Blood Transfusion

Introduction
A blood transfusion is the transfer of blood or blood products from one person (donor) into
another person's bloodstream (recipient). This is usually done as a life saving maneuver to
replace blood cells or blood products lost through severe bleeding, during surgery when blood
loss occurs or to increase the blood count in an anemic patient. The following material is
provided to all patients and/or their family members regarding blood transfusions and the use of
blood products. Although in most situations the likelihood of a blood transfusion associated with
surgery is uncommon, at times patients may require blood products. You are encouraged to
discuss your particular risk of transfusion with your doctor.
Your options may be limited by time and health factors, so it is important to begin carrying out
your decision as soon as possible. For example, if friends or family members are donating blood
for a patient (directed donors), their blood should be drawn at least two working days prior to the
anticipated need to allow adequate time for testing and labeling. You are also encouraged to
check with your insurance company for their reimbursement policy.
The safest blood product is your own, so if a transfusion is likely, this is your lowest risk choice.
Unfortunately this option is usually only practical when preparing for elective surgery. In most
other instances the patient can not donate their own blood due to the acute nature of the need for
blood. Although you have the right to refuse a blood transfusion, this decision may hold lifethreatening consequences. If you are a parent deciding for your child, you as the parent or
guardian must understand that in a life-threatening situation your doctors will act in your child's
best interest to insure your child's health and well being in accordance with standards of medical
care regardless of religious beliefs. Please carefully review this material and decide with your
doctor which option(s) you prefer.
To assure a safe transfusion make sure your healthcare provider who starts the transfusion
verifies your name and matches it to the blood that is going to be transfused.
If during the transfusion you have symptoms of shortness of breath, itching, fever or chills or just
not feeling well, alert the person transfusing the blood immediately.
Blood can be provided from two sources: autologous blood (using your own blood) or donor
blood (using someone else's blood
Autologous Blood (using your own blood)

Pre-operative donation - donating your own blood before surgery. The blood bank draws your
blood and stores it until you need it during or after surgery. This option is only for nonemergency (elective) surgery. It has the advantage of eliminating or minimizing the need for
someone else's blood during and after surgery. The disadvantage is that it requires advanced
planning which may delay surgery. Some medical conditions may prevent the pre-operative
donation of blood products.
Intra-operative autologous transfusion - recycling your blood during surgery. Blood lost
during surgery is filtered, and put back into your body during surgery. This can be done in
emergency and elective surgeries. It has the advantage of eliminating or minimizing the need for
someone else's blood during surgery. Large amounts of blood can be recycled. This process
cannot be used if cancer or infection is present.
Post-operative autologous transfusion - recycling your blood after surgery. Blood lost after
surgery is collected, filtered and returned to your body. This can be done in emergency and
elective surgeries. It has the advantage of eliminating or minimizing the need for someone else's
blood during surgery. This process can't be used in patients where cancer or infection is present.
Hemodilution - donating your own blood during surgery. Immediately before surgery, some of
your blood is taken and replaced with IV fluids. After surgery, your blood is filtered and returned
to you. This is done only for elective surgeries. This process dilutes your own blood so you lose
less concentrated blood during surgery. It has the advantage of eliminating or minimizing the
need for someone else's blood during surgery. The disadvantage of this process is that only a
limited amount of blood can be removed, and certain medical conditions may prevent
hemodilution.
Apheresis - donating you own platelets and plasma. Before surgery, your platelets and plasma,
which help stop bleeding, are withdrawn, filtered and returned to you when you need it later.
This can be done only for elective surgeries. This process may eliminate the need for donor
platelets and plasma, especially in high blood-loss procedures. The disadvantage of this process
is that some medical conditions may prevent apheresis, and in actual practice it has limited
applications.
Donor Blood (Using someone else's blood)
All donor blood is tested for safety making its risks very small, but no screening program is
perfect and risks, such as contraction of the hepatitis virus or other infectious disease still exist.
Volunteer blood - blood collected from the community blood supply (blood banks). This has the
advantage of being readily available, and can be life-saving when your own blood is not
available. The disadvantage is that there is a risk of disease transmission, such as hepatitis or
AIDS, and allergic reactions.

