Blood transfusion using cells donated by healthy volunteers can help replace red cells, platelets and other blood components. Some people with leukemia, lymphoma, myeloma and other blood diseases or disorders such as hereditary anemias and aplastic anemia need periodic blood transfusions for several reasons: Show
Patients with insufficient blood counts can develop:
Doctors take different approaches when deciding if transfusion is appropriate. How to best balance the benefits and risks of transfusions is the subject of some debate in the medical field. Currently, transfusion policies usually depend on the patient's condition, an individual doctor's training and experience and long-held medical standards of practice. LLS does not provide resources for either blood or organ donation. For more information, visit the following links: Blood ComponentsWhen you receive a transfusion, you won't be getting whole blood. Instead, you'll receive components of blood that has been filtered. The whole blood is collected from the donor and sent to a lab for separation, allowing one donation to benefit up to four patients and conserving precious blood resources. Another process that separates some blood components is called apheresis or hemapheresis. This involves removing certain components from a donor's blood and returning the unneeded parts to the donor. Components that you can receive separately by transfusion are:
Blood IrradiationA rare but potentially life-threatening complication of transfusion is graft versus host disease, which occurs when a donor's white cells attack the recipient's immune system. To prevent this, some centers irradiate (treat with radiation) blood components for patients receiving intensive chemotherapy, undergoing stem cell transplant or who are considered to have impaired immune system. Irradiation prevents white cells from attacking. Red Cell TransfusionLow red cell counts (anemia), if untreated, can cause weakness, fatigue and, in extreme cases, shortness of breath or rapid heartbeat. Most doctors prescribe red cell transfusions before a patient develops serious symptoms, particularly when managing older patients or those who have a history of heart or blood vessel disease. Blood donated to patients with blood diseases should always have the white cells removed by filtration, a process called leukoreduced or leukodepleted. Leukoreduction reduces the risks of:
If you receive ongoing red cell transfusions, you're at risk of developing iron overload, which, if not treated, can damage your heart and liver. You may need treatment with a drug called an iron chelator to remove excess iron from your body. Platelet TransfusionPlatelet transfusions are given to prevent or treat bleeding because of severely low platelet counts (thrombocytopenia). Maintaining a platelet count of more than 5,000 per microliter (µL) of blood, and sometimes higher, seems to reduce risk of:
Not all doctors agree about the appropriate platelet counts that should signal the start of preventive (prophylactic) transfusions, therefore platelet transfusion decisions vary greatly among hematologists and oncologists. Donated platelet units should have the white cells removed by filtration before transfusion, and if appropriate, they should be irradiated as well. Granulocyte TransfusionGranulocytes are a type of white cell. If you have few or no circulating white cells, you can develop an infection that doesn't respond to antibiotics. Therefore, your doctor may give you granulocyte transfusions, which can provide some benefit until your own white cell counts recover. The cells should be irradiated before transfusion but not treated with leukoreduction filters. Since there's uncertainty over whether current methods of granulocyte collection produce an effective transfusion, granulocyte donors are sometimes given a granulocyte colony-stimulating factor (G-CSF) to increase their white cell production. Plasma and Cryoprecipitate TransfusionFresh frozen plasma (FFP), the fluid that carries blood cells, and cryoprecipitate, the portion of the plasma that contains clotting factors (often called cryo for short), may be transfused to patients whose blood has abnormal or low levels of blood-clotting proteins. Problems can develop in patients as a result of liver disease or infection. Fortunately, these conditions are uncommon in most people with blood cancers, except for people with promyelocytic leukemia, who may need transfusions to prevent or treat bleeding. Intravenous Gamma GlobulinGamma globulins are portions of proteins in plasma that play a key role in preventing infection. Severely low levels of gamma globulin can lead to an increased risk of some types of bacterial infections. Very low gamma globulins are common to chronic lymphocytic leukemia. Your doctor may want to increase low gamma globulin:
Albumin TransfusionAlbumin is the most common human blood protein. Rarely, transfusion of albumin is needed in patients suffering from severe liver malfunction. Every patient and doctor is concerned about blood supply safety. The good news is that the risk of transmitting viral diseases such as human immunodeficiency virus (HIV) and hepatitis by blood transfusion had dropped dramatically in the last 25 years. This is the result of a multi-layered approach to safety. Today, 12 different tests are performed on each unit of blood donated for the following infectious diseases:
Sometimes additional testing is also done for diseases such as cytomegalovirus (CMV) and West Nile virus. Complications of Blood TransfusionsMost patients who receive a transfusion don't suffer any adverse reactions. However, it's still possible for reactions to occur with any blood component. A reaction can occur at the time of the transfusion or not until weeks or months later. Symptoms and side effects that may occur during or soon after transfusion include:
If you notice any of these changes during a transfusion, however slight, alert the nursing staff promptly. Serious complications can be prevented by recognizing a reaction early, stopping the transfusion and limiting the amount of blood given. Although rare, a hemolytic transfusion reaction can occur when transfused red cells are damaged or destroyed. This can result in a drop in blood pressure, bleeding or kidney damage that may be life-threatening. Reactions that aren't immediate include:
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