Patient Education: Blood Transfusions
by Mackenzie Gignac
A red blood cell transfusion may be required for some patients who suffer from anaemia. Anaemia is when your body doesn’t have enough red blood cells or haemoglobin to function properly. Anaemia can leave you feeling fatigued or tired and can sometimes impact your brain or heart function so having the proper red blood cell count is critical.
Additionally, if one has a low platelet count they would potentially need a blood transfusion as well. A low platelet count can increase the chance of severe bleeding, especially internal bleeding.
Why are red blood cells important?
The blood in our system consists of three main types of blood cells - red cells, white cells and platelets. Each type of blood cells serve a different function for the body.
Red blood cells contain haemoglobin which help to carry oxygen around the body. White blood cells are immune cells that defend the body against infections as well as cancers. Platelets help the body coagulation whenever we injure ourselves by coming together to stop bleeding or bruising.
What types of blood transfusions are there?
There are two main types of blood transfusions:
- Red blood cell transfusion → for low haemoglobin
- Platelet transfusion → when there is a low platelet count
When would I need a blood transfusion?
St Vincent’s Hospital Clinical and Laboratory Haematologist Dr. Matthew Ku says that when haematologists are considering a blood transfusion for their patients, they look at the haemoglobin count to determine whether it’s necessary. If the blood count gets down below a certain level, it is deemed necessary to transfuse. However, doctors take into account many different factors before referring a patient to a blood transfusion. These factors include patient age, fitness level, morbidity, the underlying medical condition causing the anaemia and if the patient has any risk factors for transfusion.
What is the blood transfusion process like?
If your doctor has deemed a transfusion is necessary the patient must go through the pretransfusion testing process. This process ensures that the right blood group is given back to the patient. The patient’s blood is drawn and tested to see if there are any antibodies that give a particular bond and cell types. Also, the blood is cross-matched to ensure that the donor’s blood is compatible with the blood of the patient.
Where is the blood transfusion administered?
Once the blood transfusion has been successfully cross-matched, the blood transfusion process will move forward and be administered in a medical facility. The red blood cell transfusion takes about 2-3 hours. Platelet infusions come in smaller bags and can be given in an hour.
Throughout the transfusion, a medical team will be monitoring the patient’s temperature, blood pressure, oxygen and heart rate for any negative reaction to the transfusion.
Once the transfusion is finished the patient will be sent home and will schedule a follow-up to make sure that their blood levels have improved to an appropriate level. Overnight hospitalisation is not necessary unless the patient becomes unwell during the period of observation after the blood transfusion.
Will a patient have to fast for a blood transfusion?
No, fasting is not required for a red blood cell transfusion.
What are the benefits of having a blood transfusion?
If a patient has systematic anaemia, a blood transfusion could improve their wellbeing, energy level and organ, cardiac and vascular functions. For someone with low platelets, a blood transfusion can make sure that they have enough haemoglobin availability to stop bleeding if they injure themself.
For someone who is really sick, the transfusion can make them feel better quickly after it is administered. For people that require multiple long-term transfusions, such as those with Leukemia or bone marrow problems, the efficacy of the transfusions might wear off with the frequency in which the transfusions are administered.
Are there any risks with having a blood transfusion?
Dr. Ku listed a couple of potential risk factors that come with having a blood transfusion such as fluid/ iron overload, allergic reactions, bacteria/ virus infections or incompatible blood.
The Australian blood supply is considered to be very safe and some of the best in the world, so Dr. Ku mentions that side effects are not very common. However, one of the side effects can be a fluid or iron overload. This occurs when a patient get too much fluid or iron in their system because of multiple infusions. Dr. Ku says it is important to be monitored for fluid balance especially for those that have a history of cardiac issues, heart failure, bone marrow failure or kidney impairment.
Bacteria and virus infections are another rare side effect that come with having a blood transfusion. Bacteria infections are slightly more common with platelet infusions because they are kept at room temperature. There is also a slight chance a patient could have an allergic or anaphylactic reaction to some of the proteins from the transfusion.
Lastly, in rare cases, incompatible blood grouping can occur which can lead to a reaction from the patient. Dr. Ku says this is rare as the Australian hospitals do have multiple checks and balances in place to make sure incompatible blood is not given.
How often would anaemic patients require a blood transfusion?
The frequency in which anaemic patients would need a blood transfusion is dependent on the underlying medical condition that they are being treated for. People with bone marrow dysfunction, Leukemia or Myelodysplasia might require multiple long-term treatments. For someone that has a severe haemorrhage or trauma they might just require a top-up blood transfusion.
Are there any alternatives to a blood transfusion?
Yes, there are alternatives that can be given for patients that have low blood count due to a nutritional deficiency, Myelodysplasia or chronic kidney disease. For nutritional deficiencies such as iron or B12 deficiency, supplements can be given as an alternative. People who suffer from chronic kidney disease quite often lack endogenous erythropoietin in their blood, which can be corrected with a drug to help with blood production. It is similar with Myelodysplasia as medication can be given to improve their blood count.
Can the doctors at the Melbourne Blood Specialists help those seeking treatment for blood disorders?
Yes, when you are referred to MBS for a blood transfusion, our haematologists will do a comprehensive review. Our specialists will assess and manage the cause of your blood count deficiency. If a blood transfusion is needed, our specialists will refer you to the appropriate facility for your blood transfusion.