Designated donor blood - blood is collected from the donors you select. You can select people
with your own blood type who you feel are safe donors. Like volunteer blood, there is still a risk
of disease transmission, such as hepatitis and AIDS, and allergic reactions. This process usually
requires several days for advanced donation. It may not necessarily be safer than volunteer donor
blood.
What is it?
Blood transfusion is the process of transferring blood or a blood component from one person, the
donor, to another person, the recipient.
Who needs this procedure?
Blood transfusions are given to increase the blood's ability to carry oxygen, to restore the body's
blood volume when there has been a great blood loss, to improve the blood's clotting ability, and
to improve a recipient's immunity to infection. Depending upon the recipient's needs, a doctor
may order a whole blood transfusion, or a blood component. Blood components include red
blood cells, white blood cells, platelets, immunoglobulins, or fresh frozen plasma, which is the
liquid part of the blood. Whole blood is usually used with patients who have lost a lot of blood,
and to make sure the body's tissues are receiving enough oxygen. Red blood cells restore the
blood's ability to carry oxygen, such as in patients who are bleeding or have anemia. White blood
cells are given to patients with life-threatening infections that reduce the white blood cell count.
Platelets are often given to patients with blood clotting disorders, such as hemophilia or von
Willebrand's disease. Plasma also helps with blood clotting, and is often transfused in patients
with liver failure. Immunoglobulins are the disease fighting components of blood and are also
given to build up immunity, especially in patients who have been exposed to an infectious
disease or whose antibody levels are low, such as those with AIDS.
How do I prepare for this procedure?
If you know you will be undergoing surgery, you may want to donate your own blood a month
before your surgery. This is called an autologous transfusion, and the blood you donate is stored
at the hospital for your use only. If you need a transfusion during or after surgery, your own
blood will be used. Or, you could ask a friend or family member with the same blood type to
donate blood specifically for you. This is called a direct donation. Many people feel more
comfortable knowing the source of the blood for a transfusion. However, the medical community
has adopted stringent screening methods to ensure blood transfusions are extremely safe. Blood
donors must answer questions about their general health, lifestyle, and any medical conditions
that might disqualify them as donors. All donated blood is carefully checked for viral hepatitis,
AIDS, syphilis, and other viruses. No blood is used until all test results have shown that it is safe.
If you have had allergic reactions to previous transfusions, you should make sure your doctor is
aware of this. Treatments are available so transfusions can be given to people who have had
allergic reactions.

How is this procedure performed?

All donated blood is classified by type, either A, B, AB, or O, and as RH-positive or RHnegative. To protect the recipient, the blood is matched to his or her blood type. Before starting
the transfusion, the healthcare professional cross-matches the donor blood by mixing a drop of it
with the recipient's to make sure they are compatible. The healthcare professional will also
double-check that the blood is intended for the recipient. Then, the donor blood is given slowly,
through an intravenous (IV) line directly into the veins. Blood transfusions are given in units,
with one standard unit of blood equaling about one pint. During the transfusion, medical
personnel watch the patient closely for any adverse reactions. When the transfusion is complete,
a compress bandage is placed over the area where the needle had been inserted.
People with heart disease are given transfusions even more slowly to avoid overloading the body
with fluid. People with serious diseases that haven't responded to other treatments might benefit
from a transfusion method called hemapheresis. Hemapheresis is a process that purifies the blood
by removing blood from the patient, cleaning the harmful components from it, then returning the
purified blood to the patient. Cytapheresis is a type of hemapheresis that removes excess
amounts of certain blood cells. It might be used to treat conditions such as polycythemia,
leukemia, and thrombocytosis. Another type of hemapheresis called plasmapheresis removes
harmful substances from the plasma. This treatment might be used for patients with GuillainBarre syndrome and myasthenia gravis.
What can I expect after the procedure?
After a blood transfusion, you will be carefully monitored for any adverse reactions. An allergic
reaction is indicated by swelling, rash, itchiness, dizziness, fever, and headache. When blood is
mismatched, the recipient's blood reacts to the transfused red blood cells and destroys them. This
is called a homolytic reaction. Symptoms may include general anxiety or discomfort, then
breathing difficulty, flushing, a feeling of pressure in the chest, and severe back pain. It is rare for
these types of reactions to be life threatening.
Definition
A hemolytic transfusion reaction is a serious problem that occurs after a patient receives a
transfusion of blood. The red blood cells that were given to the patient are destroyed by the
patient's own immune system.

