This document provides an overview of blood and blood transfusion. It discusses the composition and functions of blood, blood groups and compatibility for transfusion. It describes the processes of blood donation, collection of blood products, and administration of transfusions. Complications of transfusions and methods for estimating blood loss are also summarized.

1. MODERATOR
DR.G.SANTHOSH REDDY
PROFF&H.O.D

2. CONTENTS
• INTRODUCTION
• COMPOSITION
• BLOOD GROUPS
• BLOOD TRANSFUSION
• BLOOD DONATION
• BLOOD PRODUCTS FOR TRANSFUSION
• IV TRANSFUSION
• ADMINISTERATION RATE
• MASSIVE BLOOD TRANSFUSION
• COMPLICATIONS
• BLOOD SUBSTITUTES
• CONCLUSION

3. BLOOD
• Blood is a connective tissue in fluid form. It is considered as the fluid of life
because it carries oxygen from lungs to all parts of the body and carbon
dioxide from all parts of the body to the lungs.

4. FUNCTIONS
OF BLOOD
• NUTRIENT FUNCTION
• RESPIRATORY FUNCTION
• EXCRETORY FUNCTION
• TRANSPORT OF HORMONES
• REGULATION OF WATER BALANCE
• REGULATION OF ACID-BASE BALANCE
• REGULATION OF BODY TEMPERATURE
• STORAGE
• DEFENCE

5. COMPOSITION
OF BLOOD
• Blood contains the blood cells which are called formed elements and
the liquid portion known as plasma.
Blood cells
Three types of cells are present in the blood.
1. Red blood cells or erythrocytes
2. White blood cells or leukocytes and
3. Platelets or thrombocytes

6. BLOOD
INDICES
• PACKED CELL VOLUME (PCV)- VOL OF RBC PRESENT IN WHOLE BLOOD
• MEAN CORPUSCULAR VOLUME (MCV)
• MEAN CORPUSCULAR HEMOGLOBIN (MCH)
• MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION (MCHC)

7. BLOOD
TRANSFUSION • THE PROCESS OF ADMINISTRATION OF BLOOD OR BLOOD
PRODUCTS INTO ONE’S CIRCULATION BY INTRAVENOUS
ROUTE TO REPLACE THE LOST BLOOD DUE TO INJURY OR
SURGERY.

8. HISTORY OF
TRANSFUSION
• IN 1628, WILLIAM HARVEY DISCOVERED CIRCULATION OF BLOOD.
• IN 1818 JAMES BLUNDELL PERFORMED FIRST SUCCESSFUL BLOOD
TRANSFUSION.
• IN 1900 KARL LANDSTEINER DISCOVERED BLOOD GROUPS .
• IN 1907 , BLOOD TYPING AND CROSS MATCHING WAS ATTEMPTED
TO IMPROVE SAFETY TRANSFUSIONS.

9. BLOOD
GROUPS
•THERE ARE >30 MAJOR BLOOD GROUP SYSTEM
•THE MOST IMPORTANT BLOOD GROUP ARE THE ABO AND RH
•ABO SYSTEM BASE ON PRESENT OF ANTIGEN A OR B
• RH IS BASE ON PRESENCE OF ANTIGEN D (RH FACTOR)
• OTHER; KELL, DUFFY, MNS, LEWIS, KIDDA ETC

