Blood transfusion is a life saving measure in
which blood from a blood bag is transferred into the vein of
a recipient. Care and survival of patients brought in
emergency situations such as natural disasters, road
accidents and gun-shots would be impossible without blood
transfusions. Patients may also require transfusions
associated with treatment of conditions like thalassaemia,
chemotherapy for cancer or bone marrow transplant.
Where does the blood come from?
A normal adult has about 5 litres of blood in
his body and can safely donate 10% of it. Blood banks
conduct blood donation drives where healthy individuals
between 18-60 years are invited to donate a part of their
blood (350ml or 450ml depending on the donor’s weight).
Proper care is taken in selecting a donor. The medical
history is taken and the prospective donor is examined for
any ailments. The blood then collected is also screened for
infectious agents such as Hepatitis B, C and HIV.
Blood groups and Rh factor
Before the blood can be given to a patient,
its blood group is determined. An individual may have A, B,
AB or O blood group and Rh positive or negative, making a
total of eight groups, eg. A Rh positive, A Rh negative and
so on. The donor blood should have a blood group that
matches with the patient’s blood.
Is blood transfusion safe?
Strict screening practices should be adopted
in the selection of blood donors. Their medical history is
taken and blood is checked for HIV and other such infections
before it is administered. The storing and processing also
has to be carefully monitored. Whole blood can be stored for
a limited time only but its various components can be frozen
and stored for a year or longer.
A technique called haemapheresis is used wherein only a
desired blood component is taken from the donor’s blood and
the remaining fluid and blood cells are immediately
transfused back into the donor. This technique allows the
collection of large amounts of a particular component, such
as platelets, from a single donor. Blood for transfusion
must be taken only from blood banks that are certified by
the Ministry of Health, Government of India. Most major
hospitals have such certified blood banks.
What are the various blood components that can
be transfused?
Red blood cells: These cells give red
colour to the blood. They carry oxygen from the lungs to the
body tissues and take carbon dioxide back to the lungs. They
are administered in cases of anaemias resulting from kidney
failures, gastrointestinal bleeding and acute blood loss
resulting from trauma.
Platelets: These are cell fragments in
the blood responsible for stopping bleeding. They are given
in the treatment of decreased platelet counts associated
with chemotherapy or a condition called thrombocytopaenia.
Plasma: It consists of 90% water and 10%
plasma proteins. It is given in case of clotting disorders.
White blood cells or leukocytes: They are
the disease-fighting cells in the blood. They are given in
cases of infections unresponsive to antibiotics.
How is blood transfused?
When a patient requires a blood transfusion,
a small volume (3ml-5ml) of his blood is sent to a blood
bank. There it is grouped for ABO and Rh and it is
cross-matched with the stored donor blood of the same group.
If the donor blood matches the patient’s blood, it is
considered suitable for transfusion.
A patient receives a blood transfusion through a superficial
vein of the forearm or the upper surface of the hand. A
transfusion set, which consists of a fine needle attached by
a plastic tubing to a drip chamber with a filter, is
connected to the blood bag. The blood or blood component is
given as a steady slow drip and one transfusion generally
takes 3-4 hours to complete.
What is a blood transfusion reaction?
This is a complication of blood transfusion
in which there is an immune response against the transfused
blood cells. Transfusion of blood between compatible groups
causes no problem. Blood transfusion between incompatible
groups causes an immune response against the cells that
carry the antigen, resulting in transfusion reaction. The
immune system of the recipient attacks the donated blood
cells, causing them to break. Serious symptoms such as
kidney failure and shock may occur. Other symptoms may
include fever, rash, blood in the urine and dizziness.
What are the risks involved?
Blood transfusion carries certain risks. Some
patients may not tolerate the blood of another individual,
inspite of it being matched and may have a transfusion
reaction. This may manifest as fever, chills,
breathlessness, a drop in blood pressure and even collapse.
Blood transfusion may also transmit infections like
hepatitis B, C, or HIV despite the blood being screened.
This is because no test can detect all infections or provide
absolutely safe blood. It is important that blood
transfusions be given only when absolutely necessary. When
used judiciously, its benefits far outweigh the risks.
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