the components of blood, you may develop serious life-threatening complications.

  • Red blood cells carry oxygen through your body to your heart and brain. Adequate oxygen is very important to maintain life.
  • Platelets help to prevent or control bleeding due to low platelet count.
  • Plasma and cryoprecipitate, replacement coagulation factors, also help to prevent or control bleeding.

How safe are blood transfusions?

Blood donors are asked many questions about their health, behavior, and travel history in order to ensure that the blood supply is as safe as it can be. Only people who pass the survey are allowed to donate. Donated blood is tested according to national guidelines. If there is any question that the blood is not safe, it is thrown away.

However, there is still a very small chance that something will go undetected in the screening process. To put this in perspective, let's look at your chances of getting a disease from a blood transfusion:

  • HIV: 1 in 1.5 million donations
  • Hepatitis C: 1 in 1.2 million donations
  • Hepatitis B: 1 in 293,000 donations

For comparison, let's look at your lifetime odds for a few other things:

  • Struck by lightning: 1 in 700,000
  • Deadly plane crash: 1 in 500,000
  • Accidental drowning: 1 in 80,000
  • Deadly car accident: 1 in 5,000

Additional transfusion risks and reactions:

  • Severe allergic reaction
  • Respiratory distress due to fluid overload (Transfusion-Associated Circulatory Overload), or injury to the lungs (Transfusion-Related Acute Lung Injury)
  • Bacterial contamination
  • Fever, chills, rash
  • Hemolytic transfusion reaction (an immune reaction where antibodies lead to destruction of transfused red blood cells)
  • Mistransfusion (human error leading to the transfusion of the wrong product)

The most common reactions are mild allergic or febrile reactions, and are not life-threatening. Severe transfusion reactions such as those causing respiratory distress may be life-threatening.

Are there any alternatives to a blood transfusion?

Available alternatives and how well they work will depend on your situation. If you need a transfusion, sometimes medications can be used in order to help your body to make its own blood. Some medications may also be used to prevent or control bleeding.

If the blood loss is too great, or if you are in a potentially life-threatening situation, these alternatives may not work quickly enough to help you. In these instances, there are no other options except for receiving the transfusion.

You do have the right to refuse a blood transfusion that your doctor has ordered. You must be aware of the risks and consequences of not accepting the transfusion. As a patient, you have the responsibility to discuss this with your physician before making your decision. Very often, the risks of not receiving a transfusion include loss of life or permanent disability.

What can I expect during the transfusion?

The nurse will check your blood pressure, pulse, and temperature before the transfusion is started. The blood will be given through your IV. Before starting the transfusion a nurse must check that the blood product they are about to transfuse has been matched for you, is the product ordered by the doctor, and is labeled with your name.

A nurse will check your blood pressure, pulse, and temperature after the transfusion has been running for 15 minutes, and again when the blood is completed.

Your transfusion will take anywhere from 1 to 3 hours. It may take a little longer, or it may even take less time depending on what component (part) of blood you are receiving.

How do I know if I am having a reaction during the transfusion?

A reaction can occur during a transfusion, up to a day following the transfusion, or even up to several months after the transfusion. Your nurse will watch you closely for a reaction. If a reaction occurs, the transfusion will be stopped.

During your transfusion, please let your nurse know immediately if you have any of the following symptoms:

  • Bleeding, pain, or new bruising at the IV site
  • Severe back pain
  • Fever, chills
  • Nausea, vomiting
  • Rash, hives, itching
  • Headache, dizziness
  • Cold, clammy skin
  • Chest pain
  • Fast heartbeat
  • Trouble breathing, wheezing
  • Dark or reddish urine

After the transfusion

If any of the listed symptoms develop after a blood transfusion, you may be having a transfusion reaction. If you are in the hospital, notify your nurse or doctor immediately.

If you have been discharged from the hospital and any of the above symptoms develop on the day of the transfusion or shortly thereafter, contact your doctor immediately. If you are unable to reach your doctor, call 911 or go to the nearest Emergency Room. Yellowing of the skin or eyes may be a symptom of a delayed reaction which may take days or weeks to develop. Contact your doctor if you notice yellowing of the skin or eyes.

After your transfusion, you should rest and take care not to overexert yourself for at least 24 to 48 hours. Once you are discharged, call to schedule a follow-up appointment with your primary care physician.

References

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 6/26/2017…#14755