11. IMPORTANCE OF
BLOOD GROUP FOR
TRANSFUSION
• DURING BLOOD TRANSFUSION, ONLY THE COMPATIBLE BLOOD CAN BE USED.
THE ONE WHO GIVES BLOOD IS CALLED THE DONOR AND THE RECIPIENT IS THE
ONE WHO RECEIVES THE BLOOD.
• WHILE TRANSFUSING THE BLOOD, ANTIGEN OF THE DONOR AND THE ANTIBODY
OF THE RECIPIENT ARE CONSIDERED.
• THE ANTIBODY OF THE DONOR AND ANTIGEN OF THE RECIPIENT ARE IGNORED
MOSTLY. THUS, RED BLOOD CELL OF "0" GROUP BLOOD HAS NO ANTIGEN AND
SO AGGLUTINATION DOES NOT OCCUR WITH ANY OTHER GROUP OF BLOOD. SO,
'0' GROUP BLOOD CAN BE GIVEN TO PEOPLE WITH ANY BLOOD GROUP.
• SO, THE PEOPLE WITH '0' GROUP BLOOD ARE CALLED UNIVERSAL DONORS.
• THE PLASMA OF AB GROUP BLOOD HAS NO ANTIBODY. THIS DOES NOT CAUSE
AGGLUTINATION OF RED BLOOD CELL FROM ANY OTHER GROUP OF BLOOD. THE
PEOPLE OF AB GROUP CAN RECEIVE BLOOD FROM PERSONS WITH ANY BLOOD
GROUP.
• SO, PEOPLE WITH AB GROUP BLOOD ARE CALLED UNIVERSAL RECIPIENTS.

12. PRINCIPLES OF
BLOOD TYPING
•

14. TRANSFUSION
REACTIONS DUE TO ABO
INCOMPATIBILITY
JAUNDICE
CARDIAC SHOCK
RENAL SHUT DOWN

15. RH FACTOR
• RHESUS FACTOR IS AN INHERITED DOMINANT FACTOR. IT
CAN BE
HOMOZYGOUS RHESUS POSITIVE WITH DD
HETEROZYGOUS RHESUS POSITIVE WITH DD.
RHESUS NEGATIVE CAN OCCUR ONLY WITH COMPLETE
ABSENCE OF D (I.E. WITH HOMOZYGOUS DD).

16. TRANSFUION REACTIONS DUE TO
RH INCOMPATIBILTY
Mother RH “-ve” Father RH “+ve”
Baby RH “+ve” antigen
(inherited from father)
Mother Anti-RH agglutinins
(Because exposure to baby’s RH”+ve” antigen)
Mothers agglutinins
Diffuse through placenta
Into foetus
Resulting in RBC agglutination
(Hemolysis)
Release of HB: in blood
Macrophage  Haemoglobin  Bilirubin
Skin Yellow-Jaundice
Antibodies can
also attack and
damage other
cells of body
HEMOLYTIC DISEASE OF NEW BORN

17. NEED FOR
TRANSFUSION
• BLOOD TRANSFUSION IS ESSENTIAL IN THE
FOLLOWING CONDITIONS:
• 1. HEMORRHAGE
• 2. TRAUMA
• 3. BURNS
• 4. ANEMIA

18. PRECAUTIONS
1. Donor must be healthy without any diseases like:
a. The sexually transmitted diseases such as syphilis.
b. The diseases due to virus like hepatitis, acquired immune deficiency syndrome (AIDS) etc.
2. Only compatible blood must be transfused.
3. Both matching and cross matching of recipient blood and donor blood must be done.
4. Rh compatibility must be confirmed.
1. Apparatus for transfusion must be sterile.
2. The temperature of blood to be transfused must same as body temperature.
3. The transfusion of blood must be slow. The sudden rapid infusion of blood into the body
increases the effect on the heart resulting in many complications.

19. WHO CAN
DONATE?
• DONOR SELECTION INVOLVES
• HISTORY:
◦ AGE 18-65YEARS
◦ NOT IN HIGH RISK GROUP
◦ NO BLOOD DONATION IN PAST 6 MONTHS
◦ NO PREGNANCY WITHIN LAST 12 MONTHS, NOT
LACTATING
◦ NO MAJOR SURGERY IN PAST 6 MONTHS
◦ NO BLOOD TRANSFUSION OR ORGAN TRANSPLANT
IN PAST 12 MONTHS
Guidelines by W.H.O for blood
donation

