blood transfustion

1. BLOOD TRANSFUSIONS
Chelsea Rodriguez

2. CONTENT
Definition
Purposes
Components of blood
Grouping and cross matching
Type of blood transfusion
General Instructions
Types of mismatching

3. INTRODUCTION
Blood transfusion is the process of transferring blood
products into a person's circulation intravenously.

4. BLOOD TRANFUSION

5. PURPOSE
Anemia: This occurs when a person’s blood does not have enough
red blood cells. It can develop for a number of reasons, such as if a
person does not have enough iron in their body. This is known as
iron deficiency anemia.
Hemophilia: This is a bleeding disorder wherein the blood is unable
to clot properly.
Cancer: This occurs when cells in the body divide and spread to the
surrounding tissues.
Sickle cell disease: This is a group of red blood cell disorders that
change the shape of red blood cells.
Kidney disease: This occurs when the kidneys are damaged.
Liver disease: This occurs when the liver stops functioning
properly.

6. Early (within 24h): Acute haemolytic reactions (eg ABO or Rh
incompatibility);
anaphylaxis; bacterial contamination; febrile reactions (eg from HLA
antibodies); allergic reactions (itch, urticaria, mild fever); fluid overload;
transfusion-related acute lung injury (TRALI, ie ARDS due to
antileucocyte antibodies in donor plasma).
Delayed (after 24h): Infections (eg viruses: hepatitis B/C, HIV; bacteria;
protozoa; prions); iron overload; graft-versus-host disease; post-
transfusion purpura—potentially lethal fall in platelet count 5–7d post-
transfusion requiring specialist treatment with IV immunoglobulin and
platelet transfusions.
Complications of transfusion

7. Whole blood: (rarely used) Indications: exchange transfusion; grave exsanguination—use
crossmatched blood if possible, but if not, use ‘universal do- nor’ group O RhΩve blood, changing
to crossmatched blood as soon as possible. Blood even <2d old has no effective platelets. Red
cells: (packed to make haema- tocrit ~70%) Use to correct anaemia or blood loss. 1U Hb by 10–
15g/L. In anaemia, transfuse until Hb ~80g/L.
Platelets: (p358) Not usually needed if not bleeding or count is >20 ≈ 109/L. 1U should platelet
count by >20 ≈ 109/L. Failure to do so sug- gests refractoriness—discuss with haematologist. If
surgery is planned, get advice if <100 ≈ 109/L.
Fresh frozen plasma (FFP): Use to correct clotting defects: eg DIC (p346); warfarin overdosage
where vitamin K would be too slow; liver disease; thrombotic thrombocytopenic purpura (p308).
It is expensive and carries all the risks of blood transfusion. Do not use as a simple volume
expander. Human albu- min solution is produced as 4.5% or 20% protein solution and is for use
as protein replacement. 20% albumin can be used temporarily in the hypoproteinaemic pa- tient
(eg liver disease; nephrosis) who is fluid overloaded, without giving an exces- sive salt load. Also
used as replacement in abdominal paracentesis (p779). Others Cryoprecipitate (a source of
fibrinogen); coagulation concentrates (self-injected in haemophilia); immunoglobulin (anti-D,
OHCS p9).
Products

9. The blood used in a transfusion must be
compatible with the patient's blood type.
Type O blood is called the universal donor
People with type AB blood are called
universal recipients
People with Rh-positive blood can get Rh-
positive or Rh-negative blood.
But people with Rh-negative blood should
get only Rh-negative blood.
BLOOD GROUPING AND CROSS MATCHING

10. TYPES OF BLOOD TRANSFUSIONS
Autologous blood transfusion is the collection and re-infusion of the
patient’s own blood or blood components.
Homologous, or more correctly allogenic, blood transfusions involves
someone collecting and infusing the blood of a compatible donor into
him/herself.
Heterologous blood transfusions are those that involve someone infusing
blood and its components from a different species.