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Tuesday, September 29, 2020

Blood Transfusion – Purpose, Procedure, Risks, Complications and More

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Blood transfusion is a common technique that is commonly used in the hospital, especially when the patient is in grave danger. Although it is a usual procedure, many do not, however, understand the process of the technique or why it is done.

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This article is to further enlighten us on what blood transfusion is, what it entails as well as the possible dangers that can occur if this process is not correctly carried out.

Blood transfusion is simply the transfer of blood and spits products such as blood serum, plasma, and so on from one person who is also known as the donor to another who is called the recipient.

Mostly, this technique is done as a life-saving process in order to quickly help the patient (recipient) recover lost blood cells and other products.

One a patient loses blood and its components through severe bleeding caused by an accident, loss of blood due to the patient suffering from severe anemia or bleeding that occurs during surgery, the next best way to replace the blood loss quickly is through blood transfusion.

However, blood transfusion during surgery is not usually common; however, sometimes, the situation may be complicated, and as such, a blood transfusion may be needed.

According to research, the time taken for blood transfusion to finish taking place depends on the amount of blood that the recipient needs.

However, on the average, blood transfusion usually 1-4hours before completion.

What exactly occurs during blood transfusion?

Generally, the blood is made of several components. It has the white blood cells, the red blood cells, the platelets, the Serum, and the blood plasma.

During a blood transfusion, depending on the cause of the bleeding and what was lost during bleeding, the patient may require what is known as whole blood.

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Whole blood describes a type of blood that contains all the components of blood in its equal proportion. In other words, whole blood must contain all the parts of blood that have been listed above equally.

However, it is not all type of blood transfusion that requires the use of whole blood.

Hence, during a blood transfusion, a particular type of blood is gotten from a donor who has the kind of blood sample as the recipient, and the blood is thereby transferred from the patient either directly or indirectly through the use of a blood bag.

As much as this is a life-saving procedure, it can quickly result in a life-threatening process if it is not done correctly, the adequate measures are not taken as well as the necessary tests are not carried out.

How then do you prepare for a blood transfusion process?

Before blood transfusion can be done, there are several procedures that are carried out. They include:

Testing to know the blood type of the patient (recipient)

The blood type of the patient determines that which will be transfused to him/her. There are four basic blood types that there is.

They are blood groups A, B, AB, and O. These four different blood groups may or may not be able to collect blood from each other. In other words, blood group A can only receive blood from blood group A and blood group O.

You may be wondering why blood group O; however, you must understand that blood group O is considered to be universal donors.

Patients with blood group B can only receive from blood group and blood group O while those who are blood group AB can only receive from blood group AB and O. Likewise, people with blood group O can only receive from blood group O.

Asides the blood group factor, there is another important test that must be carried in knowing the exact kind of blood type the patient has. This test is known as the Rhesus Factor test.

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A person can only have either one of the two types of rhesus factors that we have. You can either have the Rhesus positive factor (RH+) or the Rhesus negative factor (RH-).

The essence of having to test your blood before any blood transfusion is done is to prevent any kind of adverse blood reaction that may occur.

Testing to know the blood type of the donor(giver)

The blood type of the donor is essential when considering carrying out a blood transfusion. This is because if the blood type of the donor is not known before transfusion is done, then there is a high tendency that the patient may experience a blood reaction after blood transfusion has been carried out.

Asides this, the blood of the donor must be screened for blood diseases such as HIV, malaria, hepatitis, syphilis, and any form of blood disease. This is because when transfusing blood to any patient from a donor blood, which has a type of blood disease, the patient automatically gets this disease.

In some cases, especially in the case of HIV and hepatitis B, which has no cure, it may be difficult and sometimes almost near impossible to treat these diseases, which have been gotten as a result of the transfusion of an infected blood.

What are the blood types that are available?

There are basically four blood groups according to the ABO blood grouping. They include blood groups A, B, AB, and O.

These are the universally accepted blood groups that are available, and everyone has one of these blood group types.

Among these blood groups, there are some that are considered unusual. Unusual in the sense that they are either universal recipients or they are 2universal donors.

Blood group AB is regarded as universal recipients. Universal recipients mean that people in this blood group can collect blood from any of the four blood groups without the fear of any blood transfusion reaction.

