Diseases & Conditions

Blood Transfusion


Overview & Description

Blood transfusion is a procedure in which the blood or blood components from one person, called a donor, is given to another, called a recipient. Depending on the reason for the transfusion, the person may be given whole blood or a blood component, such as:

  • red blood cells
  • platelets
  • blood clotting factors
  • fresh frozen plasma
  • white blood cells
  • This blood can be obtained from many sources. Volunteer donors are carefully screened and interviewed before they are allowed to donate blood. Friends or family members can do a "directed donation." But, findings have shown that these donations are not any safer than those given by random donors. An autologous donation means that a person has donated his or her own blood to be stored for future use. This may be done prior to an elective surgery.

    Who is a candidate for the procedure?

    People receive blood transfusions for many reasons. Blood transfusions can:

  • increase the blood's ability to carry oxygen
  • restore the body's blood volume
  • improve immunity
  • correct clotting problems
  • A person may need a blood transfusion if he or she has:

  • lost blood and fluid volume as a result of an injury, surgery, or burns
  • anemia, or a low red blood cell count
  • a bleeding disorder, such as hemophilia A or hemophilia B
  • an immunodeficiency disorder, a condition that weakens the body's ability to fight off infection
  • How is the procedure performed?

    Most transfusions are given in a hospital. Sometimes they are given in outpatient settings such as an ambulatory care clinic, a doctor's office, or even a home.

    Unless an emergency exists, a sample of blood will be drawn for blood typing and cross-matching with the blood to be received. The blood type must be accurately identified when a person is to receive whole blood or red blood cells. The four blood types are known as A, B, AB, and O. Blood will also be referred to as Rh positive or Rh negative, depending upon whether the Rh antigen is present on the membrane of the red blood cells.

    A careful history and physical will be performed before the transfusion. An intravenous (IV) will be started, usually in the hand or arm. To lessen the chance of a reaction, healthcare workers take several precautions. The blood is double checked by two healthcare workers to confirm that the blood about to be given is intended for the person about to receive it. The blood is run slowly, over 1.5 to 4 hours. The person's vital signs, such as temperature, pulse, breathing rate, and blood pressure, will be closely watched during the procedure.

    Because an adverse reaction is most likely to occur in the first 15 minutes, the person is watched closely at first. Signs and symptoms of a transfusion reaction include:

  • chills
  • fever
  • breathing problems
  • chest or back pain
  • nausea
  • pain at the infusion site
  • hives and itching
  • anything "unusual" or of concern

  • Preparation & Expectations

    What happens right after the procedure?

    After the procedure, the person's vital signs will be checked and compared to baseline measurements. Blood work, including a complete blood count or CBC, may be drawn to assess the person's response to the transfusion.


    Home Care and Complications

    What happens later at home?

    The healthcare provider will tell the person which symptoms to report after the procedure. Normal diet and most activities can be resumed after a transfusion.

    What are the potential complications after the procedure?

    Transfusion reactions are usually minor, and caused by antibodies to white blood cells still present in the blood product. This occurs in about 1 to 2% of all transfusions. Most reactions slowly clear after the transfusion is stopped. Rarely, blood cell destruction can occur when the donor blood is incompatible with that of the recipient. The person might have trouble breathing, severe pain in the chest or back, and blood in the urine. This condition is rare, but can be life threatening. Other complications, such as circulatory overload, may occur to people at risk from previous health problems.

    Despite careful donor screening and blood testing, certain diseases can be transmitted by blood transfusion, although the risk is very low. These diseases include:

  • hepatitis C, which occurs in about 1 in 10,000 transfusions
  • human immunodeficiency virus, or HIV, with a risk of 1 in 670,000 transfusions
  • cytomegalovirus (CMV)
  • bacterial infections
  • malaria
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  • Concerns about the safety of donated blood products should be discussed with a healthcare provider.


    Attribution

    Author:Barbara Mallari, RN, BSN, PHN
    Date Written:
    Editor:Smith, Elizabeth, BA
    Edit Date:07/15/00
    Reviewer:Gail Hendrickson, RN, BS
    Date Reviewed:08/09/01

    Sources

    Textbook of Medical-Surgical Nursing, Ninth Edition, 2000, Smeltzer, et al

    The Merck Manual of Medical Information, 1997