Blood Transfusions in Adults

What is a blood transfusion?

A blood transfusion is when blood is put into the body. During a blood transfusion, you receive donated blood through one of your blood vessels. A needle is put into a vein, often in the arm. The needle is attached to a thin, flexible tube called a catheter. This is called an intravenous line, or IV. Blood is sent into your vein through this IV line.

Your blood has several parts. Plasma is the liquid part of your blood. It’s made of water, proteins, clotting factors, hormones, and other substances.

Floating in the plasma are many red blood cells (RBCs). These large cells contain hemoglobin. Hemoglobin lets RBCs carry oxygen from your lungs to the rest of your body. Your whole body needs oxygen, so it’s important to have enough RBCs.

Your blood also contains white blood cells. These help the body fight infection.

And your blood contains smaller cells called platelets. These help the blood clot. Proteins called clotting factors also help your blood clot. Without these, your body can’t stop bleeding from even a tiny wound.

Whole blood refers to blood with all these parts. Most of the time, a blood transfusion is done with only part of the blood. You might be given one or more of these blood parts based on your needs.

When you have a blood transfusion, it’s important to be given the right blood. Blood comes in 4 main types: A, B, AB, and O. These types refer to molecules called antigens on the surfaces of blood cells. Antigens are substances that can cause a person’s immune system to react.

Rh factor is another type of antigen. Blood is either Rh positive or Rh negative. Each person’s blood is one of 8 specific types: A+, A−, B+, B−, AB+, AB−, O+, and O−.

If a person receives the wrong type of blood, his or her immune system will react to it. This is a serious condition that can cause severe symptoms such as fever, muscles aches, and trouble breathing. It can sometimes be fatal.

People with O− blood do not have A, B, or Rh molecules on their blood cells. These people can donate blood to anyone, and are known as universal donors.

People who are AB+ have all three molecules (A, B, and Rh) on their blood cells and can safely receive blood from anyone.

Other blood types can donate and give to only their matching blood types.

Why might I need a blood transfusion?

You might need a blood transfusion if you’ve had a problem such as:

  • A serious injury that’s caused major blood loss
  • Surgery that’s caused a lot of blood loss
  • Blood loss after childbirth
  • A liver problem that makes your body unable to create certain blood parts
  • A bleeding disorder such as hemophilia
  • An illness that causes reduced or poor-quality RBCs (anemia)
  • Kidney failure, which causes problems with blood cell production
  • Treatment for cancer (chemotherapy) that slows down your body’s production of blood cells

Different medical problems may need different types of blood transfusions. For example, after surgery you may need just RBCs. You might need plasma if you have a severe infection. A person being treated for cancer may need platelets. Your healthcare provider can tell you why you need a blood transfusion, and which type is best for you.

What are the risks of blood transfusions in adults?

All procedures have some risks. The risks of blood transfusions include:

  • An allergic reaction. This can be mild or severe. Mild symptoms can include itching or rash. Severe symptoms can include trouble breathing, chest pain, or nausea. These symptoms may start soon after your blood transfusion or within the next 24 hours.
  • Fever. This can happen within a day of the blood transfusion. It’s usually temporary.
  • Destruction of red blood cells by the body (hemolytic reaction). A hemolytic reaction happens when your body attacks the donated RBCs. This happens if you receive a blood type that your blood isn’t compatible with. Donated blood goes through a very careful matching process, so this reaction is very rare. If it does happen, it can cause chills, fever, kidney damage, and other serious symptoms. Symptoms can happen during the blood transfusion or in the next several hours. A delayed hemolytic reaction can also happen. This can happen even if you received the right blood type. This may take days or weeks to happen. It may not cause any symptoms, but it can cause your RBC count to be lower.
  • Too much blood in the body (transfusion overload). Transfusion overload may happen if a person receives more blood than needed. It can cause shortness of breath and other symptoms. The symptoms usually happen within a few hours to a day. It’s more common in people with heart problems. Taking diuretic medicine after a blood transfusion may prevent this problem.
  • Too much iron in the body (iron overload). This can happen in people who need to have many blood transfusions over time for an ongoing medical condition.
  • Viruses being transmitted. The viruses can include HIV or hepatitis. Blood goes through a very careful screening before blood transfusions. The risk of a virus being passed on is very low.
  • Graft versus host disease. This is a condition where the new, donated blood cells attack cells in the body. It’s a serious but rare condition. Symptoms such as fever and rash may start within a month of the blood transfusion.

Your own risks may vary according to your general health, the type of blood transfusion, and whether you’ve had a blood transfusion before. Talk to your healthcare provider about which risks may apply to you.

How do I get ready for a blood transfusion?

You likely won’t need to do much to get ready for your blood transfusion. Your healthcare provider will let you know if you need to prepare in any way.

Make sure to tell him or her if you have ever had a bad reaction to a blood transfusion. You may be given a medicine to help prevent an allergic reaction.

Most hospitals need a consent form before a blood transfusion. This needs to be signed by you or by a chosen family member.

Your blood may be tested before the blood transfusion to find out what type it is. This is to make sure that you get the right kind of donor blood. Your finger may be pricked to get a few drops of blood. Or you may have blood taken from a vein in your arm.

What happens during a blood transfusion?

During the procedure, you will be given blood from one or more people who donated it. In some cases, you may be given blood that was taken from you before. Or you may be given blood from a family member or friend.

A healthcare provider will clean the area where the IV will go. He or she will insert an IV into one of your veins, most likely in your arm. The whole blood or blood parts will be sent through this line. The whole process may take 1 to 4 hours.

A healthcare provider will watch you for any signs of negative reactions. These are most likely in the first 15 minutes. Tell the healthcare provider right away if you start having symptoms.

You should be able to eat, drink, and go to the bathroom with help during the procedure. Your healthcare provider will let you know about what else to expect.

What happens after a blood transfusion?

After your blood transfusion, your vital signs will be checked. These include your temperature and your blood pressure.

You may be able to go home soon after your blood transfusion. You should be able to go back to your normal activities and eat a normal diet. Your healthcare provider may give you additional instructions.

The area on your arm where you had the IV may be sore for a few hours. Tell your healthcare provider right away if you have fever, trouble breathing, swelling at the IV site, or other symptoms.

You may need to have follow-up blood tests. This is to see how your body is responding to the blood transfusion.

Next steps

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or procedure
  • What results to expect and what they mean
  • The risks and benefits of the test or procedure
  • What the possible side effects or complications are
  • When and where you are to have the test or procedure
  • Who will do the test or procedure and what that person’s qualifications are
  • What would happen if you did not have the test or procedure
  • Any alternative tests or procedures to think about
  • When and how will you get the results
  • Who to call after the test or procedure if you have questions or problems
  • How much will you have to pay for the test or procedure

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