Blood transfusion

Blood transfusion is a medical procedure in the transfusion medicine department where blood and its components are transferred to the person deficient of it. Let us understand more about blood transfusion, its indications, procedure, safety, and risk.

Conditions requiring blood transfusion:

Active injury with bleeding due to accident.
Blood loss during labor
Anemia with hemoglobin less than 8 g/dL.
Individuals receiving treatment for blood cancer.
Individuals receiving treatment for blood related genetic conditions such as hemophilia, thalassemia and sickle cell disease.
Shock or hemorrhage.

Role of blood type in blood transfusion

A blood type is also called a blood group is the grouping of blood based on the presence of antigens and antibodies. The International society of blood transfusion classified human blood grouping system into ABO (A, B, AB and O blood group) and Rh (+ or -). Rh factor is mainly present for red blood cell transfusion.

The recipient's blood type and Rh status must match the donor's blood type for a transfusion to be safe. A proper transfusion of blood can make the difference between life and death. To achieve this

before a transfusion a crossmatch test between donor and recipient’s blood is performed to reduce the life-threating reactions. The compatibility for blood transfusion across different blood group is as follows:

Recipient blood type	Compatible donor blood type
A+	A+, A-, O+, O-
A-	A-, O-
B+	B+, B-, O+, O-
B-	B-, O-
AB+	Compatible with all blood types
AB-	AB-, A-, B-, O-
O+	O+, O-
O-	O-

The recipient's blood is also examined for specific antibodies against red blood cells. Blood transfusion reactions may result from these antibodies.

On the other hand, type O red blood cells are available to everyone in an emergency. Hence, those with type O blood are considered universal donors. Individuals of blood type AB are universal recipients, meaning they can receive red blood cells from donors of any type.

Rh-negative patients must obtain their blood from Rh-negative donors (except for life-threatening situations), while Rh-positive recipients may receive either Rh-positive or Rh-negative blood.

Importance of right blood transfusion.

Severe complications such as acute hemolysis can occur post 24 hours of patient receiving an unmatched blood type. The initial symptoms of unmatched blood transfusion include.

Heat at the site of blood transfusion
Chills, Fever, Body aches.
A transfusion of the incorrect blood type might result in reactions affecting most of the endothelium. The recipient's antibodies will destroy the red blood cells in the blood artery, and simultaneous reactions can cause shock and hasten the patient's death.
Full or partial transfusions of blood might result in accidents that induce fast or slow reactions or even put the patient's life in jeopardy. As a result, when administering blood transfusions, it's important to confirm the fundamentals and closely adhere to the guidelines.

To maintain hemodynamics and quickly remove acidosis, induce diuresis, and employ medications to treat symptoms, patients with complications from blood transfusions from other groups need to be brought back to life as soon as possible.

Types of blood products

In case of pregnancy or severe bleeding, the individuals are provided whole blood transfusions. However, it is necessary to understand the fact that they are given only the part of blood component which is needed. Such elements of blood include:

Red blood cells: Red blood cells are commonly used blood components, mainly used in cases of severe bleeding and anemia. These constituents are produced by isolating them from a fluid component known as plasma, resulting in a concentrated red cell mass. These packed red blood cells can restore the capacity of oxygen carrying.

Platelets: Platelets deficiency patients are transfused with this type of blood cells, especially in cases of thrombocytopenia. Previously, multiple donors were required to supply sufficient platelets for the benefit of one individual. Modern apheresis collection methods, which effectively separate platelets from other blood components, enable a sole donor to supply ample platelets for the requirements of one person.

Plasma: Among several proteins, blood clotting factors are present in the plasma that work together with platelets to support blood coagulation, which is crucial to stop bleeding from an injury after accident or post-surgery.

Criteria for Storage and issue of blood and its components

The blood bank will be in charge of ensuring that all blood is collected, processed, and provided per government guidelines.

Each blood unit is tested for HIV, the Hepatitis C virus antibody and hepatitis B surface antigen. The results of these tests must be noted on the label of the test container.
Blood that has been tested, expired, or not tested must be stored in a designated place. The area needs to be clearly marked, and entry to it needs to be restricted.
Sufficient alternative storage space with documented instructions on how to keep the blood and its constituent parts at a specific temperature.
A UPS must be available in the preservation area in case of a power outage.
The placement of the storage equipment ensures that the blood bank staff can hear the temperature alarm in case it goes above the recommended limits, allowing for prompt corrective action.

Requests for transfusions must be granted by the checklist below.

Patient identification
Component and quantity identification
Name of requisitioning physician
Gender, age, diagnosis, and recipient's transfusion history
Verification of the red blood components' ABO type.
Verification of the Rh-negative units' kind.
Choosing ABO and Rh components that are suitable for the recipient.

Risks

It is rare for blood transfusion therapy to have adverse side effects. Before every blood transfusion, blood banks, hospitals, and healthcare providers take numerous safety measures to reduce hazards. However, in few cases there are chances of getting some significant reactions due to blood transfusion.

Infections: The largest risk associated with blood transfusions used to be infections. However, blood transfusion-related illnesses are extremely uncommon now that screening and preventive measures are in place.
Allergic Reactions: The symptoms of allergic reactions such as itching, hives, wheezing can trigger when the patient receives blood components, especially plasma during transfusion. This happens when the immune system of patients reacts to plasma.
Iron Overload: High levels in blood in called as iron overload. This condition may occur im individuals who have multiple red blood cell transfusions.
Fever: During or shortly after a blood transfusion, some patients have an unexpected fever or chills. A fever frequently indicates that the donor blood's platelets, plasma, or white blood cells are causing the patient's body to respond. Physicians can typically treat transfusion-related fever with fever-reducing medications such acetaminophen or aspirin.

Conclusion:

Transfusion medicine has evolved to safeguard patients from life threatening conditions such as gastrointestinal bleeding and trauma by providing the right blood type and blood components as needed during emergency or major surgery. The blood components used for transfusion are stored according to regulatory guidelines for safer and infection free transfusion procedures. Consult a hematologist if one is unsure about blood transfusion to know the procedure, safety, and risk.

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