This is because people who have these blood groups have both antigen A and antigen B on their red blood cells, making them capable of receiving blood from blood groups A, B, and O.

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On the other hand, blood group O is considered to be a universal donor. This is because people within this blood group are capable of giving blood to any patient without the fear of blood transfusion reaction.

This kind of blood is mostly used during emergencies or in situations where blood transfusion is required urgently but no time or facility to test the blood.

Asides the general classification of blood that is available, there is another additional factor that is based on what is known as the rhesus factor. This factor was gotten as a reaction of blood, which was first tested on rhesus monkeys hence the name “Rhesus factor.”

Under this classification, a person can either be positive or negative. If a person has the rhesus factor, he is considered to be positive, and if the factor is absent, the person is deemed to be negative.

For example, if a person has blood group A and has the rhesus factor, the person is said to be Blood group A positive(A+)

Types of blood transfusions

Contrary to popular opinion, there are different types of blood transfusions that can be carried out. The kind of blood transfusion to be carried out depends on the need of the patient.

Blood can either be transfused wholly, which is otherwise known as a whole blood transfusion or blood can be transfused in parts(whose naming depends on the part of blood transfused.)

Red cell transfusions

The red blood cell, which is a component of the blood, can be transfused to a patient. According to research, it has been observed that the most common type of transfusions that are done is the red blood cell transfusion.

The essential function of the red blood cell is to transmit oxygen from the lungs through the hemoglobin, which is present within the red blood cell, as well as transmit carbon dioxide from tissues and cells.

Hence, if there is a problem with the red blood cells, then there will be a problem with the oxygen-carrying capacity of the blood. If a patient has lost a lot of blood either through an accident or during a surgical procedure, the patient will be advised to go for a red blood cell transfusion.

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If a patient is considered anemic either though severe external or internal bleeding or from the after-effects of a particular disease, then the patient will be transfused with red blood cells in order to replace that part of the blood.

Anemia is a condition in which there has been a decrease in the hemoglobin (oxygen-carrying capacity of the blood) due to a reduction in the number of red blood cells in the body.

Platelet transfusions

Platelet transfusions are done when the platelets of the patient are low, and as such, blood clotting can’t occur. Some diseases, as a part of its symptoms, interfere with the clotting capacity of the blood.

Diseases such as hemophilia which is a rare bleeding disorder that doesn’t allow your blood to clot properly. Hemophilia is an inherited disease that is caused by genetic factors.

The platelets, also known as thrombocytes, are a part of the blood that helps prevent excessive bleeding by forming a plug (clot) at the site of injury. It’s not only external bleeding that is stopped by platelets, and internal bleeding as well isn’t left out.

What are the sources of blood that transfused?

The blood that is used for blood transfusion is human, and it just doesn’t fall from the sky, it comes from two sources;

People who are called blood donors

A blood donor is a person that willingly gives out his blood for transfusion with or without monetary attachments. There are several types of blood donor available, and they include:

  • Homologous blood donor: A homologous blood donor is someone who gives out blood to a known patient. The patient could be a friend, relative, colleague, associate, and so on.
  • A voluntary blood donor: A voluntary blood donor is a person who gives out blood to a blood bank without being paid. This means that the person willingly donates his blood for goodwill.
  • A commercial blood donor: This is a person who gives out blood to a blood bank willingly but with some form of monetary attachment. This means that commercial blood donors are people who give out blood in exchange for money.
  • A designated blood donor: A designated blood donor is a person that was personally appointed by a patient to donate blood to him before surgery. This person is carefully selected, and the patient feels comfortable with the donor. The donor is often a friend or close relative to the patient.

Autologous blood

This is a blood that is gotten from a donor who donates his blood for himself in order to be used for surgery. There are five ways autologous blood donation can be carried out. They include:

Pre-operative blood transfusion

This donation involves the patient giving out his blood before the surgery is carried out. What happens is that the blood bank draws out blood from the patient and stores it until it is needed during the patient’s surgery.

However, this process has a limitation. It is only done during non-emergency cases. This means that autologous pre-operative donation is only done when the surgery has been scheduled beforehand.

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It also requires pre-planning, and that may cause a delay in the surgical process.