Alternative Names
Blood transfusion reaction

Causes, incidence, and risk factors

Blood is classified into different blood types called A, B, AB, and O.
The immune system normally can tell its own blood cells from blood cells from another person.
If other blood cells enter your body, your immune system may make antibodies again them.
These antibodies will work to destroy the blood cells that the body does not recognize. For
example, a person with type A blood makes antibodies against type B blood cells.
Another way blood cells may be classified is by Rh factors. People who have Rh factors in their
blood are called "Rh positive." People without these factors are called "Rh negative." Rh
negative people form antibodies against Rh factor if they receive Rh positive blood.
There are also other factors to identify blood cells, in addition to ABO and Rh.
Blood that you receive in a transfusion must be compatible. Being compatible means that your
body will not form antibodies against the blood you receive. Blood transfusion between
compatible groups (such as O+ to O+) usually causes no problem. Blood transfusion between
incompatible groups (such as A+ to O-) causes an immune response. This can lead to a very
serious transfusion reaction. The immune system attacks the donated blood cells, causing them to
burst.
Today, all blood is carefully screened. Modern lab methods and many checks have helped make
these transfusion reactions very rare.

Symptoms
Bloody urine
Chills
Fainting or dizziness
Fever
Flank pain or back pain
Rash
Symptoms of transfusion reaction usually appear during or right after the transfusion.
Sometimes, they may develop after several days (delayed reaction).

Medical history interview All blood donors are asked questions about their medical history
to help determine if they can safely donate blood without experiencing any negative health
effects [1]. During the donation, one unit of blood (approximately 500 mL or 17 fluid ounces) is
removed.

Heart and lung disease Potential donors are asked if they

have ever had heart, lung, or blood diseases. In general,
people with heart disease, heart valve conditions, irregular
heartbeat, disease of the blood vessels in the brain, heart
failure, and certain lung conditions are not allowed to
donate blood unless this has been cleared with their
healthcare provider.

Other medical conditions - Potential donors are asked if they feel healthy and well on the
day of donation.

Seizures People with a history of seizures can donate

blood, provided they have had no seizures within a certain
period of time (usually 1 to 6 months).

Recent surgery People who have undergone recent

surgery are permitted to donate blood when healing is
complete and they have resumed full activity. However, if a
transfusion was given at the time of surgery, donation is not
allowed for one year.

Pregnancy Women who are pregnant are not permitted

to donate blood during pregnancy and for six weeks after
the pregnancy ends.

Age requirement The minimum age for blood donation

is 16 or 17 years, depending upon the state. When allowed,
16 year olds must bring a signed permission form from a
parent. In most cases, there is no upper age limit for
donation, although approval from the donor's physician is
required in some cases.

Weight requirement Individuals weighing less than 50

kg (110 pounds) are usually not permitted to donate blood.
The less a donor weighs, the greater the likelihood of
having a reaction, such as dizziness and fainting following

donation. Although reactions to blood donation are rare,

individuals weighing between 50 and 54 kg (110 and 119
pounds) are most likely to experience reactions.
Medical evaluation In addition to a medical history, donors undergo a brief physical
examination before donation to check for any obvious signs of illness or conditions that would
disqualify them from blood donation.

Vital signs The pulse, blood pressure, and temperature

of a donor are checked before donation. Individuals with a
fever, high blood pressure, very high or very low heart rate
(with the exception of highly conditioned athletes and those
on beta blocker medication), or an irregular heart beat are
temporarily not permitted to donate blood.

Blood test A small blood sample is taken from a

fingerstick and tested to check for the number of red cells
or the amount of hemoglobin in the blood. This is done to
ensure that the donor is not anemic or likely to become
anemic or iron deficient after they donate. Individuals with
hemoglobin levels that are too low are temporarily not
permitted to donate blood. (See "Patient information: Iron
deficiency anemia".)

