A blood transfusion is a safe and common procedure. Most people who have a bone marrow failure disease like aplastic anemia, MDS or PNH will receive at least one blood transfusion. When you receive a blood transfusion, parts of blood from a donor are put into your bloodstream. This can help some patients with low blood counts.
A transfusion usually involves only certain parts of blood. These might be the red blood cells, platelets or plasma. Rarely is whole blood (red cells, plasma, platelets, and white cells) used for a transfusion.
Blood Transfusion Process
Before a blood transfusion, a technician or nurse will check your blood type (A, B, AB or O). They also test to see if you are Rh-positive or Rh-negative.
The type of blood used in the transfusion has to be compatible with your blood type. Otherwise, antibodies (a type of protein) in your blood might attack the transfused blood and make you sick.
More on Transfusions
Transfusions usually happen in a hospital. Sometimes transfusions are done in doctors’ offices, outpatient clinics, or even the patient’s home.
Red blood cell transfusions can take up to four hours. Transfusions of other blood components, such as platelets and plasma, may take less time.
After the transfusion, you might feel some soreness or have some bruising in the area where the IV line was inserted. You might need blood tests to show how the body is responding to the transfusion. Your doctor or nurse will watch carefully to see how you are responding to the transfusion.
What are common side effects?
Most patients do not have any side effects from blood transfusions. A small number may experience:
- Fever and chills
- Mild allergic reaction, such as hives and itching
If you have had these side effects with transfusions before, you will get medicine before your transfusion to help prevent any reaction.
For many aplastic anemia and PNH patients, it is important to receive only blood that has been irradiated. This process reduces the chance of a serious immune reaction called graft-versus- host disease.
What are the types of Transfusions?
Different parts of blood may be transfused depending on a patient’s needs. For bone marrow failure disease patients, the most common transfusions include red blood cell transfusion and platelet transfusion.
Red Blood Cell Transfusions
Red blood cells carry oxygen from your lungs to the rest of your body. When you don’t have enough red blood cells you have anemia and you feel tired and may have trouble catching your breath. If your blood count is too low, your doctor might recommend a red blood cell transfusion. This is the most common type of blood cell transfusion.
Platelet Transfusions
If you don’t have enough healthy platelets in your blood, you may receive a platelet transfusion. Patients with a low platelet count tend to bruise and bleed easily. This condition is called thrombocytopenia. A platelet count of less than 10,000 per microliter of blood, or the presence of bleeding, is considered low enough to need a platelet transfusion. But each person reacts differently to a low platelet count.
Here are two things you should know about platelet transfusions:
- Platelets live just eight to ten days, so a transfusion helps for only a short time.
- Over time, platelet transfusions can become less effective. For this reason, your doctor may recommend other ways to prevent bleeding to avoid too many platelet transfusions.
Plasma Transfusions
Blood cells float in plasma, the clear, yellow part of blood. Plasma is 70% water. It also contains factors that work with platelets to help form clots and stop the bleeding. Plasma is commonly given to patients who are bleeding because their blood is not clotting the way it should.
White Blood Cell Transfusions
White blood cells are called granulocytes. If you have serious, life-threatening infections that do not respond to appropriate antibiotics, you may have low levels of granulocytes. In some cases, a transfusion of granulocytes is used for a short time to help you fight infections.
White blood cell transfusions are rarely given today due to the high likelihood of side effects. It is also not clear how well they work to reduce the risk of infections. Instead, doctors will use drugs called colony-stimulating factors or growth factors to help a patient’s own body produce more white blood cells.
Why is blood type important?
For red blood cell transfusions, it is very important that the patient’s blood type match the donated blood type. Otherwise, antibodies (proteins) in the transfused blood may trigger a patient’s immune response and attack the donated blood cells. If this happens, it can make you very sick. Matching blood type is more important for red cell transfusions than it is for platelets and plasma.
Every person has one of four groups of blood: A, B, AB or O. These blood types are known as the ABO blood type. They indicate whether the patient has antigen A, antigen B, both antigen A and B or neither of these antigens.
Blood is also Rh-positive or Rh-negative. This means that the patient either has the Rh-D antigen or doesn’t have it. The blood of someone with type A blood that is Rh-positive is referred to as type A-positive blood.
The transfusions that are safe for each ABO blood type are as follows:
- Type A red blood cells: Safe for people with type A or AB blood
- Type B red blood cells: Safe for people with type B or AB blood
- Type AB red blood cells: Safe for people AB blood
- Type O red blood cells: Safe for people with type A, B, AB or O blood
Safe transfusions by Rh status are as follows:
- Rh-positive red blood cells: Safe for people with Rh-positive
- Rh-negative red blood cells: Safe for people with Rh-negative or Rh-positive red blood cells
Blood Transfusion Safety
The U.S. blood supply is among the safest in the world, according to the U.S. Centers for Disease Control and Prevention (CDC). Blood collected in the U.S. is checked carefully for diseases like HIV (the virus that causes AIDS) and hepatitis. Any blood and blood products that have these diseases are safely discarded and are not used. The risk of getting an infection in the United States through getting a blood transfusion or blood products is extremely low.
Negative side effects of blood transfusion therapy are uncommon. Blood banks, hospitals, and health-care providers take many precautions to minimize risks before each blood transfusion. This involves many levels of testing, including:
- Blood banks test every unit of blood to find out its type.
- In the U.S., every hospital that gets blood must test it again
All this testing makes sure that when a blood transfusion is given, the blood is safe and matched with the patient’s blood.