20. • NO TATTOO OR SKIN PIERCING IN LAST 12 MONTHS
◦ NOT VACCINATED IN LAST 4 WEEKS
◦ NO HISTORY OF HIV INFECTION, HBV, SYPHILIS
◦ NOT ON CYTOTOXICS, HYPOGLYCAEMIC AGENTS, OR
TERATOGENIC DRUGS
• ◦ MEDICAL HISTORY: NO HTN, DM, CARDIAC RENAL OR
LIVER DISEASE, CANCER, BLEEDING DISORDER.
• EXAMINATION
◦ CLINICALLY STABLE
◦ NORMAL BP, PULSE, CHEST AND ABDOMINAL FINDINGS

21. BLOOD PRODUCTS
FOR TRANSFUSION

22. ANTICOAGULANTS • HEPARIN
• COUMARIN DERIVATIVES
• EDTA
• OXALATE COMPOUNDS
• CITRATE COMPOUNDS

23. METHODS TO
PRESERVE
BLOOD IN
BLOOD BANKS
• STANDARD BLOOD BAG CONTAINS 450 +/- 45MLS
• BLOOD, WITH 60MLS OF ANTICOAGULANT
• STORED AT 2-6℃
• ANTICOAGULANTS INCLUDE
◦ HEPARIN: 24 HOURS
◦ CITRATE-PHOSPHATE-DEXTROSE (CPD): 21 DAYS
◦ CITRATE-PHOSPHATE-DEXTROSE-ADENINE(CPDA): 35 DAYS

24. WHOLE BLOOD
• CONTAINS ALL BLOOD COMPONENTS
• ◦ CELLULAR ELEMENT:
• ◦ PLASMA: CLOTTING FACTORS, PROTEINS, ELECTROLYTES, GASSES, GLUCOSE,
MINERALS
• FRESH IF COLLECTED AND USED WITHIN 3HOURS
• USE IS LIMITED TO WHERE FRACTIONS ARE NOT AVAILABLE
INDICATIONS-
• SUDDEN HAEMORRHAGE WITH LOSS OF UP TO 20% OF BLOOD VOLUME
• LACK OF APPROPRIATE BLOOD COMPONENT

25. RBC PRODUCTS
• PACKED RBC:
• OBTAINED AFTER CENTRIFUGATION OF WHOLE BLOOD AT 3000R/M AND REMOVING THE
SUPERNATANT ( WHOLE BLOOD- PLASMA)
• 1 UNIT- INCREASES HEMOGLOBIN BY 1% AND HCT BY 3%
INDICATIONS
• PATIENTS WITH CHRONIC ANAEMIA
• ACUTE HEMORRHAGE ( >1500ML / 30% OF BLOOD VOLUME LOST)
• IMPROVE OXYGEN DELIVERY

26. PLATELET CONCENTRATES
• OBTAINED IN 2 WAYS
MANUALLY: WB AT 1000R/M FOR 3MIN , THEN SUPERNATANT AT 3000R/M FOR 5MIN
( DOUBLE CENTRIFUGATION)
2. AUTOMATICALLY USING PROCESSORS (APHERESIS)
• STORED AT 20-24℃ WITH CONTINUOUS AGITATION
• SHELF LIFE IS 5 DAYS
INDICATED
• THROMBOCYTOPENIA
• CONSUMPTIVE COAGLOPHATY
• APLASTIC ANAEMIA

27. PLASMA
• ACELLULAR COMPONENT , PROTEIN COMPONENT – CLOTTING FACTORS ,VWF,
VITAMIN K DEPENDENT FACTORS
INDICATIONS
• COAGULATION DEFECTS ( LIVER DISEASE, DIC)
• RAPID REVERSAL OF WARFARIN

28. FRESH FROZEN PLASMA
• WB- 3000R/M, SEPARATE AND RAPIDLY FREEZE THE SUPERNATANT WITHIN 8
HRS IN CO2+ ETHYL ALCOHOL
• STORAGE TEMPERATURE- -18℃ UPTO 12 MONTHS
• CONTAINS ALL COMPONENTS OF COAGULATION AND FIBRINOLYTIC SYSTEM
• THAW AT 37℃ BEFORE USE.
INDICATION:
• SAFE IN SURGICAL HEMOSTASIS

