3. TYPES OF BLOOD TRANSFUSION
FRESH BLOOD TRANSFUSION
Blood less than 24 hours old from the time of collection
AUTOLOGOUS TRANSFUSION
Blood collected from a patient for re-transfusion at a later time into the same individual
MASSIVE TRANSFUSION
Number of units transfused in a 24 hours period exceeds the recipient’s blood volume
MULTIPLE TRANSFUSION
Repeated transfusion of blood over a long period of time (months or year)
4. Indication of blood transfusion
Many times, blood transfusion might not be without hazards, so the risk should be
weighed out against benefit.
The dictum is - TO USE BLOOD PRODUCTS ONLY WHEN NO OTHER ALTERNATIVE IS
LEFT
6. Types of blood component transfusion
1- Whole blood transfusion:
A person may receive a whole blood transfusion if they have experienced a severe
traumatic hemorrhage and require red blood cells, white blood cells, and
platelets.
No component has been removed
Can be stored for up to 5 weeks
Platelets, factor v and factor viii are greatly reduced due to storage
Indicated when blood loss is more than 15% or after heavy RTA or gunshot
Now almost not used
7. 2- packed Red blood cell transfusions
Has Hematocrit up to 75%
Transfusion of RBCs should be based on the patient's clinical condition.
Indicated to treat anemia (e.g. thalasemia and sickle cell anemia) and blood loss
greater than 1,500 mL or 30 percent of blood volume or Hgb = 7 g/dl
Reduced 2,3 DPG
Frozen RBCs have better properties but not available at emergency situations
8. 3- Platelet transfusions:
A platelet transfusion can help those who have lower platelet counts, such as
from chemotherapy or platelet function defects.
Stored for up to 5 days at room temperature
Recently concerns have increased about zika virus in platelet transfusion
Platelet transfusion is indicated in major surgery usually at less than or equal to
50k per ml
9. 4- Plasma transfusions:
Plasma contains all of the coagulation factors.
stored at 1 to 6°C for up to five days
Also Indicated for coagulopathic disorders
It is the only source of factor V
can be used for reversal of anticoagulant effects
Or in a patient of 1.6 INR and undergoing major surgery
10. 5- cryoprecipitate
Cryoprecipitate is prepared by thawing fresh frozen plasma and collecting the
precipitate.
Cryoprecipitate contains high concentrations of factor VIII and fibrinogen.
used in cases of hypofibrinogenemia,
11. PRE-TRANSFUSION TESTING
ABO and Rh (D) blood grouping :
Patient’s and donor’s blood sample
Cross matching of blood sample:
Major cross match- Pt’s serum + Donor cells
Minor cross match- pt’s cells + Donor serum
12.
13. PRE-TRANSFUSION TESTING (contd.)
Screening for Transfusion transmitted diseases
(Donor Sample)
HIV 1 and 2 AIDS
HBsAg Hepatitis B
HCV Hepatitis C
Treponema pallidum Syphilis
Plasmodium species Malaria
15. ADVERSE EFFECTS (TRANSFUSION REACTIONS) –
Non-Immune mediated
Acute Delayed
1. Bacterial contamination HIV 1 & 2
2. Circulatory overload Hepatitis B & C
3. Chemical damage Syphilis
4. Thermal damage Malaria
5. Iron overload
16. CAUSES OF TRANSFUSION REACTIONS
Clerical errors:
Inadequate labeling
Wrong blood issued
Technical errors:
Error in blood grouping & cross matching
Incorrect interpretation of test results
Others:
Blood contamination during phlebotomy
Blood infusion thru small bore needle
Blood cooler to -30⁰C or warmed to > 42⁰ C
Concomitant administration blood & drugs thru common set
17. Common symptoms of blood transfusion
reactions include:
Fever and chills.
Dizziness.
Shortness of breath.
Itching.
Hypothermia
Back pain.
hypotension
18. REFERENCES
Hébert PC, Wells G, Blajchman MA, et al. A multicenter, randomized, controlled clinical trial of transfusion
requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials
Group [published correction appears in N Engl J Med. 1999;340(13):1056]. N Engl J Med. 1999;340(6):409–417.
Lacroix J, Hébert PC, Hutchison JS, et al.; TRIPICU Investigators; Canadian Critical Care Trials Group; Pediatric
Acute Lung Injury and Sepsis Investigators Network. Transfusion strategies for patients in pediatric intensive
care units. N Engl J Med. 2007;356(16):1609–1619.
King KE, Bandarenko N. Blood Transfusion Therapy: A Physician's Handbook. 9th ed. Bethesda, Md.: American
Association of Blood Banks; 2008:236.
Klein HG, Spahn DR, Carson JL. Red blood cell transfusion in clinical practice. Lancet. 2007;370(9585):415–426.
Ferraris VA, Ferraris SP, Saha SP, et al. Perioperative blood transfusion and blood conservation in cardiac
surgery: the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists clinical practice
guideline. Ann Thorac Surg. 2007;83(5 suppl):S27–S86.
19. REFERENCES (contd)
Carless PA, Henry DA, Carson JL, Hebert PP, McClelland B, Ker K. Transfusion thresholds and other
strategies for guiding allogeneic red blood cell transfusion. Cochrane Database Syst Rev.
2010;(10):CD002042.
Practice parameter for the use of fresh-frozen plasma, cryoprecipitate, and platelets. Fresh-Frozen
Plasma, Cryoprecipitate, and Platelets Administration Practice Guidelines Development Task Force of the
College of American Pathologists. JAMA. 1994;271(10):777–781.
Holland LL, Brooks JP. Toward rational fresh frozen plasma transfusion: the effect of plasma transfusion
on coagulation test results. Am J Clin Pathol. 2006;126(1):133–139.
Liumbruno G, Bennardello F, Lattanzio A, Piccoli P, Rossetti G; Italian Society of Transfusion Medicine
and Immunohaematology (SIMTI) Work Group. Recommendations for the transfusion of plasma and
platelets. Blood Transfus. 2009;7(2):132–150.