Transfusions 101

What is a transfusion? And when does one receive a transfusion?

A transfusion is the process of giving someone various blood components from a donor. Blood cannot be manufactured and it can only come from generous donors. About 30 million blood components are transfused each year in the US.

Red blood cells are your body’s energy cells. They carry oxygen from your lungs to your organs, muscles, and brain. Platelets are small blood cells that help form a clot when you bleed. And white blood cells help you fight infection. For many reasons, any of these blood counts can be affected, such as cancer, infections, receiving chemotherapy, etc. Red blood cells can be given when you are anemic. Platelets can be given when their numbers are low and you become at risk for bleeding. In very rare, life-threatening situations, you may also be given white blood cells.

How is a transfusion given?

A transfusion is given through your vein. It can be through an intravenous line (IV) that is usually placed in your arms. It can also be given through a central line, which is a catheter that is often placed by a surgeon into a larger blood vessel.

What are the potential risks of receiving a transfusion?

It has become very safe to receive transfusion. Each donated unit of blood is screened via a rigorous process and anonymously for infectious agents, such as HIV, Hepatitis C, Hepatitis B, syphilis, and West Nile virus. Additionally, each time a transfusion is ordered, the Blood Bank at the medical facility conducts tests to make sure you are receiving properly matched blood components.

Most people who receive a transfusion do not experience any complications or problems. However, given there are still some risks associated with transfusion, your doctor will only recommend a transfusion if and when your health may be significantly impacted if you do not receive one.

When someone experiences an adverse event, the most common side effects are fever and/or hives. These side effects are often treated effectively with medications, and one can continue to receive additional transfusions safely in the future if and when needed.

Rarely, one can have a reaction in which your own body attacks the blood cells that are being transfused. This type of transfusion reaction can then result in the release of chemicals that can damage the kidneys. Other symptoms include fever, chills, dark urine and back pain.

Given the existing rigorous blood product safety screening, transmissions of blood-borne infections have become extremely rare. There is only about 1 in 2 million chance that a donated unit of blood carries HIV. The chance of transmitting Hepatitis B is about 1 in 300,000 and 1 in 1.5 million for Hepatitis C.

Are there alternatives?

In the short term, there are often no other alternatives to receiving a blood product transfusion, especially in life threatening situations where your organ function is compromised due to severe anemia, or when you are at great risk of bleeding. However, for patients who may not be able to receive transfusions due to certain religious reasons, your doctor may be able to help avoid or decrease the number of transfusions you receive with advanced planning. This is always considered jointly between the physician and the patient on a case-by-case basis, and it may not be feasible for all patients.

Courtesy of:
Dr. Hilda Ding, M.D., Pediatric Heme/Onc Fellow, Rainbow Babies & Children’s Hospital
Dr. Alex Huang, M.D., Ph.D. Associate Professor of Pediatrics, Case Western Reserve University School of Medicine