29. CRYOPRECIPITATE
• IS THE PRECIPITATE WHEN FFP IS ALLOWED TO THAW AT 4℃ AND THE SUPERNATANT
PLASMA REMOVED
• RICH IN F8, F13, VWF, FIBRINOGEN
• STORED AT -30℃, SHELF LIFE IS 12MONTHS
INDICATIONS
• HAEMOPHILIA
• VONWILLIBRAND’S DISEASE

30. INTRAVENOUS
REPLACEMENT
FLUIDS
CRYSTALLOID SOLUTIONS
• CONTAIN A SIMILAR CONCENTRATION OF SODIUM TO PLASMA
• ARE EXCLUDED FROM THE INTRACELLULAR COMPARTMENT BECAUSE THE
CELL MEMBRANE IS GENERALLY IMPERMEABLE TO SODIUM
• CROSS THE CAPILLARY MEMBRANE FROM THE VASCULAR
COMPARTMENT TO THE INTERSTITIAL COMPARTMENT
• ARE DISTRIBUTED THROUGH THE WHOLE EXTRACELLULAR
COMPARTMENT
• NORMALLY, ONLY A QUARTER OF THE VOLUME OF CRYSTALLOID INFUSED
REMAINS IN THE VASCULAR COMPARTMENT.

31. COLLOID SOLUTIONS
• INITIALLY TEND TO REMAIN WITHIN THE VASCULAR COMPARTMENT
• MIMIC PLASMA PROTEINS, THEREBY MAINTAINING OR RAISING THE COLLOID OSMOTIC PRESSURE OF
BLOOD
• PROVIDE LONGER DURATION OF PLASMA VOLUME EXPANSION THAN CRYSTALLOID SOLUTIONS
• REQUIRE SMALLER INFUSION VOLUMES.

32. ADMINISTERATION OF
BLOOD • STERILE MEDIUM
• Y TUBING
• LARGE BORE NEEDLE
• IV INFUSION SET
• NORMAL SALINE

33. BLOOD
SALVAGE
• AUTOLOGOUS BLOOD TRANSFUSION IS THE TRANSFUSION OF BLOOD INTO ITS
DONOR.
Geng QS, Zhu YS. [Application of autologous blood transfusion in oral and
maxillofacial surgery]. Shanghai Kou Qiang Yi Xue. 2005 Feb;14(1):81-5.
Chinese. PMID: 15747023.

34. • METHODS OF BLOOD SALVAGE SHOULD BE
• ASEPTIC
• ANTICOAGULANT
• FILTRATION; 4-6 LAYERS OF GAUZE OR SPECIAL FILTERS
• SHELF LIFE 4HRS AT ROOM TEMPERATURE OR 24HRS AT 4℃

35. PRE OPERATIVE BLOOD SALVAGE
PRE OPERATIVE HEMODILUTION
PERI OPERATIVE BLOOD SALVAGE

36. CALCULATION
OF INFUSION
RATE
• INFUSION /FLOW RATES ARE ADJUSTED TO DESIRED DROPS PER MINUTE BY
A CLAMP ON TUBING
• MACRODRIP TUBING-15 DROP/ML
• MICRODRIP TUBING-60 DROPS/ML
• DROP FACTOR=NO.OF DROP CONTAINED IN MILLILITER
• ***ADMINISTRATION SET DROP FACTOR IS CONSTANT
• CALCULATION OF DROP RATES-
• AMOUNT OF FLUID(ML) X DROP FACTOR(DROPS/ML)=IV INFUSION RATE
TOTAL TIME OF INFUSION ( IN MINUTES)

37. ESTIMATION
OF BLOOD
LOSS
IMPORTANCE
• FOR TIMELY RESUSCITATION
• MINIMISES HEMORRHAGIC SHOCK
METHODS
• CLINICAL ASSESSMENT
• VISUAL ESTIMATION
• GRAVIMETRIC / QUANTITATIVE METHOD
• COLORIMETRIC