Time interval until next donation Donors are eligible to donate no sooner than 56 days after
their previous donation. However, this minimum interval can vary, depending upon how rapidly
the person's body is able to replenish their red blood cells. Some donors, especially women who
have heavy menstrual periods, will not be able to donate every 56 days because their iron stores
are not sufficient to replenish the lost red blood cells.
APHERESIS DONATION
A technology called apheresis has made it possible to collect specific components of blood
during the donation procedure. Apheresis is used to selectively collect red blood cells, platelets
(blood components that play an important role in clotting), plasma, and granulocytes (a type of
infection-fighting white blood cell).

Red blood cells Donors can give red blood cells by

apheresis once every 16 weeks. This is less frequently than
whole blood donation because a greater amount of red
blood cells are collected during the apheresis procedure.

Platelets Donors can give platelets up to 24 times per

year. About 1 percent of people have a mild reaction to one
of the substances (citrate) that is mixed with the blood
during platelet donation; the reaction can include feelings
of numbness and tingling, muscle cramping, and nausea.
The reaction can be treated or prevented by taking a
calcium supplement before or during the donation.

Granulocytes Donors of granulocytes may be given

granulocyte colony stimulating factor (G-CSF) and/or a
glucocorticoid medication called dexamethasone on the day
before donation to increase the number of granulocytes in
their blood. Glucocorticoids are usually not given to
individuals who have diabetes, gastrointestinal ulcers, or
glaucoma. The side effects of G-CSF and dexamethasone
may include headache, joint pain, fatigue, insomnia,
allergic reactions, and fever.

SCREENING MEASURES TO PROTECT THE RECIPIENT

Screening of blood donors helps to ensure that the donated blood is safe for transfusion into a
recipient. A variety of different measures are used for this screening.

Elimination of payment for donation Since the late

1970s, volunteer donors have been the source of all whole
blood and blood components in the United States. Donors
are sometimes paid for donating plasma that is used to
manufacture other blood products. However, to protect the
recipient, these products undergo additional purifying tests.

Screening for infections

Human immunodeficiency virus (HIV) The human immunodeficiency virus (HIV) is the
virus that causes AIDS. A variety of measures are used to screen donors for potential or actual
HIV infection, including questioning the donor about any signs or symptoms of HIV and
behaviors that increase the risk of HIV.
People who want to be tested for HIV or other sexually transmitted infections should NOT
donate blood for this purpose. Even though donated blood is tested for HIV, the tests are not
perfect; a person who might have been exposed to HIV could transmit the virus to a recipient if
they donate blood. Free and anonymous HIV testing is available elsewhere (see
www.hivtest.org).

Hepatitis Hepatitis is an infection that causes inflammation of the liver. Blood donors are
routinely screened to determine if they have or have been exposed to hepatitis.

People who have had viral hepatitis (A, B, or C) or

hepatitis of unknown origin after their 11th birthday are
permanently disqualified from donating blood.

People who have ever had a positive test for hepatitis B

surface antigen (a marker for hepatitis B) are permanently
disqualified from donating blood.

People who have had sexual contact or have lived in the

same dwelling (eg, house, dormitory) with someone who
has hepatitis (A, B, or C) are disqualified for 12 months
after their last exposure to that person, depending upon the
particulars of the exposure.

People who have received a blood transfusion are not

permitted to donate blood for 12 months after the date of
transfusion.

In many states, people who have received a tattoo or a body

piercing are not permitted to donate blood for 12 months.
In some states, where these industries are carefully
regulated by state law to ensure that the procedures are
sterile, earlier donation may be permitted without the need
for any waiting period.

Parasitic diseases Blood donors are routinely asked questions about possible exposure to
several parasitic diseases that can be transmitted by blood transfusion.