Intra-Operative blood transfusion

Intra-operative autologous donation is done mostly during surgery. In this process, the blood that is lost during operation is collected, filtered, processed, and transfused back into the patient’s body. This process is mostly done during emergency surgery.

The advantage of this process is that it eliminates the excessive need for donor blood during surgery. However,  the disadvantage of this process is that it can’t be done for people who may have cancer or any other infectious disease in their blood.

Post-Operative blood transfusion

This process has to do with the recycling of a patient’s blood after surgery. Blood that is lost during operation is collected, filtered, and processed and is infused into the patient after surgery.

It is almost similar to intra-operative blood donation.

Hemodilution

This process has to do with the patient donating his/her blood during surgery. Just before surgery, intravenous (IV)lines are placed to collect some of your blood, and that part taken is replaced with fluids.

The essence of this process is to dilute the patient’s blood, so he/she doesn’t lose a lot of concentrated blood during surgery. Once the operation is completed, the blood that was taken from the patient is then filtered and transfused back into the body of the patient.

The advantage of this process is that it reduces the need for a blood donor transfusion; however, it can not be done in some medical conditions, and also, the amount of blood that can be collected initially is limited, and as such, the patient may still need blood after surgery.

Apheresis

Apheresis simply refers to the donation of blood but not the entire contents as in whole blood. In this process, part of the blood is what is donated (either plasma or platelets). Before surgery, part of the patient’s platelets and plasma is collected.

During operation, these parts of the blood are then transfused back in order to prevent excess bleeding. This process is majorly done for elective surgeries.

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Who needs a blood transfusion

Blood transfusion is a very common process that is carried out in hospitals. Research has shown that in America, almost 5-6 million blood transfusions are done every year. This procedure can be carried out on people of all age groups.

The most common people who are known to need blood transfusions are those who are to undergo surgical operations. However, there are some people who need a blood transfusion for use asides medical operations. They include:

 

Complications

There are certain complications that can arise as a result of a poorly done blood transfusion. They include

 

  • Allergic reactions: Some allergic reactions can occur due to improperly done blood transfusion. However, in some people, even if the transfusion was done right, they might still have some allergic reactions. The symptoms of this reaction can range from mild to severe, and the signs include anxiety, chest pain,back pain, difficulties in breathing, fever, low blood pressure as well as nausea.
  • Transmissible infections: There are some infections that survive in the blood, and once they are transfused, they will infect the body of the patient. Blood banks try to reduce the risk of transmissible diseases. However, in case of an emergency or in situations where blood transfusion must be done, but the blood can’t be screened due to the lack of adequate facilities, the recipient may be at the risk of developing a transmissible reaction.
  • Severe fever
  • Iron Overload
  • Acute Immune Hemolytic Reaction: This is a very rare complication; however, it occurs when the blood that is transfused is rejected by the patient’s body or if by chance, the blood typing went wrong, it will cause the body to attack the new red blood cells and as such cause the kidney to produce harmful substances.

Reaction symptoms include severe chills, fever, nausea and vomiting, chest pain, back pain, and dark urine production.

  • Delayed hemolytic reaction: This is the slower form of the acute hemolytic immune response. This occurs when the body of the patient rejects the blood transfusion; however, it is not instant. The antibodies of the patient begin to fight the red blood cells destroying it little by little until the patient has a reduced amount of red blood cells left. This will cause anemia in the patient.
  • Graft-versus-Host disease: This disease occurs when the white blood cells that have been transfused begins to attack the tissues of the recipient of the blood. This disease is usually very fatal in itself. People who have a reduced or weakened immune system are those who are mostly at the receiving end of this disease.

Symptoms of this disease start gradually, usually within the first month after transfusion has taken place. The symptoms of the disease include intense fever, rash, and diarrhea.

In conclusion, blood transfusion is done as a life-saving method. It has proven to save lives, especially in the case of emergencies.

Although the possibility of contracting an infection from donated blood during blood transfusion is low, it, however, can’t be ruled out. In order to avoid this, it is best to transfuse your blood as it is safer. (autologous blood transfusion).

Blood Transfusion
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Disclaimer: This article is purely informative & educational in nature and should not be construed as medical advice. Please use the content only in consultation with an appropriate certified medical or healthcare professional.

Deborah Akinola
Wirter, poet and public speaker
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