This document discusses blood transfusion, including the types (heterologous and autologous), indications, functions of blood, blood components, blood fractions (packed red blood cells, fresh frozen plasma, cryoprecipitate, platelets), notes on donor requirements and stored blood, and complications of transfusion. The main indications for transfusion include hemorrhage, anemia, bleeding disorders, low platelets, and major trauma/surgery. Blood fractions are used to treat specific conditions like anemia, coagulation disorders, or thrombocytopenia. Potential complications include immunological reactions, congestive heart failure, infection transmission, electrolyte imbalances, and complications of massive transfusion like hypothermia and coagulopathy.

1. Blood Transfusion
Dr . Khaled Ghawth

2. Types :
1. Hetrologous :
O Transfusion of blood from one person to other
person.
2. Autologous :
O Transfusion of blood from one person to the
same person.

3. Indication :
1. After Haemorrhage (bleeding) :
O Acute blood loss (sever Hge)→hypotension or shock.
2. Sever anemia (Hb = 7 or less ).
3. Hemophilia bleeding and other familial disorder.
O Hemophilia ( 85% ↓ factor VIII )or IX or XI .
4. Purpura (↓plate.)(thrombocytopenia).
5. Leukopenia (↓WBC).
6. Chronic leukemia (↓bone marrow production ).
7. Hypoproteinemia (↓albumin).
8. Sever infection (septicemia).
9. Major trauma (major surgeries or burns ).

4. Function of blood :
1. Major transport medium for :
(nutrition–O2–temperature–wast product–hormones–enzymes)
2. Defense or protect mechanism by WBC .
3. Blood clotting.
4. Regulation of acid base balance (PH):
O Arterial PH = 7.4.
O Venous PH = 7.36.
Note: Respiration and renal also regulated PH.
5. Regulation of water balance .
O (hormonal “ADH & aldosterone” , thrist center and renal )

5. Blood
Plasma 60%
Dissolved
substance 10%
Organic
Protein
Albumin
Globulin
Fibrinogen
Lipid
Hormones
Enzymes
Inorganic Electrolyte
Water 90%
Cells 40%

6. Blood fraction :
1. Packed RBC (red cell concentrate).
Use in :
O Anemia (chronic) .
O Elderly .
O To reduced overload in cardiac patient.
o It stored for 35 days at 1-6 Co
.

7. Blood fraction :
2. Fresh frozen plasma (FFP).
Use in :
O Low protein & burn & hypoalbuminaemia.
O Coagulation disorder as hemophilia.
O Liver failure , cirrhosis.
O Massive transfusion.
O DIC.
O Revers the does of warfarin preoperative.
O Sever bleeding.
O ↓vitamin K .
o It stored for 2 years at - 40 C
o
.
o Dose 15 ml/kg.

8. Blood fraction :
3. Cryoprecipitate (prepared from FFP)
OWhen FFP thaws at 4C
o
=> white
supernatant layer it called Cryoprecipitate.
OContain factors VIII ,XIII, fibrinogen,
vonwillebrand’s factor.

9. Blood fraction :
4. Platelet (normal platelet in body = 150,000 – 450,000 )
Use in :
O Thrombocytopenia.
O Drugs induced hemorrhage ( aspirin – clopidogrel).
O In massive blood transfusion.
o 1 unit of platelet => ↑ platelet in blood abut 10,000

10. Notes :
1. Donor age > 18 years old.
2. Donor weight >45 kg.
3. In stored blood :
O Temp. at 2 – 6 C
o
.
O RBC last for 3 – 5 week.
O WBC rapid destroyed & platelet 5–7 day.
O Citrate bind with Ca++
=>↓Ca++
O ↓f VIII & V in 1st week 60 – 80 %.
O ↑H+
O Rapid transfusion => jaundice and fever after 1 week.
O Deylad transfusion >6hours lead to contaminated with bacteria
O Massive transfusion :
O Cold transfusion + blood loss => hypothermic coagulopathy (bleeding).
O ↓platelet,,↑K+
and ↓Ca++

11. Complication of blood transfusion :
1. Immunological reactions :
A. Hemolytic reaction (may killed)=> DIC (start in 1st 0.7ml Ag –Ab reaction to ABO
incompalibility .
O C/F
O ↓BP
O Chest pain with restlessness.
O Fever with chill.
O Jaundice
O Dyspnea
O IV set pain & oozing.
O R/
O Stop transfusion.
O IV fluid
O Diuretic (osmotic)
O Corticosteroid .

12. Complication of blood transfusion :
1. Immunological reactions :
B. Allergic reaction => anaphylactic shock (due to protein
allergic )
OC/F
OItching .
OUrticaria.
OLaryngeal edema => dyspnea .

13. Complication of blood transfusion :
2. Congestive heart failure (CHF):
O Due to massive transfusion (more in elderly, pregnant &cardiac
disease ).
3. Transmission of infection :
O (HBV, HCV, HIV, Malaria)
4. Electrolyte imbalance.
5. Citrate intoxication
O ↓Ca++
so give 10ml Ca++
for 2 units blood.

14. Complication of blood transfusion :
6. Air embolism.
7. Transfusion related acute lung injury (TRALI)
O Ab – Ag reaction => (ARDS)
8. Thrombophlebitis .
9. Massive transfusion complication :
O Hypothermia => coagulopathy.
O ↓Ca++
=> convulsion.
O ↑K+ => cardiac arrest.
O DIC
O ARDS
O ↓platelet => sever bleeding.