Malaria Transfusion transmitted malaria is common in

some parts of the world, but is extremely rare in the United
States. Donors who have had malaria are not permitted to
donate for three years after they become free of symptoms.
Travelers to regions where malaria occurs are not permitted
to donate blood for one year after they leave the area,
provided they have not had symptoms of malaria.
Immigrants from or residents of countries where malaria is
common are not permitted to donate for three years after

their departure from that country. (Residency is usually

defined as living in the country for at least five years.)

Chagas' disease and babesiosis Transmission of Chagas'

disease (American trypanosomiasis) by transfusion is rare
in the United States. Blood donors are asked if they have
ever had Chagas' disease and most donated blood is tested
for Chagas' disease.

Transmission of babesiosis (a malaria-like illness spread by ticks) by transfusion is uncommon.

Blood donors are asked if they have ever had this disease.

Creutzfeldt-Jakob disease (CJD) and variant CJD

Creutzfeldt-Jakob disease (CJD) is a rare but fatal
neurologic disease. Variant Creutzfeldt-Jakob disease
(vCJD) is a somewhat similar disease that first appeared in
the United Kingdom (UK) in 1996. Affected individuals
may have no symptoms of CJD or vCJD for many years.

To date, there have been no reported cases of transfusion-related transmission of CJD and only
four reports of probable transmission of vCJD in the UK. Despite this extremely small (vCJD)
risk, donors who meet one or more of the following criteria are not allowed to donate:

Have spent 3 cumulative months in the UK from 1980

to1996, or

Have spent 5 cumulative years in Europe from 1980 to

present, or

As current or former US military personnel, civilian

military employees and their dependents, have lived for 6
months at US military bases in Northern Europe from 1980
to 1990 or elsewhere in Europe from 1980 to 1996, or

Received a blood transfusion in the UK or France between

1980 to present, or

Injected bovine (from cows) insulin from the UK or other

countries with a history of mad cow disease (bovine
spongiform encephalopathy)

Bacterial infection Bacteria can get into donated blood if a donor has a bacterial infection, if
bacteria on the skin gets into the blood from the needle stick, or if there is a skin infection near
the location where the blood is drawn. To reduce the likelihood of bacterial contamination of
blood, the skin around the site is carefully examined and cleaned before the needle is inserted.
Donors who have a fever, who do not feel well, or who are taking oral antibiotics (except for
acne) are not permitted to donate blood. These restrictions also apply to individuals who are
banking blood for their own use (see 'Autologous blood donation' below).
Other medical conditions In order to protect the recipient against non-infectious
complications, the donor is evaluated for certain medical conditions before blood donation.

Cancer There have been no reported cases of the

transmission of cancer by blood transfusion. However,
because such transmission is theoretically possible, donors
are screened for a history of cancer.

Donors who have had cancer of a solid organ or tissue (such as the lung, liver, breast) are
permitted to donate if they have been symptom-free and cancer-free for a defined period of time,
usually two to five years.
Donors who have had blood cancers (such as leukemia or lymphoma) are permanently
disqualified from donating.
Donors who have had a superficial cancer that has been completely removed by surgery (such as
basal cell cancer of the skin or early cervical cancer) can donate blood without any waiting
period.

Hemochromatosis Individuals with hereditary

hemochromatosis (a condition in which frequent removal
of blood is the standard treatment) can donate their blood
for transfusion if they meet other criteria for being a donor
and if the blood bank has met certain regulations from the
Food and Drug Administration (FDA). There is no risk of
transmitting this condition to the recipient. (See "Patient
information: Hemochromatosis (hereditary iron
overload)".)

Medications Most medications taken by donors do not pose a risk to recipients. However,
five drugs are known to cause birth defects and are considered during donor screening:

Etretinate (Tegison), used for severe psoriasis

Acitretin (Soriatane), also used for severe psoriasis

Isotretinoin (Accutane), used for severe acne

Finasteride (Propecia, Proscar) used for benign

prostatic hypertrophy and hair loss.