38. SALMA RG, AL-SHAMMARI FM, AL-GARNI BA, AL-QARZAEE MA. OPERATIVE TIME, BLOOD LOSS,
HEMOGLOBIN DROP, BLOOD TRANSFUSION, AND HOSPITAL STAY IN ORTHOGNATHIC
SURGERY. ORAL MAXILLOFAC SURG. 2017 JUN;21(2):259-266. DOI: 10.1007/S10006-017-0626-1.
EPUB 2017 MAY 2. PMID: 28466191.

39. MASSIVE
BLOOD
TRANSFUSION
• THE REPLACEMENT BY TRANSFUSION OF BLOOD EQUIVALENT TO OR
GREATER THAN A PATIENT’S TOTAL BLOOD VOLUME WITHIN A 24
HOUR PERIOD
• REPLACEMENT OF MORE THAN HALF OF THE PATIENT’S BLOOD
VOLUME IN 1 HOUR

40. INDICATIONS
• HAEMORRHAGIC SHOCK FROM TRAUMA
• RUPTURED ANEURYSM
• MASSIVE GI HAEMORRHAGE

41. COMPLICATIONS • 1. TECHNICAL & CLERICAL ERRORS
• 2. CIRCULATORY OVERLOAD
• 3. HYPOTHERMIA
• 4. HYPERKALAEMIA
• 5. HYPOCALCAEMIA (CITRATE TOXICITY)
• 6. ACIDOSIS

42. COMPLICATIONS
OF BLOOD
TRANSFUSION
ACUTE TRANSFUSION REACTIONS ARE TYPICALLY
CLASSIFIED INTO THE FOLLOWING ENTITIES :
• VOLUME OVERLOAD
• BACTERIAL CONTAMINATION AND ENDOTOXEMIA
• ACUTE HEMOLYTIC REACTIONS
• NONHEMOLYTIC FEBRILE REACTIONS
• TRALI
• ALLERGIC REACTIONS

43. • VOLUME OVERLOAD OCCURS WHEN THE VOLUME OF THE
TRANSFUSED BLOOD COMPONENTS AND THAT OF ANY
COINCIDENTAL INFUSIONS CAUSE ACUTE HYPERVOLEMIA,
WHICH CAN LEAD TO ACUTE PULMONARY EDEMA.

44. BACTERIAL CONTAMINATION AND ENDOTOXEMIA MAY RESULT FROM ANY OF THE
FOLLOWING:
• OPENING THE BLOOD CONTAINER IN A NONSTERILE ENVIRONMENT
• INADEQUATE STERILE PREPARATION OF THE PHLEBOTOMY SITE
• THE PRESENCE OF BACTERIA IN THE DONOR’S CIRCULATION AT THE TIME OF BLOOD
COLLECTION

45. • ACUTE HEMOLYTIC REACTIONS MAY BE EITHER IMMUNE MEDIATED OR NON–IMMUNE
MEDIATED.
• IMMUNE MEDIATED HEMOLYTIC TRANSFUSION REACTIONS ARE USUALLY CAUSED BY
IMMUNOGLOBULIN (IG) M (ANTI-A, ANTI-B, OR ANTI-A, B). THEY RESULT IN SEVERE AND
POTENTIALLY FATAL COMPLEMENT-MEDIATED INTRAVASCULAR HEMOLYSIS.
• NON-ABO ANTIBODIES TYPICALLY RESULT IN EXTRAVASCULAR SEQUESTRATION,
SHORTENED SURVIVAL OF TRANSFUSED RED CELLS, AND MILD CLINICAL REACTIONS.
• NONIMMUNE HEMOLYTIC TRANSFUSION REACTIONS OCCUR WHEN RBCS ARE
DAMAGED BEFORE TRANSFUSION, RESULTING IN HEMOGLOBINEMIA AND
HEMOGLOBINURIA WITHOUT SIGNIFICANT CLINICAL SYMPTOMS.

