Who Needs a Blood Transfusion? Blood transfusions are very common. Each year, almost 5 million Americans need blood transfusions. This procedure is used for people of all ages. Many people who have surgery need blood transfusions because they lose blood during their operations. For example, about one-third of all heart surgery patients have a transfusion. Some people who have serious injuries—such as from car crashes, war, or natural disasters—need blood transfusions to replace blood lost during the injury. Some people need blood or parts of blood because of illnesses. You may need a blood transfusion if you have: A severe infection or liver disease that stops your body from properly making blood or some parts of blood. An illness that causes anemia, such as kidney disease or cancer. Medicines or radiation used to treat a medical condition also can cause anemia. There are many types of anemia, including aplastic, Fanconi, hemolytic, iron-deficiency, and sickle cell anemias and thalassemia (thal-ah-SE-me-ah). A bleeding disorder, such as hemophilia or thrombocytopenia (THROM-bo-si-to-PE-ne-ah).Before a blood transfusion, a technician tests your blood to find out what blood type you have (that is, A, B, AB, or O and Rh-positive or Rh-negative). He or she pricks your finger with a needle to get a few drops of blood or draws blood from one of your veins. The blood type used in your transfusion must work with your blood type. If it doesnt, antibodies (proteins) in your blood attack the new blood and make you sick. Some people have allergic reactions even when the blood given does work with their own blood type. To prevent this, your doctor may prescribe a medicine to stop allergic reactions. (For more information, see What Are the Risks of a Blood Transfusion?) If you have allergies or have had an allergic reaction during a past transfusion, your doctor will make every effort to make sure youre safe. Most people dont need to change their diets or activities before or after a blood transfusion. Your doctor will let you know whether you need to make any lifestyle changes prior to the procedure.Blood transfusions take place in either a doctors office or a hospital. Sometimes theyre done at a persons home, but this is less common. Blood transfusions also are done during surgery and in emergency rooms. A needle is used to insert an intravenous (IV) line into one of your blood vessels. Through this line, you receive healthy blood. The procedure usually takes 1 to 4 hours. The time depends on how much blood you need and what part of the blood you receive. During the blood transfusion, a nurse carefully watches you, especially for the first 15 minutes. This is when allergic reactions are most likely to occur. The nurse continues to watch you during the rest of the procedure as well.After a blood transfusion, your vital signs are checked (such as your temperature, blood pressure, and heart rate). The intravenous (IV) line is taken out. You may have some bruising or soreness for a few days at the site where the IV was inserted. You may need blood tests that show how your body is reacting to the transfusion. Your doctor will let you know about signs and symptoms to watch for and report.What Are the Risks of a Blood Transfusion? Most blood transfusions go very smoothly. However, mild problems and, very rarely, serious problems can occur. Allergic Reactions Some people have allergic reactions to the blood given during transfusions. This can happen even when the blood given is the right blood type. Allergic reactions can be mild or severe. Symptoms can include: Anxiety Chest and/or back pain Trouble breathing Fever, chills, flushing, and clammy skin A quick pulse or low blood pressure Nausea (feeling sick to the stomach) A nurse or doctor will stop the transfusion at the first signs of an allergic reaction. The health care team determines how mild or severe the reaction is, what treatments are needed, and whether the transfusion can safely be restarted. Viruses and Infectious Diseases Some infectious agents, such as HIV, can survive in blood and infect the person receiving the blood transfusion. To keep blood safe, blood banks carefully screen donated blood. The risk of catching a virus from a blood transfusion is very low. HIV. Your risk of getting HIV from a blood transfusion is lower than your risk of getting killed by lightning. Only about 1 in 2 million donations might carry HIV and transmit HIV if given to a patient. Hepatitis B and C. The risk of having a donation that carries hepatitis B is about 1 in 205,000. The risk for hepatitis C is 1 in 2 million. If you receive blood during a transfusion that contains hepatitis, youll likely develop the virus. Variant Creutzfeldt-Jakob disease (vCJD). This disease is the human version of Mad Cow Disease. Its a very rare, yet fatal brain disorder. There is a possible risk of getting vCJD from a blood transfusion, although the risk is very low. Because of this, people who may have been exposed to vCJD arent eligible blood donors. Fever You may get a sudden fever during or within a day of your blood transfusion. This is usually your bodys normal response to white blood cells in the donated blood. Over-the-counter fever medicine usually will treat the fever. Some blood banks remove white blood cells from whole blood or different parts of the blood. This makes it less likely that you will have a reaction after the transfusion. Iron Overload Getting many blood transfusions can cause too much iron to build up in your blood (iron overload). People who have a blood disorder like thalassemia, which requires multiple transfusions, are at risk for iron overload. Iron overload can damage your liver, heart, and other parts of your body. If you have iron overload, you may need iron chelation (ke-LAY-shun) therapy. For this therapy, medicine is given through an injection or as a pill to remove the extra iron from your body. Lung Injury Although its unlikely, blood transfusions can damage your lungs, making it hard to breathe. This usually occurs within about 6 hours of the procedure. Most patients recover. However, 5 to 25 percent of patients who develop lung injuries die from the injuries. These people usually were very ill before the transfusion. Doctors arent completely sure why blood transfusions damage the lungs. Antibodies (proteins) that are more likely to be found in the plasma of women who have been pregnant may disrupt the normal way that lung cells work. Because of this risk, hospitals are starting to use mens and womens plasma differently. Acute Immune Hemolytic Reaction Acute immune hemolytic reaction is very serious, but also very rare. It occurs if the blood type you get during a transfusion doesnt match or work with your blood type. Your body attacks the new red blood cells, which then produce substances that harm your kidneys. The symptoms include chills, fever, nausea, pain in the chest or back, and dark urine. The doctor will stop the transfusion at the first sign of this reaction. Delayed Hemolytic Reaction This is a much slower version of acute immune hemolytic reaction. Your body destroys red blood cells so slowly that the problem can go unnoticed until your red blood cell level is very low. Both acute and delayed hemolytic reactions are most common in patients who have had a previous transfusion. Graft-Versus-Host Disease Graft-versus-host disease (GVHD) is a condition in which white blood cells in the new blood attack your tissues. GVHD usually is fatal. People who have weakened immune systems are the most likely to get GVHD. Symptoms start within a month of the blood transfusion. They include fever, rash, and diarrhea. To protect against GVHD, people who have weakened immune systems should receive blood that has been treated so the white blood cells cant cause GVHD.
Posted on: Mon, 24 Nov 2014 07:10:08 +0000