Dutasteride (Avodart) usually given for prostatic

enlargement

Donors who have taken isotretinoin and finasteride are asked to wait one month after the last
dose before donating blood, donors who have taken dutasteride are asked to wait six months, and
donors who have taken acitretin are asked to wait three years. Individuals who have taken
etretinate are permanently disqualified from donating blood.
People who took aspirin or aspirin-containing medications within the previous 48 hours are
allowed to donate whole blood but are not allowed to donate platelets by apheresis. People who
took warfarin (Coumadin) are generally not allowed to donate blood for approximately 7 days
after the last dose. The reason for this is that this blood does not contain sufficient quantities of
clotting factor.
Laboratory testing of donated blood After a unit of blood has been donated, the blood is
tested in a laboratory for infectious diseases that can be transmitted by blood transfusion. These
include tests for HIV, hepatitis B, hepatitis C, human T-lymphotropic virus (HTLV), West Nile
virus, syphilis, and in most areas, Chagas' disease. (See "Patient information: West Nile virus
infection".)
Confidential unit exclusion (CUE) The confidential unit exclusion (CUE) process allows
someone who has donated blood to confidentially indicate that his or her blood should not be
given to others. This process protects individuals who feel pressured to donate at the workplace
or during community blood drives. Donors are asked to place a bar code sticker on their donation
form, indicating if their blood should be used. This is done after the interview, but before
donation. This procedure is used by some, but not all, US blood banks.
Registry of deferred donors A registry of deferred donors contains names of individuals
who have been disqualified from blood donation in the past. Some donors in the registry have
infectious diseases such as hepatitis B or HIV infection. Theoretically, it is possible that an
individual with one of these diseases could have a positive test result at one time but negative
test results at a later time.
Other donors in the registry have provided information in the past that disqualified them from
blood donation. A donor's name is usually checked against this registry before and after donation.
The reason for the deferral is not usually available to staff at the collection facility.

Telephone callbacks After donating blood, donors are given a phone number so that they can
call the donation center to report any factors that may affect the use of their blood or to report
symptoms of infections in the first days after donating (such as symptoms of upper respiratory
tract infection or gastrointestinal illness). Such reports will be evaluated and the unit of blood
may be destroyed.
RISK OF INFECTION FROM A TRANSFUSION
Safety measures, such as improved screening tests, have dramatically reduced the risk of
acquiring a viral infection from a blood transfusion. Recent estimates suggest the following risks
of developing certain infections after receiving a unit of blood:

One in 58,000 to 269,000 for hepatitis B

One in 2 million for hepatitis C

One in 2 million for human immunodeficiency virus (HIV)

One in 2 million for human T-cell lymphoma/leukemia

virus (HTLV)

AUTOLOGOUS BLOOD DONATION

Autologous blood donation is when a donor donates blood for themselves several days to six
weeks ahead of a scheduled surgery, when blood might be needed. Autologous blood donation
reduces the risk of most, but not all, infectious complications of blood transfusion.
POTENTIAL COMPLICATIONS OF BLOOD DONATION
Most people who donate blood do not have any complications that require medical care. The
most common complications include bruising or soreness at the needle site and fatigue.
A small percentage (2 to 5 percent) of people feel faint and/or pass out before, during, or after
donating blood. This is more common the first time a person donates and in people who are
younger. Drinking a 16 ounce (473 mL) bottle of water before donating may reduce this risk.
Preparation for Blood Transfusion
1.

Before a blood transfusion is performed, the doctor will order a blood specimen to
confirm the patient's blood type and compatibility with the blood being donated. This test is
done even when the patient is donating his own blood. This is done to ensure the patient's
safety and health.

Transfusion Procedure
2.

Before the transfusion begins, the patient must sign a consent form. The doctor will then
order the patient to take medications, such as antihistamines and acetaminophen, before the
transfusion. Before the transfusion begins, two nurses will check the patient's identity. The
nurse performing the transfusion will then insert an intravenous line into the patient's arm.
Nurse's Responsibility During Procedure

3.

The nurse handling the transfusion has a number of responsibilities to ensure that the
procedure is performed correctly and to ensure the patient's safety and health. Before, during
and after the transfusion, the nurse will check the patient's temperature, pulse and blood
pressure , and will check for any signs of adverse reactions to the transfusion. While
reactions are rare, they are monitored. Symptoms for adverse reactions include breathing
problems, chills, fever, itching/hives, rash, nausea, lower back pain, apprehensive feelings,
tingling or numbness, heat, pain, or swelling at the site where the IV is inserted. Patients are
urged to keep the nurse abreast of any symptoms they experience.
What Patient Can Expect During Transfusion

4.