46. NONHEMOLYTIC FEBRILE REACTIONS ARE USUALLY CAUSED BY CYTOKINES FROM
LEUKOCYTES IN TRANSFUSED RED CELL OR PLATELET COMPONENTS.
• THIS CONDITION RESULTS IN FEVER, CHILLS, OR RIGORS. A NONHEMOLYTIC
TRANSFUSION REACTION IS A DIAGNOSIS OF EXCLUSION BECAUSE HEMOLYTIC AND
SEPTIC REACTIONS CAN PRESENT SIMILARLY.

47. TRALI HAS 2 PROPOSED PATHOPHYSIOLOGIC MECHANISMS:
• THE ANTIBODY HYPOTHESIS AND THE NEUTROPHIL PRIMING HYPOTHESIS. BOTH
MECHANISMS LEAD TO PULMONARY EDEMA IN THE ABSENCE OF CIRCULATORY
OVERLOAD.
• THE ANTIBODY HYPOTHESIS STATES THAT AN HLA CLASS I, HLA CLASS II, OR
HUMAN NEUTROPHIL ANTIGEN ANTIBODY IN THE TRANSFUSED COMPONENT
REACTS WITH NEUTROPHIL ANTIGENS IN THE RECIPIENT. THE RECIPIENT’S
NEUTROPHILS LODGE IN THE PULMONARY CAPILLARIES AND RELEASE
MEDIATORS THAT CAUSE PULMONARY CAPILLARY LEAKAGE. AS A CONSEQUENCE,
MANY PATIENTS WITH TRALI DEVELOP TRANSIENT LEUKOPENIA.
• THE NEUTROPHIL PRIMING HYPOTHESIS DOES NOT REQUIRE ANTIGEN-ANTIBODY
INTERACTIONS AND OCCURS IN PATIENTS WITH CLINICAL CONDITIONS THAT
PREDISPOSE TO NEUTROPHIL PRIMING AND ENDOTHELIAL ACTIVATION, SUCH AS
INFECTION, SURGERY, OR INFLAMMATION. BIOACTIVE SUBSTANCES IN THE
TRANSFUSED COMPONENT ACTIVATE THE PRIMED, SEQUESTERED NEUTROPHILS,
AND PULMONARY ENDOTHELIAL DAMAGE OCCURS.

48. ALLERGIC REACTIONS PRESENT WITH RASH, URTICARIA, OR PRURITUS.
THEY ARE USUALLY IGE MEDIATED. THESE REACTIONS ARE ATTRIBUTED TO
HYPERSENSITIVITY TO SOLUBLE ALLERGENS FOUND IN THE TRANSFUSED BLOOD
COMPONENT.

49. BLOOD
SUBSTITUTES
• PLASMA SUBSTITUTES
• RED CELL SUBSTITUTES
• PLATELET SUBSTITUTES

50. PLASMA SUBSTITUTES
• ◦ CRYSTALLOIDS: NS, RL
• ◦ COLLOIDS: DEXTRANS- DEXTRAN 70, 40, 110
• GELATINS- HAEMACEL, GELOFUSCINE
• ◦ STABLE PLASMA PROTEIN SOLUTION
• ◦ ALBUMIN
• ◦ HYDROXYETHYL STARCH PREPARATIONS: HETASTARCH, PENTASTARCH

51. RED CELL SUBSTITUTES
• ◦ DIASPIRIN CROSS LINKED HB: SIMILAR O2 TRANSPORT AND EXCHANGE PROPERTIES AS WHOLE BLOOD
• ◦ PERFLUOROCHEMICALS: DISSOLVE O2 AND RELEASE TO TISSUES BY DIFFUSION
• ◦ ENCAPSULATED HB
• ◦ RECOMBINANT DNA DERIVED HB

52. • POGREL MA, MCDONALD A. THE USE OF ERYTHROPOIETIN IN A PATIENT HAVING MAJOR ORAL AND
MAXILLOFACIAL SURGERY AND REFUSING BLOOD TRANSFUSION. J ORAL MAXILLOFAC SURG. 1995
AUG;53(8):943-5. DOI: 10.1016/0278-2391(95)90289-9. PMID: 7629627.

