Blood Transfusion

• When do people need blood?
• What is a blood transfusion?
• Safety of bood poducts
• Donor transfusion
• Risks of donor transfusion

When do people need blood?

Blood is a bodily fluid which carries oxygen, nutrients and wastes around the body via small vessels. Since blood serves such an important function, large losses of blood volume can be fatal. Some people may have conditions which affect certain components of their blood, such as the white blood cells, red blood cells and platelets. A person may require extra blood if they have any of the following conditions:

• Serious bleeding due to trauma or accident
• Bleeding during surgery
• Haemophilia (a blood clotting disorder)
• Cancer
• Pregnant women whose baby is at risk of Haemolytic Disease of the Newborn (HDN)
• Serious anaemia
• Premature babies
• Heart disease

What is a blood transfusion?

Blood transfusion is the process through which patients receive extra blood. Blood from a donor or from the patient him/herself is transfused into the body to increase blood volume. Blood components may be separated prior to the procedure and transfused into the patient.

Safety of blood products

Blood borne viruses can be transmitted from a donor to a recipient through transfusion. For this reason, it is important to ensure that donor blood is free from viruses such as HIV, Hepatitis B, Hepatitis C, and Syphilis. Apart from testing for specific diseases, donors are also required to complete a thorough medical history questionnaire before donating. This helps to stop individuals at high risk of disease from donating.

Donor transfusion

Donor transfusion is where the patient receives blood from another individual (the donor). Since the blood is not the patient’s own, there is a chance that it may be rejected. The hospital will order the blood type that is required, and the number of units of blood. A doctor will then double check the blood type and ensure that it is correctly matched to the patient’s. The blood is then transfused into the patient’s vein, which takes about 2 hours. Throughout the procedure the patient is carefully monitored, in case there are any adverse reactions to the donor blood.
For more information, see Blood Donation.

Risks of donor transfusion

Viral infection
As noted above, all donated blood products undergo rigorous testing to ensure their safety and quality. However, occasionally administrative errors may result in the transmission of a viral infection.
The Australian Red Cross Blood Service Transfusion Medicine Manual states the approximate risk for the following viruses:

• HIV: less than 1 in 10 million
• Hepatitis C: less than 1 in 10 million
• Hepatitis B: 1 in 660,000
• Variant Creutzfeld-Jacob Disease: 1 in 127,000
• Malaria: between 1 in 4.9 million and 10.2 million

For more information, see also Organ and Tissue Donation

References

1. Australian Red Cross Blood Service. Who Needs Blood? [online] 2008. [cited 22 January 2008] available at: http://www.donateblood.com.au/ recipient-stories.aspx? IDDataTreeMenu=77 &parent=30
2. National Health and Medical Research Council (NHMRC) and the Australasian Society of Blood Transfusion (ABST). Clinical Practice Guidelines on the Use of Blood Components. Canberra: 2001
3. National Blood Authority. The Supply and Use of Plasma Products in Australia. Canberra: 2006
4. Goodnough, L. Risks of Blood Transfusion. Crit Care Med. 2003; 31(12): 678-686
5. Australian Red Cross Blood Service. Transfusion Medicine Manual – Potential Hazards of Transfusion [online]. 2003 [cited 22 January 2008]. Available from URL: http://www.transfusion.com.au/ ResourceLibrary/ TMM_ch16_Potential.asp
6. Australian Health Ministers’ Advisory Council (AHMAC) Blood and Blood Products Committee. Review of the Alternatives to Homologous Blood Donation. Canberra: 2000
7. Australasian Society of Blood Transfusion (ASBT). Guidelines for Autologous Blood Transfusion. Topics in Transfusion Medicine. 2002; 9(2): 1-53
8. Australasian Society of Blood Transfusion (ASBT). Topics in Transfusion Medicine. 2001; 8(2): 1-27
9. Skene, L. Law & Medical Practice: Rights, Duties, Claims and Defences, 2nd ed. Australia: LexisNexis Butterworths, 2004