Blood transfusions are relatively simple procedures that can up to 1-1/2 to two hours,
depending on the amount of units being transfused into the patient. Generally, most
transfusions require at least two to three units. The patient is allowed to eat and drink during
the procedure and is able to use the bathroom with assistance from the nurse.

What Are the Risks Associated with Blood Transfusions?

The Food and Drug Administration (FDA), The American Association of Blood Banks (AABB),
and The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) regulate the
process of obtaining, storing, preparing, and testing of blood. These organizations are responsible
for ensuring a safe blood supply.
Blood donors must go through an extensive screening process before they are able to donate
blood. After blood is drawn, it is tested for blood type, RH factor, as well as for antibodies.
Multiple individual screening tests are performed for evidence of infection and viruses. With this
extensive testing, the chance of receiving a unit of blood containing the Human
Immunodeficiency Virus (HIV) or hepatitis C virus is around 1 in 2 million, and less than 1 in
200,000 for hepatitis B.1
How Do I Prepare for a Blood Transfusion?

You can expect that your doctor will order a blood specimen to confirm your
blood type and to check compatibility with the donor unit. Compatibility testing
(also referred to as cross matching ) is done even if you have donated your own
(autologous) blood.

Check with your doctor about how much time to plan for your blood transfusion
procedure. Each unit of blood usually transfuses over 1 to 2 hours. Some
transfusions are for 2-3 units. You may be here for several hours depending on
what your doctor has ordered for you. Please arrange your transportation
accordingly.

Where Do I Go for my Blood Transfusion?

If You Are a Patient in the Hospital: Your nurse administers your blood
transfusion at your bedside and monitors you throughout the entire procedure.

If You Are a Patient Coming from Home to the Pacific Campus: Blood
transfusions are given in our Ambulatory Care Unit (ACU), 2351 Clay Street, on
the 6th floor. Register with the admitting staff in the Ambulatory Care Unit when
you arrive. Parking is available in the garage located at 2405 Clay Street (corner
of Clay and Webster Streets).

If You Are a Patient Coming from Home to the Davies Campus: The staff will
contact you the day before your blood transfusion procedure. Proceed to either:
1. North Tower - 4th floor, Ambulatory Care Unit (ACU), Nurses'
Station, or
2. South Tower - 1st floor, Outpatient Infusion Services (OIS), Room
151A
Parking is available in the garage located at Castro and Duboce Streets.

What Can I Expect During a Blood Transfusion?

The nurse will ask you to sign a consent form verifying that you understand and
agree to the procedure as explained by your doctor.

You will be positioned comfortably for this procedure. The nurse will insert an
intravenous line (IV) in your arm.

Your doctor may order medication for you to take prior to the transfusion. The
nurse will explain the reason and action of the medications.

For patient safety, 2 nurses will verify your identity by checking your I.D. band
with the unit of blood.

The nurse will start the transfusion and monitor your temperature, pulse, and
blood pressure before, during, and after the transfusion.

Also, the nurse will observe for signs of a reaction to the transfusion(s). Reactions
to blood transfusions are rare. Symptoms may include shortness of breath, chills
or fever (101F / 38.3C or above), itching/hives, rash, nausea, lower back pain,
feelings of apprehension, tingling or numbness; heat, pain, or swelling at IV site.
Please report these symptoms immediately to your nurse.

You may eat and drink during this procedure. With the assistance of a nurse, you
may get up and go to the bathroom.

What Should I Watch Out for After I Go Home?

You may resume your normal activities.

Continue your usual diet and medications.

Be alert for symptoms of a reaction after you go home. Call your doctor
immediately or go to the Emergency Room if you experience any of the
following symptoms:

Shortness of breath

Chills or fever (101F / 38.3C or above)

Itching/hives, rash

Nausea

Lower back pain

Feelings of apprehension

Tingling or numbness

Heat, pain, or swelling at IV site