53. PLATELET SUBSTITUTE
• ◦ PEGYLATED RECOMBINANT HUMAN MEGAKARYOCYTE GROWTH AND DEVELOPMENT FACTOR (PEG-RHUMGDF)
• DIRECT ALTERNATIVES TO PLATELET TRANSFUSION INCLUDE AGENTS TO STIMULATE
ENDOGENOUS PLATELET PRODUCTION (THROMBOPOIETIN MIMETICS),
• OPTIMISING PLATELET ADHESION TO ENDOTHELIUM BY TREATING ANAEMIA
• INCREASING VON WILLEBRAND FACTOR LEVELS (DESMOPRESSIN),
• INCREASING FORMATION OF CROSS-LINKED FIBRINOGEN (ACTIVATED
RECOMBINANT FACTOR VII, FIBRINOGEN CONCENTRATE OR RECOMBINANT FACTOR
XIII),
• DECREASING FIBRINOLYSIS (TRANEXAMIC ACID OR EPSILON AMINOCAPROIC ACID)
• USING ARTIFICIAL OR MODIFIED PLATELETS (CRYOPRESERVED PLATELETS,
LYOPHILISED PLATELETS, HAEMOSTATIC PARTICLES, LIPOSOMES, ENGINEERED
NANOPARTICLES OR INFUSIBLE PLATELET MEMBRANES).
Desborough MJ, Smethurst PA, Estcourt LJ, Stanworth SJ. Alternatives to allogeneic platelet
transfusion. Br J Haematol. 2016 Nov;175(3):381-392. doi: 10.1111/bjh.14338. Epub 2016 Sep 21.
PMID: 27650431.

54. • BLOOD PRODUCTS ARE ROUTINELY USED TO MANAGE
VARIOUS COAGULATION AND HEMATOLOGICAL DISORDERS.
• ORAL AND MAXILLOFACIAL SURGEONS MUST HAVE A BASIC
KNOWLEDGE AND UNDERSTANDING OF THE VARIOUS
AVAILABLE PRODUCTS.
• RISK MUST BE WEIGHED AGAINST BENEFITS EACH TIME OF
TRANSFUSION.
• A CONSULTATION WITH EACH PATIENT’S HEMATOLOGIST IS
ALWAYS ADVISED IN ORDER TO DECREASE THE RISK OF
ADVERSE EVENTS AND IMPROVE THE PATIENT’S SAFETY.

55. • TEXTBOOK OF MEDICAL PHYSIOLOGY – ARTHUR C. GUYTON.
• ORAL AND MAXILLOFACIAL SURGERY CLINICS OF NA, CORRECTED PROOF.
DOI:10.1016/J.COMS.2016.06.009
• COMPLICATIONS IN ORAL AND MAXILLOFACIAL SURGERY: MANAGEMENT OF
HEMOSTASIS AND BLEEDING DISORDERS IN SURGICAL PROCEDURES. ORAL AND
MAXILLOFACIAL SURGERY CLINICS OF NA, 23 (2011) 387-394.
DOI:10.1016/J.COMS.2011.04.006
• POGREL MA, MCDONALD A. THE USE OF ERYTHROPOIETIN IN A PATIENT HAVING
MAJOR ORAL AND MAXILLOFACIAL SURGERY AND REFUSING BLOOD TRANSFUSION.
J ORAL MAXILLOFAC SURG. 1995 AUG;53(8):943-5. DOI: 10.1016/0278-
2391(95)90289-9. PMID: 7629627.
• HANDBOOK WORLD HEALTH ORGANIZATION BLOOD TRANSFUSION SAFETY ,GENEVA